National Context To create an enabling society that maximises - - PowerPoint PPT Presentation
The Role and Value of Local Area Coordination in reducing Health Inequalities on the Isle of Wight Anita Cameron-Smith, Deputy Director of Public Health Heather Rowell, Local Area Coordination Programme Manager Chad Oatley, Public Health
Anita Cameron-Smith, Deputy Director of Public Health Heather Rowell, Local Area Coordination Programme Manager Chad Oatley, Public Health Practitioner
“There is extensive evidence that connected and empowered communities are healthy communities.” “To create an enabling society that maximises individual and community potential” “ our health services need to change and argues for a new relationship with patients and communities” local authorities to ‘consider the person’s own strengths and from their wider support network
in considering ‘what else other
care and support might assist the person in meeting the
Lower numbers in the 0 to 14 age group (14.9%) than elsewhere in England (17.8%) and these are set to decline further; An economy based around a few industry sectors, a high reliance upon seasonal work, low productivity, low wages and low skills levels 74,997 people living with one or more long term condition with a projected increase in the future causing increased pressures on the health and social care system a rising population with growing numbers of
mid-2013 population estimates) is 138,393 and 25.5% are aged 65 years and over. This is forecast to rise to around 30.2% by 2025 Around 1 in 6 households on the Isle of Wight are occupied by a single person over 65
Outcome 1: Increased healthy life expectancy Taking account of the health quality as well as the length of life Outcome 2: Reduced differences in life expectancy and healthy life expectancy between communities Through greater improvements in more disadvantaged communities
Vision: To improve and protect the nation’s health and wellbeing, and improve the health of the poorest fastest
DOMAIN 1 DOMAIN 2 DOMAIN 3 DOMAIN 4 IMPROVING THE WIDER DETERMINANTS OF HEALTH HEALTH IMPROVEMENT HEALTH PROTECTION HEALTHCARE PUBLIC HEALTH AND PREVENTING PREMATURE MORTALITY Objective: improvements against wider factors that affect health and wellbeing, and health inequalities Objective: People are helped to live healthy lifestyles, make health choices and reduce health inequalities Objective: The population’s health is protected from major incidents and other threats, while reducing health inequalities Objective: Reduced numbers of people living with preventable ill health and people dying prematurely, while reducing the gap between communities LAC Contribution to PHOF: 1.01 Children in low income families 1.02 School readiness 1.03 Pupil absence 1.04 First time entrants to the youth justice system 1.05: 16-18 year-olds not in education, employment or training 1.06: Adults with a learning disability/ in contact with secondary mental health services who leave in stable and appropriate accommodation 1.07 Proportion of people in prison aged 18 or over who have a mental illness 1.08 Employment for those with long-term health conditions including adults with a learning disability or who are in contact with secondary mental health services 1.11 Domestic Abuse 1.12 Violent Crime 1.13 Levels of offending and re-offending 1.15 Statutory homelessness 1.17 Fuel poverty 1.18 Social isolation LAC Contribution to PHOF: 2.02 Breast feeding 2.05 Child development at 2-21/2 years 2.06 Child excess weight in 4-55 and 10-11 years olds 2.07 Hospital admissions caused by unintentional and deliberate injuries for children and young people under 25 2.08 Emotional wellbeing of looked after children 2.09 Smoking prevalence – 15 year olds 2.10 Self-harm 2.11 Diet 2.12 Excess weight in adults 2.13 Proportional of physical activity and inactive adults 2.14 Smoking prevalence – adults 2.15 Drug and alcohol treatment completion and drug misuse deaths 2.16 Adults with substance misuse treatment need who successfully 2.18 Alcohol-related admissions to hospital 2.22 Take up of the NHS Health Check programme 2.23 Self-reported well-being 2.24 Injuries due to falls in people aged 65 and over LAC Contribution to PHOF: 3.03 Population vaccination coverage LAC Contribution to PHOF: 4.03 Mortality rate from causes considered preventable 4.10 Suicide rate 4.11 Emergency readmissions within 30 days of discharge from hospital 4.13 Health-related quality of life for older people 4.14 Hip fractures in people aged 65 or over 4.15 Excess winter deaths
Local Area Coordination (Isle of Wight) - Logic Model – A theory of action
INPUTS IT/Technology: phones, laptop/Ipad per Local Area Coordinator Leadership: LAC accountable to the Leadership Group who are accountable to the BCF and ultimately report to the JACB which feeds into the H&WB Communities: Freshwater, Shanklin and Ryde Staff: Local Area Coordinators Resource: grant money, consultancy/national support Eligibility: older people, people with disabilities, mental health needs Introductions: from the community, health and social care, housing, local people, police, fire etc Review of existing literature and evaluations of LAC Engagement and involvement: with key stakeholders locally and within other LAC sites Learning and Development: continuous improvement of Local Area Coordinators Evaluation: Framework and tools co-produced
KEY ACTIVITIES
Tier one support: Information and advice Training and capacity building to create resilient and inclusive communities Tier two support: Advocacy, information, advice,
ensure that plans and goals are achieved LACs work underpinned by citizen vision principles: Purpose, Freedom, Money, Help, Home, Life and Love Supporting processes: LACs accountable to community Implementation of Evaluation Framework LACs reach within individual/family and community to influence reform of the system LAC induction and peer-support network Induction and peer-support from regional partners
OUTPUTS
Between 50-65 individuals/families per Local Area Coordinator One Local Area Coordinator per community (10-11 thousand population) Employment, training, education and volunteering Genuine citizen contribution People actively participate in discussions and supported to pursue their vision of how they would like life to be Established trust and respect between LAC, individuals/families and communities LAC build partnerships with and between people/families, communities and services Evaluation carried out
OUTCOMES (un)Intended
Increased individual social networks increase in individual sharing of gifts and ideas, and involvement and engagement within their community Increased individual (self) advocacy, control and choice Individuals supported to find non- statuary and no-cost solutions More personalised budgets Families/Carers able to continue to care Increased capacity, inclusivity and activity within communities Increased use of non-statutory and no-cost solutions Increased partnerships between LAC and other sectors and services Reduced attendances at A&E, non- elective admissions, bed days and delayed transfers of care for selected population groups Empowered, Inclusive and better resourced communities Increased Social Capital Increased awareness, understanding and commitment to systems change to support LAC Reduction in demand, dependence and cost for services Increased number of carers needs assessments Increase in joint and co-funded services, and services adopting LAC principles. Closing the gap between citizens and decision makers Services becoming a back-up to local solutions Reduction in preventable illness
Practice – Evidence – Working Knowledge - Informed practice
LAC Principles: Citizenship, Relationships, Information, Gifts, Expertise, Leadership and Services
Our approach to capturing and modelling the impact of Local Area Coordination on the Isle of Wight follows realist evaluation and simulation, supported by Southampton Solent University. We want to understand ‘how and why (or not), Local Area Coordination works, for whom, in what set of circumstances’. This micro impact can then be costed and incorporated into a model to simulate the macro impact of Local Area Coordination across the island on the wider health and care system, contribution to social capital, reducing inequalities and improvement in individual health and wellbeing.