heywood integrated care organisation (hico) demonstration site update 15 th december 2010 dr michael...
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Heywood Integrated Care Organisation
(HICO)
Demonstration Site Update15th December 2010
Dr Michael Taylor, York House Surgery, Heywood, OL10 4NNEmail: [email protected]
Heywood Integrated Care Organisation
The Glass That is Half Empty
Heywood Integrated Care Organisation
Introduction: Aims
Clarify wellbeing services Increase public awareness Facilitate easier access Help the work vulnerable Maximise self care Guide people to appropriate support
Heywood Integrated Care Organisation
Introduction: Objectives 1
Use population approach Improve physical care of those with
wellbeing issues Improve liaison between GP and
PCMHT Reduce stigma
Heywood Integrated Care Organisation
The Population as a Patient
Heywood Integrated Care Organisation
Introduction: Objectives 2
Reduce frequent attenders Reduce frequent flyers Sign post to wellbeing services
Heywood Integrated Care Organisation
Complete de-stigmatisation Paperless referrals Short waiting times Seamless care achieved! No, really!! Attendance rates of 82% Simple feedback loop to adjust the
volume of referrals.
Process Outcomes
Heywood Integrated Care Organisation
Methodology: Organisational diagram
Senior Commissioning TeamNHS HMR
Mental Health Commissioning Team
HICO Stakeholder Group HICO Mobilisation Team
Heywood Integrated Care Organisation
Methodology: Team
Two Heywood GPs A Project Manager, Public Health, (Chair) An Operational Manager, PCMHT A Graduate Mental Health Worker A Practice Manager A Senior Commissioner, Rochdale MBC A Lead Commissioner, NHS HMR
Heywood Integrated Care Organisation
Methodology: PDSA
Heywood Integrated Care Organisation
Methodology: Questionnaires
Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS)
Patient Health Questionnaire 9 (PHQ9)
General Anxiety Disorder Assessment (GAD 7)
Heywood Integrated Care Organisation
Mental health worker Nil
Wellbeing worker 1/3
Medication 1/3
Watch and wait 1/3
Patient choice of treatment
Heywood Integrated Care Organisation
Evaluation: Problems
Rochdale MBC support difficulties. Cultural differences especially
PCMHT and GP. Wellbeing Worker overwhelmed. Scarcity of Wellbeing Worker. WEMWBS completion difficulties in
waiting room.
Heywood Integrated Care Organisation
Evaluation: Lessons Learned
Wellbeing is not stigmatised. GP practices are suitable
environments for wellbeing workers. Wellbeing leaves responsibility with
the citizen. A better, quicker, cheaper service is
realistically achievable. Roll-out is easy.
Heywood Integrated Care Organisation
Evaluation: PCMH perspective
60% of patients referred complex. WW reported being overwhelmed. WW compared and contrasted the
cultures. Better liaison with the GP practice
about patient population was a learning outcome.
Invaluable learning experience.
Heywood Integrated Care Organisation
Evaluation: Academic 1
Services provided are seen as positive alternatives.
Access to psychology via Wellbeing Worker is more acceptable.
Relational and cultural tensions were addressed.
Understanding was improved. Increased awareness of wellbeing
services.
Heywood Integrated Care Organisation
Speed-dating event was innovative and cost effective.
Regular PDSA meetings were challenging and important.
The WW role should be reviewed. WW’s should be more involved with
the GP practice. GPs to realise to abilities and
limitations of the WW.
Evaluation Academic 2
Heywood Integrated Care Organisation
Conclusion: Patient perspective
No stigma Full consultation Choice Quick help Local help Place of comfort Seamless care (“no glitches”)
Heywood Integrated Care Organisation
Conclusion: Practice Perspective
In house Need to understand the WW Need for signposting Reduced DNAs Prioritisation of work-vulnerable of
great help
Heywood Integrated Care Organisation
Conclusion: PCMH perspective
Location crucial More capacity needed Different solutions for different
practices Incorporation of learning into IAPT
Heywood Integrated Care Organisation
Conclusions: L.A. Perspective
Can include greater numbers of citizens.
Responsibility for self-improvement. Builds up community assets. One stop health and social care in
citizens interest. Demonstrates benefit of joint
commissioning.
Heywood Integrated Care Organisation
Conclusions: NHS Perspective
Better, quicker, potentially cheaper. Transformation not additional. Different ‘populations’ may have
different needs. Uses assets as well as services. May reduce secondary care
demand.
Heywood Integrated Care Organisation
Next Steps:
Five Ways to Wellbeing website. Supporting community assets. Commissioning in-house services. Incorporating wellbeing into IAPT.
York House Surgery
Website: www.5w2w.org
Heywood Integrated Care Organisation
HICO Outcomes
Wellbeing score 39.6 Regional average 55.5 Wellbeing not stigmatised Seamless care Opportunity to be better, quicker, cheaper
Heywood Integrated Care Organisation
Relationship between WEMWBS scores and PHQ-9 scores
0
10
20
30
40
50
60
70
PHQ-9
WE
MW
BS
Heywood Integrated Care Organisation
What WEMWBS Scores Mean
60-70 Life treats you well
50-60 No big worries
40-50 Life has its ups and downs
30-40 Life can be a worry
20-30 Life’s a big hassle
14-20 If you are not already in treatment see your GP now
Heywood Integrated Care Organisation
Focus of treatment
Focus of recovery
The Glass That is Half Full
Disorders of mood
Wellbeing
Heywood Integrated Care Organisation
(HICO)
Dr Michael Taylor, York House Surgery, Heywood, OL10 4NNEmail: [email protected]
Demonstration Site Update15th December 2010