Reimagining Care Closer to Home Partnership meeting 3 1 st February 2018

1. Reimagining Care Closer to Home Partnership meeting 3 1st February 2018 @SocialEnt_UK @IVAR_UK #BHPselfcare

2. Introduction On the 1st February 2018 the North Central London Building Health Partnership (BHP) group held its third partnership workshop to design tangible projects to develop the Care Closer to Home Integration Network (CHIN) model in a way that will: • Support people to self-care • Connect social prescribing and community initiatives across North London • Re-imagine how the system could work best for patients and residents • Establish the roles local voluntary sector organisations, commissioners and others can play The meeting was designed to build on progress made at the first and second partnership workshop and core group meetings to date. The meeting was attended by representatives from voluntary and community organisations, local authorities, GP’s, CCGs and the NHS from across the Sustainability and Transformation Partnership area. These slides were produced as a record of the event for those who attended and those who may not have been able to attend, as well as to aid the core group and borough groups (established during the third workshop) to progress action plans that were discussed during the third workshop.

3. Hearing from the local area To frame discussions, the workshop began with an update on what’s happening in other BHP areas and four presentations: • Strategy and Local Context - Katie Coleman, NCL Clinical Lead Primary Care and Care Closer to Home • What does it mean in terms of people’s lives and needs here in North London? Baljinda Heer-Matiana, Camden and Islington Public Health • Social Prescribing - Definition, North London Mapping, Evidence and NHS E plans. Jason Tong, HLP. • Self Management: Evidence for better outcomes - Claire Davidson, Whittington Health and Hazel Pak, guest speaker During the second half of the workshop, borough groups discussed the following, with a focus on Social Prescribing and/or Self Management: • Identified priorities and possibilities for their borough • Action Planning Priorities and action plans were written down in the borough groups and the typed up version can be viewed on the following slides. A list of contact details of the people involved in borough discussions were collated and distributed after the workshop to facilitate progress of action plans in working groups.

4. Peer networking in voluntary sector Local Needs – Key Insights How do you encourage training for MECC? How to approach this as it is huge! How can you support people better? Impact and diversity Include EPP in services MECC training signposts to empower people to use and access services Housing is very important Think about financial needs not just medical Peer support all communities use e.g. mosques Wider MECC training across all sectors How can we share learning? Need to join up training provision with changing service provision Inequity of access between general practices Wellbeing hub Evaluation of service Links with non-health partners essential Evaluate impact on health coaches in primary care Ripple effect on care Expand MECC to everyone

5. Self Management/ EPP – Key Insights How to make it easy to access SMP Peer support important Who commissions EPP? Lets not reinvent the wheel How to support all LTCs Very powerful when it works but issues around comms and future funding

6. Social Prescribing – Key Insights Building BC Chins – Prevention wellbeing coordinator Needs to happen in neighbourhoods Needs to happen at all levels Need to get signposting right to fully benefit from social prescribing initiatives Ensure it’s a partnership – avoid top down Important that any QA system is designed by/ with the SVS & VCSE at grass roots to avoid practical workers spending more time ticking boxes than talking to people. Keep it as simple as possible ‘Prescribing’ a difficult term in context of self help, mutual aid Upskilling existing staff to SP or pay new specific staff

7. CCG area: Haringey CCG • What Element is a priority for this borough? • Joining up all areas of activity related to care navigation, Social Prescribing, local area coordination etc. • Why? • Fragmentation • Greater clarity around service access • Get population coverage • Raise awareness and develop relationships • What is already happening? • Local area coordination • Referral to EPP? Future funding • Bridge Renewal Trust doing asset mapping – database • Care navigation linked to CHINS (using GPFV funding) • What would a great self-management/care/closer to home system look like? • Have a clear process in place to actively identify the right people • Ensure individual outcomes identified and supported – needs to be person centred • Develop relationships and communication with all system partners, especially VCSE. • Ensuring everyone has access to database that is up to date and easy to access. • Who needs to be involved? • Voluntary sector rep • CCG/Public Health • General Practice • Neighbourhood spaces • What resource is needed? • Build capacity within VCSE • Identify local need to shape services • Support around service development to VCSE • Identify people who can input into system

8. CCG area: Haringey CCG Target: Join up all current activities linked to social prescribing Action Project: When? This week This week Feb Feb • Resource: • Nil • Who? • KG (database - GP portal) • RL (strategy) • TH (sharing projects) • GO (Care Navigators) • Activity: Voluntary Sector Forums • Take advantage of existing meetings to start to discuss agenda • Develop a process within CCG/Publish Health about what current projects are, so can start to join the dots • Clear strategy that describes CCG/Public Health/ LA Plans to embed self management support and social prescribing • Develop clear comms plan to raise awareness of what currently exists • Prioritise asset mapping done by Bridge Renewal Trust, look at gaps and then build capacity • Training for health and care providers using competency framework • Establish care navigation offer • Very Next Steps • Explore resources? • What’s already here? - Build on it. How can we spread and embed? What do we need to know more about?

9. CCG area: Barnet CCG What Element is a priority for this borough? CC2H and CHIN model Test it on a small scale (be clear what you’re testing). Why? Way of getting proof of concept of SP/SM to lead to buy in fromsocial care benefits of Social prescribing = increased quality for patients and decreased demand for GPs. What is already happening? MH link workers – BEH MH trust Conversationshappening RO developing an EPP through CPEN Two adult social care local area coordinators (in progress) Health champions – could be used in a more structures way Diarising GP appointments – appropriate activity? Seen elsewhere (incl. SP/SM) Prevention and wellbeing coordinators Testing 3 experiment – SP - next steps – action planning for more detail • What would a great self-management/care/closer to home system look like? • Culture change in • Involving care champions in the entire quality care process. • Evidence based • Different workforce? • Innovation Hub? • Prescription slips for SP (RFL already doing) • Alert to social need • Who needs to be involved? • Public Health - JL • GPs – JP (CEPN) • Social Care – SP • CHIN lead – AB What resource is needed? PH currently leading or coordinating 3 experiments – realistic in terms of capacity?

10. CCG area: Barnet CCG Target: CreateOperational Plan for 3 Social Prescribing experiment Action Project: Workshop– Public Health, CCG and Social Care • Activity: • EPP: • Recruiting • Model assumptions • Cost • 2) Prevention and NB coordination: • Build on local area coordination • CHIN 1 • 3) Wider social prescribing – generic • Digital • Self-care/prevention • Culture Change/comms • Very Next Steps – attend workshop this afternoon • Resource: • Who? • PH • PH/ASC • PH When? This PM This PM What do we need to know more about? How can we spread and embed? LA/CCG to be bold to have holistic evaluation on all the experiment.

11. CCG area: Enfield CCG • What Element is a priority for this borough and why? • On-line directory of services – 766 groups! • Co-ordination across all sectors • Support Toolkit for those already doing it – describe it • Link with Social Care, Housing and LA services – incl. children and young people. • What is already happening? • CEPN ‘Golden book’ – a hand-held book for people with LTCs • Age UK – Care Navigators • Buddies and mentors What would a great self-management/care/closer to home system look like? Patient knows where to go to get help, notnecessarily through GP. Who needs to be involved? What resource is needed?

12. CCG area: Enfield CCG Target: CHIN support for a directory Action Project: CHIN Development Meeting • Activity: • Diarise by March • Identify resources needed at March meeting • Discuss who else to involve • Vince McCabe and Claire Davidson to talk re: EPP • Very Next Steps • Kerree A to contact Sandra. • Who? When? • Resource: What do we need to know more about? Who to involve from LA, Children and Young People, Housing. How can we spread and embed?

13. CCG area: Islington CCG • What Element is a priority for this borough? • Initial contact point • Capacity building - local area • LA • Why? • Route into systems of support • Early intervention • Taking activity away from GP • What is already happening? • Care navigation • Fire safety • SHINE What would a great self-management/care/closer to home system look like? Integrated Single approach Collaborative approach Who needs to be involved? All parts of the system Becky Kingsnorth What resource is needed?

14. CCG area: Islington CCG Target: Integrated, simplified approach to initial contact/ Identification of Self Management needs and opportunity. Action Project: Culture change, behaviour change, collective approach, Community of Practice (design and build). • Activity: • Assets based approach • Summit • Very Next Steps • Age UK Islington to communicate/initiate event • Who? • Resource: When? What do we need to know more about? How can we spread and embed?

15. CCG area: Camden CCG What Element is a priority for this borough? Bringing existing work together into a cohesive system/model Suitable infrastructure for VCS Challenge of sharing information (timely, comprehensive) Why? • What is already happening? • Reviews on key local services – adults • Have developed a Social Prescribing model to bring existing services together – about to be signed off • Linking up websites (Care Choices and NHS Choices) – important to keep updated • Self Care action plan • Community asset mapping – VCS org. across partnership • What would a great self-management/care/closer to home system look like? • Investment and support for VCS and VAC – sustainability • Next steps – would be aligning new model to other workstreams e.g. MH and children. • Who needs to be involved? • Adult Social care – aligning with local care strategy • Public Health • VCS • LCS group • What resource is needed? • Understanding of diversity of our population • Falls

16. CCG area: Camden CCG Target: Key theme in our local strategy Action Project: • Who? • CCG and partners • Local Care Strategy group • Ensuring support from voluntary sector • Activity: • New model of social prescribing/care navigation and procure • Delivery of key actions for our self care strategy (asset based, resilience, independence) – ‘directory of services’ • Focus on what this means for people – what do for myself? What right to people have? Volunteer ‘Workforce’. • Linking and growing ownership in neighbourhoods • Very Next Steps • Specification Integrated Commissioning Group • Partnership action plan Local Care Strategy Group • Involvement of neighbourhoods When? Approx. 1.5 months Ongoing – feedback at next meeting • Resource: • Wider community team (LBC) What do we need to know more about? Meeting needs of our population – diversity, vulnerability, not engaged, frustrated, by cuts and changes in services. How can we spread and embed?