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SOAR’S GP SIGN-POSTING SERVICE 2013 TACKLING HEALTH INEQUALITIES IN NE SHEFFIELD Paul Nash, SOAR Health Trainer

NE SHEFFIELD The GP Sign-posting Service works across 3 Healthy Communities Programmes in NE Sheffield. Deprivation levels are generally higher than the Sheffield average, life expectancy is significantly worse than the Sheffield average and there is generally poorer educational attainment.

South West

North East

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Sheffield Health Profile 2011

HOW THE PROJECT WORKS Health Trainers and Advocacy workers spend time with those referred, to understand, build confidence, plan, support and/ or refer them on to additional support. Health Trainers were mostly based in GP Practices but working in other community bases was found to be more effective. The skills of these staff are key to the success of this work.

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There is poor health generally, including high prevalence of smoking, high obesity levels, low levels of physical activity, generally high levels of hospital admissions and a high prevalence of mental health disorders.

Julie Bramall, A dv oc a er ork W cy

THERE IS A DIFFERENCE IN WOMENS LIFE EXPECTANCY OF NEARLY 7 YEARS IN SHEFFIELD

BACKGROUND During 2011/12 North East Community Assembly (NECA) together with NHS Healthy Communities Programmes and evolving ideas from a local GP practice identified the need to improve links between local public health providers and GP’s. Funding was initially provided by NECA for a period of 1 year, SOAR has since gained additional funding through North Locality to the end of March 2014. In addition SOAR used resources from NHS Healthy Communities Programme funding, time from Advocacy Worker and Health Trainer Posts. A pilot project was begun with Shiregreen Medical Centre, but since then 9 more practices have joined the scheme. The project was designed with input from both local NHS and SOAR staff.

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OVERALL AIM The project aims to tackle inequalities in health, in line with the NHS Sheffield Clinical Commissioning Group, Health and Well-being (Partnership) Board and City Council Strategies for 2013/14 and also in line with UK Department of Health, Public Health Outcomes Framework 2012. Delivering health, social and lifestyle support is a key objective for SOAR, along with increasing access to economic opportunities and managing community assets. Specifically, this project has the following key objectives:

1.TO INCREASE GP AWARENESS OF PUBLIC HEALTH SERVICES IN NORTH SHEFFIELD 2.TO IMPROVE COMMUNICATION LINKS BETWEEN GP’S AND THE SUPPORT AVAILABLE 3.TO INCREASE GP REFERRALS INTO PUBLIC HEALTH SERVICES

Shiregreen Medical Centre (pilot practice) Referrals 2011/12

Referrals 2012/13

58

129

18

Health From GP’s ToTrainer

48

Health From GP’s ToTrainer

The GP Sign-posting Service has helped referrals to the Health Trainer

OVERALL REFERRALS

232

(Shiregreen MC and other participating practices, to end March 2013)

Referral Reason:

Referred To:

%

%

Healthy Lifestyle 20% Employment 20% Welfare 19% Self Management 24% Social Networks 11% Families 6%

Advocacy 30% Health Trainers 27% VCS 23% Employment 13% Not Engaged 7%

FEMALE 45%

MALE 55%

SOAR works with a range of partners, including Sheffield City Council, NHS Sheffield, Sheffield Wellbeing Consortium and Sheffield Health Trainers, and currently refers into a range of services provided both by SOAR and within other organisations.

GP Sign-posting Service

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One Person’s Journey Dereck is a 66 year old retired bus driver. He retired early due to poor health and then he became less mobile and his diet deteriorated. This resulted in him gaining weight. Dereck was visiting his GP regularly for medication for joint pain, heart fibrillation and high blood pressure but no one had offered him support to lose weight. He suffered an aneurism 2 years ago and was hospitalised for 2 weeks.

MEASURING IMPACT

SUPPORT

OUTCOME

In March 2012 Dr Starbuck from Shiregreen Medical Centre referred him to the SOAR Health Team, where Dereck worked with a Health Trainer.

Dereck continues to go to the GYM and hasn’t been back to the GP. Dereck is now volunteering as a Living Well Champion!

LOW COST

The DOH public health framework measures success against:

INCREASED HEALTHY LIFE EXPECTANCY AND REDUCED DIFFERENCE IN LIFE EXPECTANCY AND HEALTHY LIFE EXPECTANCY BETWEEN COMMUNITIES BY IMPROVING THE WIDER DETERMINANTS OF ILL HEALTH SUCH AS INCOME AND HOUSING AND

The GP Sign-posting Service is a low cost and flexible way of providing support in local communities. There is a small amount of management and administrative support needed but mostly the cost is for the support given by workers. Local and national evaluations show that it is this aspect of personal support that is key to the success of these programmes, helping to improve confidence and empower people to make lifestyle changes. SOAR QUALITY STANDARDS SOAR has recently been awarded quality standards from Customer First, Investor in People & Matrix.

HEALTH IMPROVEMENT Extracts from SOAR’s outputs (Southey Healthy Communities Programme) 2011/12

£51,507

DEBT WRITTEN OFF GP Sign-posting Service

6

EVICTIONS PREVENTED

£30,898

BENEFITS GENERATED P3


THE SOAR MODEL CLIENT

FAMILY

SERVICES

OUTCOMES

ONE STOP SHOP Employment & Training Health & Wellbeing Volunteering

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Im Increased awa prov e ren es Improved s fina n

SUCCESSFUL ‘CASE MANAGEMENT’

CLIENT QUOTES

Social prescribing/sign-posting is still a relatively new area of work with various models beginning to emerge but the King’s Fund 2011 has identified the following areas for successful ‘case management’ projects against which we aim to model our work:

“Having had this support from Danny was invaluable, I’m now ready to move forward and train to do the job I always wanted to, because if we don’t move forward how can we look back to see how bad it was. Thank you”

* Part of a community wide programme of care * Joined up health and social care * Good communication at all stages * A single point of access * Continuity of support & empowering approach * Clear accountability and roles at all levels * Training for staff and appropriate case loads Access the full report at www.kingsfund.org.uk

“I can not express the relief I feel now the ordeal is over, the positive outcome would not have happened without your help.” Advocacy Clients

SUMMARY GP’s are in contact daily with the most vulnerable people within our local communities but may not have the time or knowledge in order to provide community-based non- medical support to improve the physical and mental health of the local community. Public Health services in the local community often struggle to reach the most excluded people in their communities and so ‘sign-posting’ and social prescribing projects benefit in return from this close relationship. The key to success has been shown to be the focussed level of support given to individuals and families that builds confidence and empowers people to take charge of their own lives. In addition a wide range of services and activities within the local area is essential to a provide choice of support for individuals. GP Sign-posting Service

For further information contact Guy Weston, Health Services Manager E: Guy.weston@ soarcommunity.org.uk T: 0114 213 4065

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SOAR GP Signposting Service 2013