Catching people before they need health and social care intervention comes high on our list of priorities. When you consider the long-term pressures on health and social care budgets it makes absolute sense for us to provide more than just a safety net for people in crisis, through an investment in prevention.
Our Prevention Matters programme aims to help individuals who are socially isolated or struggling to maintain their independence. This could be because of an illness, bereavement, or due to frailty in old age. The aim is that by encouraging and sustaining independence we ensure people require a less intensive social care package and, across Buckinghamshire, there are fewer admissions to hospitals and care homes.
At a county level, we are looking at an increase in residents aged over 65 from 16.7% of the population in 2011 to 21.7% by 2025, with the 85-plus age group doubling to 3.9%. In addition, we have a significant number of younger adults with social care related needs who may not be eligible for social care services but need support with daily living, education, training and employment, access to health services and tackling social isolation.
Prevention Matters was co-produced with more than 100 statutory, voluntary and community organisations, including district councils and the NHS. The Innovation Unit, a social enterprise working to transform public services, worked with us all to develop the service model and conduct a number of ethnographic studies.
Lynda and Gwen
“Some positive outcomes, and really quickly.”
Gwen, who has dementia and a visual impairment, lives with her daughter Lynda and her family.Lynda wanted to find activities for her mother to give her independence and to also allow herself time for relaxation. A community practice worker helped them to access a carers’ break fund to allow Lynda to go on holiday and referred them to a sensory service to ensure they received specialist equipment and advice. The worker also enabled them to join “Singing for the Brain” and dementia cafes, as well as attend a day centre for two days a week.
It was clear that to be effective we needed to work in partnership across the public, private and third sector agencies and organisations. There is a great deal of ‘silo’ working in the current system, which leads to duplication of effort and wasted resources. Additionally, we recognised the gap between formal or semi-formal services, where paid professionals are involved in delivery, and informal networks and associations where levels of trust and reciprocity are much greater.
We have four strands to Prevention Matters, with 70% commissioned through the third sector. We have a team of 14 community practice workers dedicated to motivating, ‘hand-holding’ and building confidence with clients. Individuals can be referred by their GP or health professional, or can refer themselves to the service. The CPWs are employed across five third sector organisations, and were specifically recruited for the role. They are not meant to replace social workers as their purpose is to help people before they need social care intervention.
The council employs seven community link officers from a variety of backgrounds, including some with social work experience. They are the bridge between the informal and formal sectors. They work to establish new community-based services and enhance existing ones, identifying gaps in provision and working closely with the CPWs to find solutions for individuals. To complement their work, we have set up a community grants scheme administered by an independent charity to which organisations and groups can apply for funding to start up services or to sustain or enhance existing services.
The third strand of Prevention Matters is the volunteer hub, commissioned with two third sector organisations: Community Impact Bucks and Just Add Spice. The hub assists with recruiting, screening and training volunteers to address the gaps identified by the CLOs and CPWs. Through a series of events and online promotion the hub has had 72 people apply to become volunteers since it launched in January this year. Of them, 55-60% had never previously done any volunteering.
Volunteers can be thanked with time credits for giving their time to help others in their community or service. Opportunities to ‘earn’ time credits build on the interests, skills and availability of local people and encourage new people to become involved – often those who previously did not recognise that they had something of value to offer to others.
Recipients receive one credit for each hour they volunteer. Credits can be used to access events, training and leisure services; from theatres to film nights as well as higher profile opportunities such as visiting St Paul’s Cathedral and the Tower of London.
Just Add Spice meets with local businesses to discuss how they might want to engage with the community. It has a track record of ensuring that the community and business will benefit from any relationships forged through time credits. Businesses welcome new and diverse customers and this gives them an insight into their needs.
The final strand of the service model is the intelligence hub which has the most potential to lead to a dramatic and sustainable change across the sector.
A small dedicated council team monitors intelligence through a database shared with our Prevention Matters partners. The hub details information about existing provision of community and other prevention-related services and activities. It contains information about users within our cohort and the services they access, as well as about preventative services. Through the intelligence gathered we maximise the benefits we derive from existing resources, helping to bridge the objectives of different sectors and organisations.
Since we started we have helped more than 1,300 individuals, a large number referred by their GP or other primary care worker
Loneliness is considered a key factor in accelerating a decline in health. Prevention Matters therefore aims to link people to their communities to reduce isolation and create greater social networks. We estimate we can save up to 25% of our social care budget over the three-year programme.
We have commissioned an external evaluator to validate data collection processes, quality assure outputs, make connections with work being undertaken in other local authorities and open up national networking and dissemination opportunities.
We used an initial £4m grant, as part of the recent s256 transfer of monies from the NHS and agreed locally with Buckinghamshire’s clinical commissioning groups, to develop this prevention service.
Since we started it in July last year we have helped more than 1,300 individuals, a large number referred by their GP or other primary care workers. While we know that many have experienced positive outcomes and enjoy a greater sense of health and wellbeing, measuring prevention, or the avoidance of something that never takes place, is difficult. By looking at historic and predicted profiles and trends the external evaluation (an initial report is due early 2015) should indicate if we are getting it right economically as well as socially.
If Prevention Matters succeeds, we should significantly alleviate the pressure on primary, acute and social care in Buckinghamshire as well as providing better outcomes for the residents of Buckinghamshire.
“Some positive outcomes, and really quickly.”
Gwen, who has dementia and a visual impairment, lives with her daughter Lynda and her family.
Lynda wanted to find activities for her mother to give her independence and to also allow herself time for relaxation.
A community practice worker helped them to access a carers’ break fund to allow Lynda to go on holiday and referred them to a sensory service to ensure they received specialist equipment and advice. The worker also enabled them to join “Singing for the Brain” and dementia cafes, as well as attend a day centre for two days a week.