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1 Newsletter Our Health Sat Nav mobile app uses GPS (Global Positioning System) to signpost people to nearby services including GP surgeries, pharmacies and walk-in centres, as well as informing them where they can have the flu jab. It also describes which conditions need to be seen by which services to help people make better decisions about where to go for appropriate treatment. The app was downloaded nearly 700 times in December. Issue: 7 Winter 2014 Social media drive sends winter video viral! There has also been an extremely positive reaction to our animation video, Dee s A&E Fail Tale, which has had nearly 40,000 views to date after being shared widely on social media. In this issue Homeless Discharge Projects Winter Campaign Update Community Projects Funding 1

2 Winter campaign update Our Feel Well, Choose Well campaign, which is a partnership-wide project that spans health and social care providers in Coventry and Warwickshire, is well underway. Over the last couple of months we have been encouraging members of the public to prepare for cold weather and choose health services wisely. Winter is typically an extremely busy time for health services, particularly in A&E departments. Certain long-term conditions can be exacerbated by cold weather and with flu circulating in the community and more time spent indoors in close proximity to others; a breeding ground for viruses is created. Therefore, it is important to remind people of the range of health services available which provide appropriate advice and 2 treatment and keep A&E free for people who need emergency care. Another key element of the campaign has been the many engagement events that have been taking place at schools, shopping centres, gyms and job centres across the area. At the events people have been having their photo taken with characters from the video and sharing the pictures using their own social media accounts helping to spread our messages far and wide. The campaign will continue throughout January and February with additional events including some interactive artwork sessions focussing on hand hygiene.

3 Discharge programme success in local care homes A pilot programme that aims to improve the experience of older patients being discharged from hospital is operating successfully in two local care homes. The Discharge to Assess (D2A) programme is a fantastic example of how the local health and social care economy is working together to improve outcomes for patients who are unable to return home unsupported and who may otherwise stay in hospital longer than they need to. NHS South Warwickshire CCG, NHS South Warwickshire Foundation Trust, local GPs, and Warwickshire County Council Social Care are working as a team to ensure this programme is a success. Chief Officer, Gillian Entwistle and Director of Strategy and Engagement, Anna Burns, recently visited Avon Court Care Centre in Stratford-upon-Avon and Kenilworth Grange in Kenilworth to see the results. Gillian said: D2A patients are moved out of hospital and into care homes so that we can assess their needs in an appropriate environment. It means that patients whose treatment is complete do not remain in hospital whilst their long term care needs are reviewed. These visits have been really interesting and it s been good to meet some of the staff and residents involved. We have also been able to pick up on any areas that aren t yet running as smoothly as they could be and we will ensure that those issues are addressed. Avon Court Nursing Care Home is currently looking after a number of D2A residents, who stay for up to six weeks whilst their future health and social care needs are assessed. Laura Taylor, Manager at Avon Court, has seen the benefits to both residents and staff. Laura said: We ve found the D2A process extremely successful. During their stay here, residents undergo detailed assessments from a multidisciplinary team of health and social care professionals, which allows for smoother, more joined up working and improved outcomes. This approach means all professionals involved in a person s care have the same knowledge and understanding of each case and regular team meetings ensure we re all working to the same goals and are keeping on track. D2A has been operating in pilot form since the summer. Kenilworth Grange also has D2A beds and a third care home is being identified in the Warwick/Leamington area to create additional beds for D2A patients. Gillian Entwistle (back left) and Anna Burns (back right) from NHS South Warwickshire CCG meet Ivy Bakewell (front left) and Joan Davies (front right, residents at Avon Court Care Centre in Stratford-upon-Avon one of the care homes taking part in the D2A pilot. 3

4 Increased medical support in care homes A relatively high proportion of south Warwickshire s population is elderly and as a result, nursing homes in our area are looking after an increasing number of people with complex needs. Ensuring high standards of medical care in all nursing homes is part of our strategy and we are pleased to announce that a new GP support programme has gone live. The introduction of a single, named GP to provide care for all the residents within one home aims to improve continuity of care, patient and staff confidence and reduce the number of unplanned attendances at A&E. GP practices within south Warwickshire bid for the new contracts during November and successful practices were awarded contracts in December and January. GPs providing cover to nursing homes under the new contracts will have the following responsibilities: Visit the care home on a weekly basis to do a ward round. This will include seeing residents with appointments, residents that care home staff have concerns about and undertaking reviews of new residents to make sure care plans are in place; Participate in regular multidisciplinary team meetings involving care homes and community staff; Undertake a thorough medical review for each resident once every six months; Carry out medication reviews; Advise care home staff on managing medical issues; Review the reasons for admissions to hospital from the care home; Ian Allwood Include relatives and carers in discussions about the on-going needs of the resident; Ensure other specialists are brought in as and when needed; Document a medical plan for each resident which includes key issues, anticipated outcomes, patients preferred place of care, concerns and wishes, resuscitation status and escalation decisions; Identify patients at risk of deteriorating and dying within 12 months and ensure that they are on the supportive and palliative care register at the GP practice; Ensure an Advance Care Plan is developed in collaboration with the patient, their family and care home staff; Participate in regular training with care home staff. Dr Ian Allwood, a GP in Stratford and clinical lead on this project, said: As a CCG, we have been investing in nursing homes by increasing the medical support that is provided to them. These dedicated GPs will have more time to build good working relationships with the staff, residents and their relatives and improve continuity of care. The interest from GPs has been really encouraging. They are engaged in the project and can see the benefits to patients, care homes and medical professionals. 4

5 Community Projects Together with Public Health Warwickshire, Warwick District Council and Stratford District Council, we have funded a number of community projects across south Warwickshire. Here is a little about each of them. Garden Organic (Orbit Heart of England, Stratford and Warwick District food banks, Trussell Trust) Families that rely on local food banks will be given the opportunity to learn from a master gardener how to grow and cook healthy food. ILEAP 4 Health and Wellbeing People with mild and moderate learning disabilities are being offered the chance to take part in community based leisure activities, which will help to increase their confidence and teach them about living a healthy lifestyle. Let s Get Healthy Skills Workshops (Entrust Partnership) Seven Let s Get Healthy skills workshops for disabled young people aim to teach them about healthy living and encourage them to access mainstream leisure and activity facilities. Growing Families (Nuneaton and Bedworth Healthy Living Network) Growing Families, an outreach project in Warwick that will support families with young children to change their eating habits, attitude to, and knowledge about food so to help improve nutrition, health and wellbeing and prevent disease and obesity. Warwickshire Association of Youth Clubs Obese and inactive residents in south Leamington will take part in regular sports sessions over five eightweek programmes to encourage uptake of regular exercise and improve physical fitness levels. The New Man Project (Warwickshire Community and Voluntary Action) Men with physical or learning disabilities, mental health problems and those experiencing social isolation will be offered self-esteem building workshops that focus on a number of important areas including diet, exercise, the role of men in families and communities, alcohol consumption and personal hygiene. Pledge, Share, Do, Inspire Director of Strategy and Engagement, Anna Burns, has been sharing the CCG s engagement work to date with colleagues throughout the NHS and voluntary sector at a national NHS Change Day event in London called Pledge, Share, Do, Inspire. Anna presented the results of our Change Day engagement work which saw CCG representatives hitting the streets of south Warwickshire in a bid to get the views of local people and sign them up as Health Champions. Health Champions is a scheme where public, patients and carers can register to give their views on healthcare services in south Warwickshire on a regular basis. We are currently planning a re-vamp of our Health Champions scheme to ensure our members get as much out of their membership as possible and we put their invaluable views and feedback to the best use. The Pledge, Share, Do, Inspire event was attended by a wide variety of organisations from across the health, social care and voluntary sectors and was widely discussed on social media. Last year a single tweet sparked a staff-inspired social movement that saw people take collective action. 189,000 pledges were made nationally. Look for Change Day 2014 on the 3rd March. This year, the goal is for 500,000 pledges. People are making pledges to make small changes to make a big difference to the NHS. Visit changeday.nhs.uk for more information and to make your pledge. 5

6 Homeless Discharge Project In a national Improving Hospital Admission and Discharge Report published in May 2012, it was highlighted that 70% of homeless people are discharged back onto the streets after a hospital visit. Dr David Spraggett, Chair, said: A new project to improve local outcomes for Warwickshire s homeless population has introduced navigators in hospitals to identify homeless patients. The navigators are co-ordinating routes to accommodation, care, support and prevention services and brokering packages of interventions within the voluntary sector. Identification of homelessness will be improved through training, direct contact and the establishment of a formal protocol, including reporting. The aims of the project are to enable effective discharge from hospital and prevent unplanned admissions. Its target is to work with and support 80 homeless patients over a six month period. A core project team are closely monitoring the impact and working with Coventry University to capture the benefits for both patients and commissioners. Partnership working highly commended for Quality and Productivity in national healthcare awards We were pleased to be part of South Warwickshire NHS Foundation Trust s (SWFT) highly commended Quality and Productivity award for their work on cutting the human and financial cost of frailty, which was recognised at the prestigious 2013 HSJ (Health Service Journal) Awards. The Trust received the highly commended status for their work with partners like us to deliver the right care, at the right time, in the right place, every time across Warwickshire. To achieve this, the Trust has worked alongside patients, clinicians and partners to transform the way care is delivered to older people. 6

7 GPs in south Warwickshire rank amongst best in the country Congratulations to our member GP practices who have ranked 9th out of 211 CCGs in the country, according to the latest Quality and Outcome Framework (QOF) scores. QOF is a scheme for GP practices in the UK which scores practices according to their level of achievement in four areas. The areas are Clinical (the quality of medical care), (how well the practice is managed), Additional Services (additional services on offer such as cervical screening) and Patient Experience (how satisfied patients are with services). Not only did south Warwickshire GPs combined average score put them in 9th place overall, the CCG ranked 4th out of 211 CCGs in the Clinical domain. The CCG scored 100% against the Patient Experience criteria. Dr David Spraggett said: We are delighted with the excellent QOF results that our practices have achieved. Our GPs are central to the work of the CCG and their positive QOF results should be really encouraging to us and to our patients. I was particularly pleased to see that we d done so well in the Clinical category, which highlights the work being done to support patients with long-term conditions such as asthma and diabetes. This is an area we are focusing on as a priority so it is good to see that positive steps are already being taken. GPs in South Warwickshire achieved excellent QOF scores Keep in touch To find out more about NHS South Warwickshire CCG, visit southwarwickshireccg@nhs.uk or call: Follow us on 7

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