Self-care Building Health Partnerships

1. Self-careBuilding Health Partnerships @IVAR_UK @SocialEnt_UK #BHPselfcare

2. WelcomeJulia Clarke – BNSSG STP Executive Board and Sponsor of the STP Integrated Primary and Community Care workstream Chief Executive - Bristol Community Health

3. National programme aims ‘…build trust and mutual understanding around work with Health, Social care and Voluntary sector partners in 8 areas of the country.’ ‘Support senior, cross-sector staff and local Carers to develop and exercise shared local leadership to wellbeing and self-care.’ @SocialEnt_UK @IVAR_UK #BHPselfcare

4. Julia Clarke BNSSG STP Executive Board and Sponsor of the STP Integrated and Primary Care workstream (CEO Bristol Community Healthcare) Mark Pietroni BNSSG STP Executive Board & Provider Sponsor of the STP Prevention, Early Intervention and Self Care workstream (Director of Public Health South Glos) Vicki Morris STP Integrated Primary and Community Care Design & Strategy Group & West of England Civil Society Partnership (CEO of The Care Forum) Dr Ann Sephton Urgent Care & Frailty Lead and Commissioner Sponsor of the STP Integrated Primary and Community Care Workstream (South Glos CCG) Justine Rawlings STP Integrated Primary & Community Design and Strategy group (Delivery Director – OneCare) Core group members @SocialEnt_UK @IVAR_UK #BHPselfcare

5. Look at how this programme can support your area • Define what we mean by • self-care? Prevention? • Find out more about what’s happening across BNSSG • Build consensus around the things to focus on and where we want to get to • Explore how we will communicate/share, what we have to support us Why we're here today… @SocialEnt_UK @IVAR_UK #BHPselfcare

6. ????? @SocialEnt_UK @IVAR_UK #BHPselfcare

7. What does self-care mean here in BNSSG? ? @SocialEnt_UK @IVAR_UK #BHPselfcare

8. Some of what we’ve heard so far… • A need to look at ways to improve the profile of the VCSE in the STP overall • A focus on people and place – new approaches to engagement • Identify a specific area to test out a new approach – a health condition pathway • Social prescribing approaches @SocialEnt_UK @IVAR_UK #BHPselfcare #BHPselfcare

9. Social isolation (an underpinning theme?) • Mental health – Tier 1 support (building resilience in the system) • Comprehensive Geriatric Assessments (frailty) – how can the VCSE be better linked-in? • Condition specific pathways – take one and use as an exemplar (e.g. stroke)   Some of what we’ve heard so far… @SocialEnt_UK @IVAR_UK #BHPselfcare #BHPselfcare

10. Engaging citizens What’s most important about planning health and social care? @SocialEnt_UK @IVAR_UK #BHPselfcare

11. Dr Ann SephtonClinical Lead for Urgent & Emergency Care, South Gloucestershire CCG

12. Services for people living with frailty;The development of South Gloucestershire practice based multidisciplinary teams

13. An example of a VCSE, health and social care working together to support self care

14. A personalised integrated care service

16. A new pathway for stroke in Bristol North Somerset and South Gloucestershire

17. Voluntary, social and health sectors working together to develop a stoke pathway from prevention to rehabilitation and living with stroke. Integrated co-design

18. Dr Marion SteinerGP Lead for Self-Care, Bristol CCG

19. Primary Care GPs, Practice Nurses , HVs, DNs etc. supported by Community Resource Leads Bristol SP Approach 2017 Healthy Living Pharmacies Social Prescribing Co-ordinators at locality based centres Volunteers /buddies e.g. Health Champions RSVP Locality based low level mental health support e.g. support groups IAPT Advice networks and employment advice Wellbeing Programmes e.g. Kitchen on prescription Exercise on referral Art on referral Dose of nature Shared reading Community activities and volunteering

20. Vicki Morris – West of England Civil Society PartnershipChief Executive of the Care Forum

21. BNSSG has a vibrant & diverse VCSE sectorGeneric & health focusedContribute to improved health and wellbeing

22. VCSE is close to/ led by local residentsCan represent opinionsCan engage people in consultationCan envisage local solutionsCan innovate and test

23. Self care is part of what VCSE has always encouragedSocial vs medical modelEncouraging people to be involved and empoweredSelf actualization

24. How can VCSE get involved?Compact vs social value policies?How can STP engage with large, medium & micro organisations?What do you need to bring you into the partnership?

25. What does good look like and how do we get there?  @SocialEnt_UK @IVAR_UK #BHPselfcare

26. 1. Explore the options put forward, • any to add? • 2. Discuss and critique • Does it make sense? • Is it worth pursuing? • 3. What do you think? And want to take forward and why? • 4. Take options/ideas on template think about • What GOOD looks like • What will it take to get there • What might get in the way? • How will we know if its working? What can we do together in BNSSG? @SocialEnt_UK @IVAR_UK #BHPselfcare

27. Tasks to take away • What do I bring/what we can collectively do? twitter.com/SocialEnt_UK @SocialEnt_UK @IVAR_UK #BHPselfcare

28. How will you cascade the messages from today? Immediate next steps Sharing the messages from today @SocialEnt_UK @IVAR_UK #BHPselfcare

29. What worries people about self-care locally? • Whether people are willing/able to take responsibility for their care. People may lack the confidence to engage with self-care and the terminology itself could be a barrier. • Self-care places responsibility of care on the individual when issues are actually systemic. • STPs present a massive change which is not resourced. The NHS is in crisis and people tend to make bad decisions when they are in crisis. • Patients are not properly involved so there isn’t enough ‘lived experience’ in the STP. There is also a perception that there is no community representation in the Partnership. • There is a history of clinicians telling people what to do and perception that the ‘medical model’ dominates. Self-care requires a social approach. • There is a gulf between professional’s conversations and conversations about health in the community. • Hospitals get paid to provide care and the STPs are run by clinicians. The more they do, the more money they get. • The STP/BHP programme is not linking up with other local initiatives e.g. Bristol Health Care Change Makers. • Decent housing is a barrier. @SocialEnt_UK @IVAR_UK #BHPselfcare

30. Shared understanding of local priorities • Place resources in communities, create more equitable relationships between health services and communities – draw from and build on good examples where this is already happening. • Ensure VCSE understand commissioning of self-care (and commissioning intentions). • Investigate what’s needed to create a visible (integral partner) offer to the self-care/prevention priorities, including delivery and impact measures: “we are working in a system that is constantly changing and dominated by the medical model. Loads of self-care happens in the community. Community organisations need to come together to make an offer to BNSSG STP in terms of facilitating access to services and be confident about that offer.” • Find ways to measure impact in a consistent way and share indicators for success. Help organisations recognise and value wellbeing as an impact. • Build recognition of the cost and value of VCSE sectors within the STP. • Find ways to access resources to address inequalities. • Avoid turning VCSE organisations into mini-statutory organisations. • Reduce isolation across the STP using link workers and making services accessible, paying attention to physical and digital exclusion. @SocialEnt_UK @IVAR_UK #BHPselfcare

31. Worked up themes: 4 possible areas for joint action Demonstrating the impact of VCSE Wellbeing is valued as an impact and can be demonstrated. VCSE and health organisations develop a shared understanding of impact and measurement. How to shift the resourcing model for self-care? Self-care is co-designed. Gaps in services are identified and communities have equitable access to services. Good information is freely and widely available. Commissioners support self-care programmes and replicate success. Self-care is supported through a social approach. People and communities People engage with self-care as part of their communities. Information about self-care is shared creatively and widely through ‘local grapevines and buzz’. There is a common language used between professional’s conversations and conversations about health in the community. @SocialEnt_UK @IVAR_UK #BHPselfcare

32. Actions to take away • Engage/facilitate participation of smaller voluntary and community organisations and hospitals in BHP. • Investigate what’s needed to create a visible (integral partner) offer to the self-care/prevention priorities, including delivery and impact measures. • Find ways to measure impact in a consistent way and share indicators for success. Help organisations recognise and value wellbeing as an impact in itself. • Move prevention resources into communities - learn from and build on examples of where this is already happening. • Build recognition of the cost and value of VCSE sectors within the STP. • Ensure VCSE sector understands the commissioning of self-care. @SocialEnt_UK @IVAR_UK #BHPselfcare

33. Thank you.