Alyson mcgregor slides

Collaborative Practice : An approach to connect people, health and communities Health Equity & Transformation Conference Toronto June 14th 2018

Plenary: Healthier Together: Social Prescribing in Action in the UK Alyson McGregor - National Director Altogether Better C & Glossop Integrated Care

Š Altogether Better 2017

What is Collaborative Practice?

Its an evidenced based approach which enables leaders in primary care organisations to find fresh new ways of working with local people, to improve health services, improve health outcomes andIntegrated makeCare everyones lives NHS Foundation Trust better side & Glossop Integrated Care NHS Foundation Trust Tameside & Glossop Integrated Care NHS Foundation Trust

Š Altogether Better 2017

Evidence Evaluation from 30 GP practices including over 500 Champions, and 125 practice staff demonstrated:

1. Patient care improves – peoples needs are met 2. Lives of staff improve - Patients begin to use services differently

3. Sustainability & profitability are improved- a new business model for general practice emerges and a new model of carereduces pressure

“We have increased our patient list by 4500 people but seen no increase in demand for either primary or secondary care consultations because we do things differently” Mev Forbes , Managing Partner Robin Lane Medical Centre, Leeds © Altogether Better 2017

What GPs (physicians) told us • 10-15% minor ailments – pill, sore throat, headache

pharmacist , a wise granny • 10-15% depressed, anxious, stressed, fatigued. Need a job, some friends, a loving partner, not antidepressants or counselling • 10% obesity & lifestyle related – type 2 diabetes, hypertension, heart disease

• 5% lonely and we are the only social contact

“I estimate that 40-

55% of patients I see every week could be better supported by someone else – they don’t need to see someone with 5 degrees” Dr Niall Macleod

GP, Exeter

• 5-10% just getting old! Lots of problems, no cure © Altogether Better 2017

Designed a system intervention •

We invite local people to gift their time to work alongside the practice team on the things that matter most

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A new collaborative relationship develops

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We work together in an extended practice family/team on what matters – “couturier”

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The way the practice works changes

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Needs are met differently

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It makes life better for everyone © Altogether Better 2017

Improving services…216 types of of new offers/activities • Reception welcomers • Flu clinic • Improving the quality of the consultation • Signposting • Changing the appointment system • Helping people access records • Increasing screening uptake • Diabetes group • Changing the environment © Altogether Better 2017

Research : Loneliness and isolation are harmful to health – (Marmot 2010 and Holt- Lunstad 2015)

“Will you help us feed the birds?”

• • • • • • • • • • • • •

Conversation club Quilt making & cross stitch Singing for the brain Carers support Gardening/allotments Local history walks Coffee mornings Ukulele group Poetry & a pint Glass painting Dancing…belly, ballroom, circle!

Film matinees Painting

• Christmas lunch!! © Altogether Better 2017

What REALLY happens?

We see change from the inside out •

Changing members of the family changes its identity

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Changing identity of who is in the team/family changes the culture

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Changes who we are and what we do

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Changes how we see the world

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Changes what counts and what we pay attention to

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Changes relationships © Altogether Better 2017

Changing the identity of the family leads to culture change

Š Altogether Better 2017

Everyones lives are better “

Š Altogether Better 2017

This work is NOT… • A paid ‘link worker’ model of social prescribing - though it does deliver the 3 key elements of social prescribing: • helping people to get to the right support • local support offers - groups etc • opportunities to volunteer • A time limited ‘project’, ‘scheme’ or ‘programme’ • A traditional volunteering programme: • There is no job description or defined role • No hierarchy • Not based on a medical/formal model © Altogether Better 2017

But it IS… • Gentle and subversive organisational development which allows general practice to evolve

• A way of working which changes the ‘practice team /family’, becoming simply ‘how we do things around here’ • Sustainable ….happens without continual funding

© Altogether Better 2017

It works because • We change the conversation by changing who is in it • We work on the things that matter to people and follow the energy • We work with people- we don’t do things for or to people • We believe that everyone matters and brings unique offers and insights ( We don’t walk in other people’s shoes - we invite them to join us) • We pay attention to the relationships • We work on things that have meaning and are fun!

© Altogether Better 2017

Your thoughts?

Chat to us at altogether.better@swyt.nhs.uk