With housing and health increasingly integrating to respond more effectively to citizens’ needs, Hugh Irwin from United Welsh explains a new wellbeing partnership that is drawing from housing expertise to improve the patient and GP experience.
Social landlords such as United Welsh have long contributed to the aims of statutory agencies such as the NHS through the provision of specialist housing, support and befriending schemes.
Our staff are well trained to engage with people who are in a challenging social situation with lifestyle habits that have a detrimental impact on their health, and we already work effectively with hard to reach groups in our existing services – leading to positive outcomes for individuals and communities.
Improving wellbeing amongst tenants and the wider community has therefore been part of our business strategy for a number of years.
Wellbeing 4U is a community wellbeing service delivered by Thrive, the team that manages specialist accommodation and support services for United Welsh. It is a joint partnership between United Welsh (provider) and the NHS (commissioner).
The aim is to deliver public health priorities through social intervention, focusing on increasing physical activity, improving diet, immunisation and screening uptake, and helping to reduce harmful habits such as substance misuse, heavy alcohol consumption and smoking.
Social prescribing is a big part of the project, which means staff are co-located in GP surgeries to provide assistance to GPs and members of the public by targeting key areas that can help to drive up health and wellbeing.
This includes uptake of immunisations, vaccinations and screenings of target groups, as well as signposting people to wellbeing and community activities such as healthy eating courses and exercise options and helping people through therapeutic approaches with issues such as depression or substance misuse.
It’s an exciting partnership for us as I think our links with the NHS are vitally important to provide the best possible services for people that come into contact with our services and the wider community.
The success of our current housing support services is underpinned by a strengths-based approach: the belief that focusing on people’s strengths rather than their deficits is a respectful and meaningful basis for helping people achieve positive, lasting change.
The Wellbeing 4U service is built on this approach – helping people to recognise their skills and abilities so they can achieve more and take control of their lives. It is currently offered in eight GP surgeries in Cardiff and the Vale. People can be referred to use the service through their GP or other primary health care workers, or alternatively they can refer themselves. Wellbeing 4U is delivered by specifically employed wellbeing co-ordinators, a team of six who work across the eight GP practices.
The results so far are wide-ranging. We are currently working with 35 patients across the eight surgeries and our contact involves a mixture of outreach, one-to-one work and signposting to community activities and the third sector.
In one surgery, we are also proactively working with a target group of 240 patients who have not engaged with the cervical screening programme.
One of the key outcomes of the service is a reduction on the pressure on GPs’ time. Our wellbeing co-ordinators don’t have the same time constraints so as well as freeing up medical appointment time they can establish programmes of intervention which can last as long as they are needed.
To date we have helped patients in the following areas:
- Access and engagement with the Education Programme for Patients
- One-to-one work focusing on emotional wellbeing for people with mental health challenges and victims of abuse
- Accessing parenting classes
- Grant and funding referrals for setting up a new home
- Helping people to find out what is going on in their local area with support to get involved
- Mental health awareness training
- Access to Foodwise weight loss group
- Access and support to engage with Action and Commitment Therapy
- Support and access to legal advice regarding benefit tribunals
In some cases we have also been able to provide advice and guidance that may have traditionally come from the GP, such as the referral to the Education Programme for Patients.
Another key outcome is prevention. People with a good sense of wellbeing are less likely to rely on statutory and professional services, and we have provided interventions which mean that a future visit to a GP can be avoided.
It is an agile way of working which can be easily adapted to any location. Wellbeing 4U works well with the co-location with GP surgeries but it could equally work within other health care environments.
Helping people engage with services
Alyson Vorres is a wellbeing co-ordinator based in Fairwater Health Centre and Caerau Lane Surgery in Cardiff.
‘We started working in the surgeries in early June and since that time we have engaged with hundreds of patients, helping them to achieve goals to change behaviours and enhance their life’s journey.
‘It’s really about bridging the gap between the practice, local community and support services within the third sector.
‘We’re helping people to engage with other services rather than primary health care, making the most of what’s available in the community to help people build long-term relationships and support networks that will help them make and sustain the life changes they want.
‘The support from GPs and practice staff in referring patients has been really encouraging, but we’re also working with patients who have referred themselves.’
In the surgery
We save money and time for statutory services. The case study below is one of many examples.
Mr A, a 76-year-old man, was referred to us because of the high number of GP visits he was making. During the period January to June of this year has had attended on 47 occasions. Mr A has several conditions including diabetes, heart and lung issues as well as mobility issues. Mr A used to enjoy going for walks but due to his health problems his family have restricted his activity and he has not been allowed to drive further than the mosque or local shop. Mr A also felt he was not being supported well enough by his GP.
Support provided includes emotional support, liaising with his family, referral and attendance for massage therapy, preparation for Route to Wellness programme due to start late September. Since being involved with Wellbeing 4U, Mr A has only attended his GP once during a two-month period.
Cost of the 47 visits from January to June: £2,107.95
Number of visits prevented over two month period: 15
Costs saved in the two month period: £650.33
Cost savings over 12 months: £3,946.80