TEAM was asked to contribute to two emerging strategic priorities for the Nottinghamshire STP;

• Developing an Integrated All Age Mental Health Strategy
• Developing a Vision for Community Centred Approaches

Mental Health Strategy

There was an emerging consensus amongst stakeholders that the path to a transformed Mental Health landscape for the STP should be supported by a number of key pillars:

1. Developing integrated system infrastructure;
2. Developing integrated working in local communities;
3. Enhancing workforce culture and competencies across the public sector;
4. Mitigating adverse childhood experiences (ACE);
5. Transforming user-involvement through co-design, choice and control;
6. Developing an integrated mental/physical health approach to urgent and emergency care needs;
7. Providing the right care in the right place.

A number of other considerations for the strategy were:

a) A joined up, coherent approach to self-care/prevention. The Public Mental Health model should be utilised to highlight what elements are universal (prevention), selective (targeting at risk groups) or indicative (treatment and recovery);

b) An acknowledgement that this broad range of priorities cannot be delivered all at once and that implementation will not necessarily be linear. There is a requirement to build foundations and set milestones to meet along the way in achieving the long-term vision (co-produced with consumer/service user);

c) A focus on mental health recovery – how people move on and away from statutory services – particularly in relation to prevention, promotion and community work;

d) Greater focus on building individual and community resilience to reduce the impact of adversity and the subsequent impact of adverse experiences on individuals’ physical and mental health. Rather than simply focus on treatment, the strategy should also embody a wellness model and incorporate prevention/self-care across all its elements;

e) An understanding of the key root causes of poor mental health (such as social isolation, housing issues, alcohol, unemployment, education, crime), and;

f) Addressing the stigma and labelling around mental health conditions, challenging outdated myths and beliefs.

 

Community Centred Approaches

The aim of these workshops is for stakeholders to coproduce an agreed standard for community centred approaches that support people to live well in their communities across Nottingham and Nottinghamshire.   For us to work together to reduce health inequalities and create healthy, resilient, engaged communities.  There are a number of barriers and challenges to be recognised and overcome including the need for;

• longer term investment in order to build capacity
• a wider culture change
• skills, knowledge and values in communities
• meaningful engagement to support and empower people to contribute

For consideration was the development and scaling up of a number of areas:

• Social Prescribing
• Health Coaching
• Shared Decision Making
• Patient Activation Measures
• Building Community Resilience/Capacity
• Reducing Loneliness

 

Mid Notts Better Together Alliance

Staying Independent and Healthy

TEAM has recently joined the ‘Staying Independent and Healthy’ Programme Delivery Board.  The group aims to knit together activity on common agendas from health and social care, with TEAM representing the third sector.  After only one meeting, we have already raised awareness of the debt support programme available in CAB’s, and are working to create a more formal referral process with NCC, District Councils and Primary Care.

To avoid duplication of work and maximise existing resources, it was agreed that the Notts Help Yourself website, managed by Notts County Council, is best utilised for community mapping.

Members of the groups including representatives from County County, District councils, Primary care and TEAM agreed to support and encourage the use of Notts Help Yourself.

 

Notts Help Yourself Website

The website provides a valuable database of approximately 6500 community groups and organisations across the county.

The database that sits behind is up-dated by auto reminders to the owners of the information and can be used to populate different web site front interfaces if necessary.  A 6 monthly refresh/prompt cycle ensures data is maintained and kept accurate, with reminders being sent to organisations before the record expires.  Quality checks are carried out on some user information and groups now registering must also provide an email address and contact telephone number, to make contact by the public easier.

The website’s search engine is currently undergoing an upgrade and will be available in the New Year.  The user interface itself will not change a great deal, but the search engine behind it, will be improved and TEAM has suggested that a user guide be made available to both organisations and the public to show how best to use the search facilities.  

A provider guide is already available, assisting groups to set up their details and show basic functions of the website. If you do not have this, you can contact the Notts HelpYourself team to request any additional help.  Either use the contact form on the website or email nottshelpyouself@nottscc.gov.uk

https://www.nottshelpyourself.org.uk/kb5/nottinghamshire/directory/home.page

 

Frailty Project Group

The Frailty project group has recently relaunched aiming to bring together organisations and individuals across mid Notts who provide services to people that are frail or otherwise vulnerable and at risk of hospital admission.  The objectives of the group include;

• bringing services and support closer to people in their homes
• ensure they have the best care, treatment and support at the right time in order to reduce hospital admissions, improve quality and enhance patient experience.

TEAM attended the first meeting where the organiser was asking for services and organisation details for a mapping exercise for the future locality hubs/GP’s.  We were informed that 4 locality hub navigators will be in place to work with GP’s, social care, health and community, signposting patients to appropriate services.  TEAM suggested that the Notts HelpYourself website was an existing directory of services, to avoid further duplication of work.

If you would like to be involved, contact Jill Thompson, Mansfield & Ashfield CCG –  Jill.thompson11@nhs.net

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GDPR

The training session on the new General Data Protection Regulations was well received.  15 organisations were represented by one or two delegates and everyone had plenty of opportunities to ask questions specific to their organisation, and how the GDPR will affect them.

The following links provide information on GDPR from the ICO website (Information Commissioner’s Office).  Press CTRL + click to view.

The ICO guidance on legitimate interests: https://ico.org.uk/for-organisations/guide-to-the-general-data-protection-regulation-gdpr/legitimate-interests/

Their main page on GDPR: https://ico.org.uk/for-organisations/guide-to-the-general-data-protection-regulation-gdpr/ and it’s always worth looking in the ‘What’s new’ section.

[one_third_first]The slideshow and presentation have been sent to all attendees, but for anyone unable to attend, please click on the link below to download the information.[/one_third_first][one_third]

Download (PPTX, Unknown)

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Download (PDF, 169KB)

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End of Life DOS

As part of the End of Life Service redesign across Mid Nottinghamshire, TEAM will be providing and maintaining a Directory of Services for relevant third sector service providers for End of Life patients and their carers.  The DOS will be available to all Health Care Professionals in the EOL pathway.

We will be contacting organisations delivering EOL services shortly to check on the accuracy of the data we have included, for example; contact details, opening times, group session times and services offered.  However, if you deliver services and support to patients or carers who are End of Life, and would like to be included in the DOS please contact myself, Karen Howe on 01623 415966 or Karen.howe@tea-m.org.uk

 

The Healthy Mansfield Commission has recently been set up to identify how best to support and improve the health and wellbeing of the people of Mansfield.  It aims to consider the opportunities for improving access to high quality Health and Wellbeing through closer working between agencies across the health and social services and to deliver more appropriate, targeted health and wellbeing.

TEAM has been asked to be part of the Commission, along with a number of charities and statutory bodies representing health and social care, the third sector, County and District Councils.

The first meeting was held on the 19^th April 2018.  We will keep you posted of developments.

 

Social Prescribing Update

Unfortunately, TEAM was unsuccessful in our joint funding application with mid Notts CCG to the Health and Wellbeing Fund to resource a Social Prescribing programme across Mansfield, Ashfield, Newark and Sherwood.  We are still hoping to secure funding from the CCG, and are currently working with them to consider scale, timelines and availability of resources.  We will keep you all up to date as soon as we have any definitive news.

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Small Grant Fund Summary 2017

A big Well Done to all organisations supported by the Small Grant Fund 2017 which have now completed their projects and hopefully, will continue either as separate courses sustained through alternative funding sources, or as part of existing programmes.

The fund enabled six projects to run from between 6 and 24 weeks, introducing new courses to support and inform people with various health conditions across mid Nottinghamshire. The projects were funded at a cost of £15,635, with 431 direct beneficiaries and indirectly supported families and carers, as well as raising the profile of the individual organisations and generating new partnership working with both statutory and voluntary groups.

 

• APTCOO delivered a course to young people with special educational needs and/or disability who are transitioning into adulthood.  8 people attended, with the course covering activities to help with social interaction, understanding healthy eating and developing healthy cooking skills.  The approach to learning adopted on the project removed the barriers to learning for these young people and in doing so, increased their confidence, reduced disaffection and enabled the clients to develop a full transition pathway to adulthood and more independent living. Links were made with the British Sign Language Society, with one volunteer now teaching sign language to staff at Tesco.APTCOO social enterprise, based at their Learn, Work and Earn centre is run by the young people and enables them to see a complete business cycle from producing goods and products to selling them.  It is a source of income for the charity and ensures sustainability for projects.  As such, they will be offering a full transition programme, ‘Preparing for Adulthood’, using the learning gained from this pilot project.Case StudyAt the start of the course, CH was a quiet young person, who rarely voiced his own opinions. When he felt anxious, frustrated, or out of control with the group dynamics, he would storm out of the building, whilst shouting at other attendees and staff alike. Changes to routine would result in him demonstrating challenging behaviour. His Autism Spectrum Disorder limited his communication and interaction with others, resulting in him being partially segregated from the group.

  CH now voices his own opinions, and helps shape activities that are delivered to the group. When he feels anxious, has had a bad day at school, or has some issues with peers at school, he speaks with staff about his concerns. He has benefitted from participating in group games, caring for the plants, and completed woodwork tasks. This has focused his attention and improved his confidence to participate in the group with some genuine sense of meaning. He is able to communicate with others, socialise, and has improved his understanding of social conventions, such as using manners, and engaging in humour/jokes. Overall he has developed his confidence, capability and a sense of humour!

•   Reach delivered a 24 week Diabetes Prevention course to improve lifestyle choices (diet and exercise, confidence building and social connections) for adults with learning disabilities.  15 individuals attended the course, specifically aimed at raising awareness around the increased risk of Diabetes and other serious health problems.The groups met weekly, with each session starting with a fitness activity and followed by a focussed topic and group discussion about goals.  Individuals were also allocated 1:1 time to discuss personal issues with a tutor.  Topics included;
  • Healthy eating & cooking
  • Reducing alcohol/smoking
  • Building exercise into everyday life
  • What is Diabetes
  • Preventative measures to reduce the risk of Diabetes

  The sessions were led by tutors and supported regularly by a number of volunteers.  The pilot project highlighted the need to include carers and/or family members’ in future healthy lifestyles courses as many individuals’ motivation was lost when not supported at home with their newly learned lifestyle choices.

  There was an overall reduction in the amount of chocolate eaten, with 40% of clients losing between 0.5 – 4 inches on their waistline measurement.  1 client reduced cigarettes smoked, and all increased exercise and confidence.  1 client was able to discuss his alcohol problem and was signposted to an alcohol support.

  Case Study:

  Dave* faces multiple barriers to inclusion.  Though initially reluctant to join in with the group, he became more confident as the weeks went on.  By week 6, the group focussed on the risks involved with alcohol and its long term side effects.  As part of the group discussion, Dave acknowledged that he often drinks heavily and would like to be able to change this.  His open admission and request for help meant that the tutor was able to work with him on a one to one basis and signpost him to local, specialist support services.  Dave’s trust in the group and tutor has meant that he is able to share what changes he is making to tackle his issues.

• Headway delivered therapeutic drama and art workshops to 39 adults with brain injuries. The level of engagement on the course was a huge achievement, as historically, people with brain injuries lack motivation and struggle to remember key appointments. The sessions focussed on listening and communication skills to enable better social relationships with individuals and groups, improving coping strategies and increasing self confidence and independence. The course enabled valuable respite for carers and families and improved family relationships due to the learned behaviours met in the therapy sessions – appropriate interactions, increased confidence and pride, ability to express their feelings with others and increased patience/appreciation of others needs.

Due to the success of the course, Headway are applying to the Arts Council of England to deliver therapy via art and drama on a long term basis.

• Hettys delivered 54 workshops to a total of 349 unique individuals across Mansfield, Ashfield, Newark & Sherwood.  The aim of the sessions were to engage and maintain substance users in treatment and recovery services, as well as provide support and raise awareness and knowledge of addiction amongst families.Evaluation forms completed by attendees show the following progress since starting the project;
  • 99% said they feel more informed about all aspects of addiction
  • 93% said they feel better equipped to cope and plan for potential difficult situations
  • 71% reported substance users have entered and maintained treatment programmes
  • 76% reported substance user has reduced their drug/alcohol use
  • 95% reported having better coping strategies and more able to cope in a crisis
  • 48% now volunteer in the community, started a new hobby or gained employment

  Hettys are now liaising with CGL (drug treatment service provider) who are referring clients to them.  Due to the success of the workshops, Hettys have made the strategic decision to continue this provision, sourcing alternative funding to support the workshops as part of their standard support plan.  They currently have 3 charity shops across mid Notts and plan to open more shops to increase their income and sustainability for support projects.

•   She delivered a healthy living and life skills course to their members in Mansfield, all victims of sexual abuse.  12 individuals attended the weekly workshops and gained confidence, enabling them to identify areas within their personal recovery journey to work in with therapists.  These included identifying eating disorders, assertiveness and taking control of their lives.Connections have been made with the NHS nutritionists, DESMOND, Inspire Cultures and Mansfield District Leisure Trust.  Working in partnership with these groups, SHE aims to deliver similar courses later in the year to Mansfield and Worksop residents. Some clients with Fibromyalgia are now attending the gym and leisure facilities which are having a positive impact on their pain.  The relaxation techniques taught in one of the sessions have been adopted by many of the women at home, as a coping mechanism against stressful situations.Case studyOne member identified that she was in a very abusive relationship with her husband. The course increased her self-confidence thus empowering her to take responsibility for her own well-being and take herself away from that relationship.  With the support of her keyworker, she contacted a women’s refuge in Nottingham. On doing this she has been able to give herself a new start in life without the unnecessary negative impact of continual abuse. She has also sought outside support from other organisations, again encouraged by the course. She is now settled in her own home and enjoying a life away from abuse.

 

•    Rhubarb Farm delivered a 6 week Independent Skills course, one full day a week, to 8 individuals with a range of multiple and complex needs.  They were transported to the farm from the Mansfield district and covered the following topics;
  • Understanding healthy living/exercise and a balanced diet
  • Cooking and food budgeting skills – trip to the supermarket as a practical demonstration
  • Drug and alcohol awareness
  • Support for mental health issues
  • Increasing confidence in social situations/independence skills and reducing social isolation

  The success of the course has led to a change in organisation policy – sugary drinks and confectionary are no longer allowed at the farm.  A healthy meal is also being provided daily to volunteers at the farm from the kitchen to encourage good diet.

  Rhubarb Farm has increased collaborative working with other VCS groups:

  • Inspire to facilitate Healthy Eating course
  • Release to facilitate Budgeting course

  Case Studies:

  R, a man with depression and diabetes said in a survey of volunteers: “Rhubarb Farm is good as it gets me out and reduces my social isolation. It gets me socially active. I have learnt how to cook some food and learnt some gardening skills. I have met more people and am gaining confidence in my day to day living.”

  S, a young woman is socially isolated, overweight and depressed. When she first attended RF she would hide at break-times and not mix with others. She attended the Independent Living Skills course, gaining confidence in her cooking skills, and by the end was supporting others with their tasks. In the survey, she says: “Rhubarb has greatly improved my confidence and helped me make new friends. Suffering with depression, Rhubarb has given me a reason to get up in the mornings.”

 

TEAM are hoping to release a further Small Grant Fund round this year.  We are currently working with mid Notts CCG and local Health Providers to formulate health priorities and KPI’s for potential projects across mid Notts.

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End of Life Care Pathway

In response to a request by Mid Notts CCG to redesign the End of Life Care Pathway, the Alliance Partners, including TEAM, have developed a joint approach to a fully coordinated, high quality End of Life service.  This is due to go live in April 2018.

Transformation through integration is central to the success of the new model.  Gaps in the current service were identified and the rights of patients to receive their preferred place of care and preferred place of death prioritised.

The Alliance want to coordinate the care of End of Life patients through a single point of access, ensuring patients are able to access the right service at the right time to meet their individual needs.  The Primary Health Care Team will be supported by education, training, specialist advice and guidance, respite care through Hospice at Home, Day Therapy services and Bereavement services.

As part of this process, TEAM invited current third sectors providers of End of Life care, to participate in the development of the model, and they continue to be an active and valuable member of the operational group.  Thanks go to Nottinghamshire Hospice, Beaumond House Hospice and Cruse Bereavement Care.

Alliance members involved in the End of Life Care Pathway are:

• Mansfield & Ashfield CCG
• Newark & Sherwood CCG
• Nottinghamshire Healthcare (Local Partnerships)
• Sherwood Forest Hospitals
• Nottingham University Hospitals
• TEAM

 

TEAM Small Grant Fund Update

Progress on all of the six TEAM funded projects is going well, with one project completed, four more than half way through and one preparing to start.

•   APTCOO are delivering a course to young people with special educational needs and/or disability who are transitioning into adulthood. So far, they have covered activities to help with social interaction, understanding healthy eating and developing healthy cooking skills.
•   Reach have set up a Diabetes Prevention group for adults with learning disabilities. The weekly sessions include a fitness element (HIT pyramid workout), activity and group discussion.  So far, topics covered have included; healthy eating, affects of alcohol and smoking, fitness and health goals. Mid way evaluation shows reduction in amount of chocolate eaten, slight reduction in cigarettes smoked, increase in exercise and an increase in confidence, enabling clients to be signposted to other support groups around their specific issues (eg. alcohol use).
• Headway are delivering therapeutic drama and art workshops to adults with brain injuries. The sessions focus on listening and communication skills to enable better social relationships with individuals and groups, improving coping strategies and increasing self confidence and independence.
• Hettys have so far delivered 36 workshops to a total of 232 unique individuals. The aim of the sessions are to engage and maintain substance users in treatment and recovery services, as well as provide support and raise awareness and knowledge of addiction amongst families.  Evaluation forms completed by attendees show the following progress since starting the project;
• 36% reported substance users have entered and maintained treatment programmes
• 45% reported substance user has reduced their drug/alcohol use
• 76% reported an improvement in relationships across the rest of the family
• 95% reported having better coping strategies and more able to cope in a crisis
• 30% now volunteer in the community

 

Healthy Living Engagement Event at West Notts College

TEAM and Mansfield CVS were asked by Mid Notts CCG to facilitate an engagement event at West Notts College, held to promote healthy living amongst young people.  80 Social Care students aged between 17 and 20 attended the event to discuss their eating habits, exercise regimes and general lifestyle choices.

The consultation proved very useful, with insights gained into student habits, choices made and the reasons for them, and how healthier choices could affect their health and finances.  Ian Marshall from TEAM said, “The majority of the students formed the fast food group, this was because it was convenient, cheap and the best excuse ‘ there is no pots and pans the clean’.  This group of students also lacked any organised physical exercise”.

Following on from the event, TEAM are hoping to work with the College and the CCG to better promote healthy living, and arrange informative talks from the Diabetic team to explain and demonstrate the negative effects of poor eating/lack of exercise, even in young people.  A similar campaign was set up by TEAM to a local Air Cadets squadron, which then went on to introduce a healthy canteen and exercise sessions both locally and nationally across 180 groups.

 

 

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Falls Prevention

Public Health Nottinghamshire are piloting some falls prevention training specifically for the third sector, as part of their ‘Get Up & Go’ Campaign. TEAM have been asked to join the pilot to feedback from a third sector strategic perspective on what they might need to do to adapt the training to make it most appropriate for frontline workers in Mid Notts.

Following on from the pilot, training will be rolled out to each locality with a specific locality focus.  One event will cover Mansfield & Ashfield, and one event for Newark & Sherwood.  Invites will be sent to relevant groups when the dates are confirmed.

If you have a particular interest in this training, please contact me (Karen.howe@tea-m.org.uk) to be added to my list.

For more information on the campaign, go to the NCC website.  You can download the Get Up & Go booklet by clicking on the following picture;

Making Every Contact Count

What is Making Every Contact Count?

Making Every Contact Count is an approach to behaviour change that utilises the millions of day-to-day interactions that organisations and people have with other people to support them in making positive changes to their physical and mental health and wellbeing.  It maximises the opportunity within routine health and care interactions for a brief discussion and delivery of consistent and concise healthy lifestyle information on health and wellbeing factors.

Evidence suggests that the broad adoption of the approach by people and organisations across health and care could potentially have a significant impact on the health of our population.

Rather than telling people what to do, Making Every Contact Count is about recognising opportunities to talk to people about their wellbeing using the skills of asking and listening. It’s about enhancing the conversations we have.

Making Every Contact Count is one of the core priorities of Nottinghamshire’s STP (Sustainability and Transformation Plan) and this approach is being embedded across NCC and the NHS.  Both providers are asking Third Sector partners to sign up to this approach. Online training is free to access, although you will need to register for an account before you can undertake it.  The E-learning modules are designed to support learners in developing an understanding of public health and the factors that impact on a person’s health and wellbeing, emphasising how asking questions and listening effectively to people is a vital role for us all.

Click on the following link to register with the e-learning for healthcare programme.   http://e-lfh.org.uk

Click on the red ‘Register’ button in the top right corner then complete the registration form and select the ‘Making Every Contact Count’ module.

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