A new service for Portsmouth – what you told us

We are planning a new service for Portsmouth, which is intended to offer a different way of supporting people’s emotional and mental health.

The service will offer both booked and ‘drop-in’ slots, with both professionals and peer supporters. We wanted to check in with city residents whether we were on the right track, and what you thought of a couple of possible names.

Almost 300 people responded to our survey, and a quick summary of the headline findings can be seen here.

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Local NHS team sets the national standard for improving foot care for patients with diabetes

Diabetes is one of the most common chronic diseases in the UK and its prevalence is increasing.

In 2013, there were almost 2.9 million people in the UK diagnosed with diabetes. By 2025, it is estimated that more than 5 million people in the UK will have diabetes.

In England, the number of people diagnosed with diabetes increased by approximately 53% between 2006 and 2013, from 1.9 million to 2.9 million. The life expectancy of people with diabetes is shortened by up to 15 years, and 75% die of complications i.e. stroke and heart disease.
The risk of foot problems in people with diabetes is increased, largely because of either diabetic neuropathy (nerve damage or degeneration) or peripheral arterial disease (poor blood supply due to diseased large and medium sized blood vessels in the legs), or both.

Peripheral arterial disease affects 1 in 3 people with diabetes over the age of 50. Diabetes is the most common cause of non traumatic limb amputation, with diabetic foot ulcers preceding more than 80% of amputations in people with diabetes. After a first amputation, people with diabetes are twice as likely to have a subsequent amputation as people without diabetes.

Mortality rates after diabetic foot ulceration and amputation are high, with up to 70% of people dying within 5 years of amputation and around 50% dying within 5 years of developing a diabetic foot ulcer.
If the early signs of an ulcer developing are not picked up or acted upon swiftly, the possibility of more significant problems leading to amputation can occur.
Against this background, a team from the Wessex Cardio-Vascular Network which is based in the local Southampton office of NHS England and covers Hampshire, the Isle of Wight and Dorset, reviewed all local services for good practice and to identify potential gaps in service. The aim of this was to reduce the overall incidence of patients’ suffering from ulceration and amputation.
The team’s work has now been recognised by the National Institute for Health and Care Excellence (NICE), the body which provides national guidance and advice to improve health and social care. NICE has published this work as the standard foot care guidance that should be followed by clinicians nationally, when providing care to people with diabetes.
As part of the National Diabetes Treatment and Care Programme, NHS England invested £42 million in 2017/18 in proposals to improve the treatment and care of people with diabetes, and is one of four key priority areas targeted by NHS England for diabetes transformation funding.
Sally Rickard, Associate Director, Clinical Senate and Networks, NHS England South, said: ” The team here, working with a number of our clinical colleagues across the area, have done a fantastic job in standardising what is now acknowledged by NICE as the best, standard practice for providing foot care to diabetic patients. This work will make a tremendous difference to patients, and at the same time will save the NHS significant time and money, through improved efficiency and effectiveness. We are all very proud of their achievement.”

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Around 20,000 patients use Portsmouth’s new 24/7 primary care service

Portsmouth’s new 24/7 Integrated Primary Care Service (IPCS) has already had more than 20,000 patient contacts.
The service, launched at the end of June 2018, offers patients registered with a city GP practice improved choice and access to out-of-hours care.

It has linked three services for patients needing urgent out-of-hospital care – the Acute Visiting Service (AVS); the extended access service and out-of-hours provision.

New figures show that the number of people accessing the service is around 3,000 a month on average.

More than 19,000 patients have used the Extended Access and Out of Hours scheme – around 40% of whom have required a face-to-face appointment, with the others “managed virtually” – by advice or prescription over the phone.

And nearly 2,600 patients have benefited from the Acute Visiting Service. Of the 332 home visits undertaken on behalf of GP practices in December 2018, 95% were managed by the visiting GP in their own home, many of whom will have avoided conveyance to hospital.

Of the 162 patients (7% response) who have so far responded to a new virtual patient feedback mechanism, 96% recommended the service.

Patients particularly praised the quick response time to speak to or see a clinician, the positive attitude, kindness and compassion of staff, the fact that they felt listened to, and that they received treatment when it was needed.

You can read the full story on the CCG website here.

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Southampton and Portsmouth awarded funding to tackle mental health stigma

Portsmouth and Southampton have been selected as one of eight areas in England to tackle mental health stigma locally after winning a bid to become one of 2019’s Time to Change Hubs.

Time to Change Southampton & Portsmouth will work to change the way we all think and act about mental health problems. It is an exciting partnership between Portsmouth and Southampton City Councils, local mental health charity Solent Mind and local people who are Time to Change Champions.  The Hub will support communities, workplaces and schools to end negative attitudes and behaviours towards people experiencing mental health problems in their communities.

Anna Fiers, a local Time to Change Champion, says, “I am thrilled at the news. As a Time to Change Champion, having access to the Hub will make it easier for me to connect with other champions, organise events and work together on voicing our important message.”

Each funded Hub is provided with £15,000 start-up budget along with £10,000 for a Champions Fund where local champions can bid for funding to run stigma-busting events and activities within their area.

Kevin Gardner, Solent Mind CEO, says, “I am delighted that Solent Mind is working in partnership with Southampton and Portsmouth City Councils to bring a Time to Change Hub to our area. This is a wonderful opportunity to achieve genuine change around how we think and talk about mental health. We will be harnessing the power of people’s personal experiences to tackle mental health stigma and discrimination.”

Councillor David Shields, Cabinet Member for Health and Community Wellbeing, Southampton City Council, said, “This is great news for our city. Being a Time to Change Hub will enable us to build on the good work taking place at the council and in our communities, and particularly, in ensuring that those with lived experience can use their skills and talents to lead local action on tackling mental health stigma. Mental health issues affect one in four of us, and touches many of us throughout our lives. That’s why we need to engage with all sections of society — families,  businesses, education establishments, public services, community organisations, unions and faith groups – to address stigma and discrimination ‎in our city.

“Southampton City Council has demonstrated a strong commitment to tackling mental health stigma for a number of years, including our support of Time to Talk Day and signing the Time to Change Employer Pledge last year, to address mental health issues in the workplace.”

Councillor Matthew Winnington, Cabinet Member for Health, Wellbeing and Social Care at Portsmouth City Council, said, “I’m thrilled that Portsmouth and Southampton have jointly been chosen to become a Time to Change Hub. There is still a lot of misunderstanding and stigma around mental health and it’s an issue that I’m passionate about. Through becoming a Time to Change Hub we’ve got a real opportunity to get people across the city talking about mental health, and in doing so positively change how people think and act around it.

“To further demonstrate our commitment to supporting people with their mental health I’m pleased to be taking on the role of Mental Health & Wellbeing Champion within the council and am looking forward to this being one of many projects we’re involved in to make it easier for people in the city to look after their mental health and wellbeing.”

Time to Change, the national campaign run by charities Mind and Rethink Mental Illness, launched its first regional Hubs in March 2017.

The announcement of eight further funded Hubs, including Portsmouth and Southampton, is part of the campaign’s three year plan to establish a network across England to provide a focus for local campaigning work.

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Take part in helping to shape health and care schemes in Portsmouth.

Can you spare some time to help design better care for Portsmouth people?

The NHS and Portsmouth City Council are working on a series of projects that will help shape the way health and care is delivered in the city. But rather than just giving your feedback, we want to work differently so that you are involved from an earlier stage to really help design care around the patient.
Two sessions are currently being arranged to provide more information on how we will work together and further details on two projects we have in mind will also be discussed. Once the group is set up we would hope to work with you for up to 18 months on different projects.

The two sessions are due to take place in the week beginning Monday March 18, and are likely to take up to five hours on each of the days. Refreshments, including lunch, will be provided and you will be reimbursed for any travel expense.

Coming to both sessions is desirable so you are able to fully understand how this new way of working will be carried out.

The two projects we would initially like to talk to you about are:

  • a long term conditions hub focusing on people recently diagnosed with Type 2 diabetes or those who have a chronic respiratory disease such as asthma or Chronic Obstructive Pulmonary Disease (COPD)
  •  a mental health support service that aims to help people facing a wide range of challenges such as bereavement, work-related stress, isolation and loneliness or a relationship breakdown

Anyone living with or having had experience with these will undoubtedly have an immense amount of knowledge on which areas work well in health care, but also where changes can be made.
This is a great opportunity to get involved and help shape the way a health and care service works. Whether that’s input from a patient point of view, help to make language used easier to understand, or making sure we are sharing the right information – we want to hear from you.

To find out more please contact Jo Atkinson on j.atkinson2@nhs.net

or call (023) 9289 9541

 

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Health and care survey returns – have your say!

The 2019 Different Conversations survey is now open and we need your input!

The way we deliver health and social care is changing. Part of this change is about making sure that the people we support receive personalised care that works for them. This survey will help improve our understanding of how confident the people of Portsmouth are about making choices about their own care.

The survey is available for individuals and carers, with individuals rating their own care and carers completing it with the view of them being the carer for someone else and how their knowledge, skills and confidence supports the individual they care for. In 2018 140 individuals completed the survey, with 24 carers also taking part –  Portsmouth City Council and Portsmouth CCG are working together to carry out the 2019 Different Conversations survey, hoping to involve even more participants this year in order to get an even better idea of patient activation levels in Portsmouth.

To take the survey now, click here

For more information on this survey and why understanding levels of patient activation is important, please visit the NHS website here

 

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Phase 2 of Your Big Health Conversation has now ended – here are the first findings

Phase 2 of Your Big Health Conversation – an ongoing engagement project running across the three CCGs serving Portsmouth, Fareham and Gosport, and South Eastern Hampshire –  has now ended, and an initial, high-level presentation of the findings is now available and can be found here.

The second round of engagement work focused on face-to-face discussions with patient and carer groups from across the wider Portsmouth and south east Hampshire area, seeking views about four specific topics: community-based mental health care; frailty; same-day services, and supporting those living with long-term illnesses.

Some of the insights received, to inform our thinking about how we can best deliver new models of out-of-hospital care, include:

  • A strong sense of ‘computer says no’ from people living with mental illness – they often perceive services which are designed to suit the NHS, not them, and feel that they have to fit themselves into the NHS structure, rather than the NHS flexing to meet their personal needs
  • The sense of burden that people living with several long-term illnesses may feel, confronted by systems which can often break down and leave them with the task of chasing up results, rearranging appointments, or being left in limbo between different departments with nobody able to promote their interests
  • The importance of recognising that people who are extremely frail can also be extremely isolated, and that helping them tackle loneliness can be just as important as addressing physical health needs.

A public-friendly summary of the feedback we received can be found here. (A much more detailed, full report will be available shortly.)

For more information visit www.portsmouthccg.nhs.uk/Join-In/your-big-health-conversation.htm 

 

 

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HIVE: There’s a new buzz around Portsmouth Central Library

The HIVE Portsmouth City Centre

HIVE Portsmouth is a project bringing together people from the statutory, voluntary and community sectors to build a healthier, happier and more connected city.

As well as finding innovative ways to deliver services for the people of Portsmouth, HIVE Portsmouth will also provide information, advice and support. We’re creating a shared office space in the lower ground floor of Portsmouth Central Library.

My Time, a service providing support for unpaid carers and Social Prescribing Portsmouth, a service providing non-clinical support to people struggling with a range of issues, will be first to move in.

To find out more click here

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MCP Away Day

On Friday 7 December the Portsmouth MCP programme held an away day to review the progress of the partnership and agree priorities moving forward.

The partnership, made up of Portsmouth Primary Care Alliance (PPCA), Solent NHS Trust, Portsmouth Clinical Commissioning Group (CCG) and Portsmouth City Council (PCC), have committed to work together to meet the challenges facing health and care services in the city. This will be achieved through the development of new models of care that dissolve the traditional boundaries between the delivery of primary care, community health, and social care and hospital services.

The afternoon marketplace presented information on each of the projects and was attended by staff from PCC, Solent, CCG, GP practices, voluntary organisations, Healthwatch, MP’s, councillors and colleagues from health and care services in Fareham, Gosport and South East Hampshire.

Portsmouth MCP away day presentation

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Personalised care success

Personalised care means people have increased choice and control over the decisions that affect their own health and wellbeing.
There is no ‘one size fits all’ model for personalised care with the emphasis on empowering individuals who access health and care services in a way that fits them as an individual and the goals they set themselves.
Personalised care includes,
• Shared decision making – people are supported to understand the care, treatment and support options available and the benefits and consequences of the options

• Supported self-management – people are supported to develop the knowledge and confidence to manage their health and wellbeing through health coaching or peer support

• Social prescribing and community based support – people can access community connection projects to enable them to be connected in to community based support

• Personalised care and support planning – people have a personalised conversation and plan based on what matters to them including identification of their needs and their health and wellbeing

• Personal health budgets – an agreed  amount of money to support an individual’s health and wellbeing needs as identified by the personalised care and support plan

Here is just one case of how this has worked well:

Mrs A:

Client is a 93 year old female who lives alone in the North of the City.

She was referred to the Community Connector Service via the Red Cross.

Client suffered a stroke in 2017, after a long hospital stay she was discharged home with support from the Red Cross. Red Cross discharged and referred to the service.

Resulting from the stroke this client has reduced sight, which she finds frustrating. She has had a recent diagnosis of breast cancer and has had a bad fall in her garden; all this have impacted on her feeling vulnerable. The client has not been out of her home alone since July 2017. She is lacking in confidence and has anxiety.

Client’s mobility is restricted, she mobilises with a four wheeled trolley and walking stick indoors. She was issued a three wheeled walker for outdoors from hospital discharge but due to living on the hillslopes and having several steps to get in and out of her home it was restricting her to use the three wheeled walker, it was unused and kept in the shed.

There were several restrictions to her being able to get out of her home which creates a barrier for her to be able to access the community independently and safely. She has lived in her property for many years and does not feel that she would like to move from her family home.

Client used to mobilise independently, socialise with friends, enjoying shopping and having lunch, she was confident to use public transport but on referral feels lonely and isolated, having to rely solely on her friends to take her out.

Client does not feel safe to go out on her own and was anxious of falling again.

Goals

  • To regain confidence and reduce anxieties.
  • To join a new group and meet new people.
  • To be less reliant on her friends.
  • Improve her skills to use her walking aid.
  • To reengage with the Salvation Army Befriending service

Intervention

  • Community Connector assessed the property and arranged adaptations to be completed to the outside of the property to make it safer and accessible to get outside, this included installing clamp rails, grab rails, rehanging of garden gate and concrete infill to outdoor steps.
  • After discussion with client it was evident that she was unable to use the three wheeled walker due to its weight. A four wheeled rollator was ordered.
  • Supported to reengage with Salvation Army Befriending service.
  • Supported with walking practice with rollator and to regain confidence to use public transport and taxi service.
  • Mrs A was supported to join a new social group in the area she lives.
  • Mrs A was supported to arrange Meals on Wheels.
  • Referral to Good Gym for a befriender.

Outcome

Client’s confidence has grown to use the four wheeled rollator.

Using the newly installed rails makes her feels less anxious about falling and enabling her to access the outdoor space to the property independently also to be able to enjoy her garden again.

After confidence practice sessions to use the bus she felt that due to the distance to the bus stop and living on the hill slopes that she would feel happier to take a taxi

Client now attends a local social group, has met new people and enjoys the company, conversation and activities. She is now arranging to meet friends for lunch independently.

The Salvation Army Befriending service have reengaged and continues to visit, they have arranged for an old friend to visit for afternoon tea and client is waiting to be paired to a befriender from the Good Gym.

Client reports she now feels that she is enjoying socialising again, feeling less lonely and no longer feels that she is isolated. Client said that she feels a “great sense of achievement”.

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