IESD case studies
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IESD case studies IESD case studies Presentation Transcript

  • IESD 2013 – 2014 Posters
  • Advocacy in Wirral PARTNERING WITH University of Liverpool Addressing mental health inequalities: integration of a non-medical mental health model into primary care Merseyside Key Objectives This project aims to address the growing burden of mental health problems within the community through developing innovative approaches for accessing care in the primary care setting. Our particular concern is to address inequity of care provision for people with complex needs. We will do this by integrating a new service into primary care: offering innovation in access to care in terms of how needs are assessed. There are 2 elements to our planned change – influencing how GPs discuss mental health issues with patients presenting to them; and providing ready access to the non-medical needs assessment process that is the AiW model. This innovation project will deliver on 3 aims: to integrate the AiW model into a primary care (general practice) setting – being the context in which we know our target groups often seek help; to apply the model and deliver care to clients over a 12 month period, supporting by an integrated evaluation run on action-learning principles to identify learning and benefit for patients, primary care teams, health services, and communities; to inspire wider change in service design and provision through disseminating learning through conversations with commissioners, education programmes, community groups. Outcomes Based on AiW’s past experience of delivering care, we anticipate our proposal will improve productivity of services through delivering i) improved mental health outcomes ii) reduced service use including GP appointments, medication use and referrals to specialist mental health services through better targeting of care to needs (see below) and through enhancing resilience. Improved outcomes for individuals will include improved mental health and improved daily living (engagement in meaningful occupation, quality of life) Improved outcomes for primary care in addressing inequalities will include: i) improvements in candidacy (in people identifying themselves as eligible for care, and improved uptake by hard to reach groups; ii) improved concordance (satisfaction and engagement with service, including evidence of self-activity e.g. engagement with meaningful occupation); and improved recursivity (resilience, less repeat GP visits) The innovation will improve productivity for service users by targeting access to the most appropriate and best care to support individual needs. Currently the primary route of access to support is through General Practice, and assessment of a PHQ-9 score. From there people may be referred to IAPT services, or similar, for support. During the needs assessment and intervention process, practical problems which both contribute to distress and limit recovery are often identified. It is only at this stage that individuals may be referred on/flagged up for practical support. Experience at AiW highlights that for some people, especially the exemplar groups highlighted, addressing practical problems at the outset can improve mental health outcomes and avoid unnecessary/inappropriate medicalisation of distress. Delivery Methods Through GP practices, and working with Health Care Professionals Dissemination i) Negotiation with local commissioners for continuation of the local service ii) Hold a stakeholder conference/workshop to discuss innovation in needs assessment with national stakeholders and explore how stakeholders can integrate findings into their own context. iii) Outreach: development of educational packages for potential future service providers and for GPs on how to assess mental health needs using a non-biomedical approach. iv) Reports and publications via clinical and academic journals, social media, AiW/CPCD websites and via press releases. Service Users In particular, our work has focused on supporting traditionally disadvantaged groups: including those with complex mental health needs (ADHD, PD, MUS); people with comorbidity; and vulnerable groups from socioeconomically deprived communities e.g. those who are unemployed or at high risk. We will target a population who may experience depressed mood as a result of feeling ‘overwhelmed’ or exhausted by the pressures (practical problems) of daily living (Reeve et al 2009).
  • AVA (Against Violence & Abuse) In partnership with the Institute of Psychiatry Promoting recovery: improving mental health service responses to violence against women Key objectives: To introduce a recovery-based ap- proach to working with mental health patients who are victims of violence against women. We will work strategi- cally with two Mental Health Trusts to develop Trust-wide responses which move beyond managing risk to also fo- cus on recovery. Delivery methods:  Provide expert input to Trust safeguarding, clinical and recovery frameworks to develop holistic re- sponses to VAW  Mentor team managers/senior practitioners to become VAW champions for their service  Deliver train the trainer training and develop a VAW competency framework to inform long-term workforce development  Strengthen relationships with local VAW services Outcomes: 1. Clearer strategic framework to implement work around violence against women 2. Improved practitioner responses to vio- lence against women 3. Improved experience of services for pa- tients who are survivors of abuse Service users: Our service users are sur- vivors of domestic and sexual violence who access a range of mental health ser- vices in two Mental Health Trusts in Eng- land. Based on current research, we esti- mate that around 30% of female mental health patients and a smaller number of male patients in each Trust will benefit Dissemination: We will dissemi- nate our findings through our estab- lished networks of domestic and sexual violence, mental health and substance use practitioners, policy makers and academics. Together with our partners, we will write arti- cles for journals and practitioners publications.
  • Age Concern Yorkshire & Humber PARTNERING WITH Age UK Barnsley, Age UK Wakefield District, Age UK Bradford District, REACT Together for Health Barnsley, Wakefield, Castleford, Bradford, Keighley, North Yorkshire Key Objectives • Design a referral process for health and social care professionals to ‘prescribe’ Age UK interventions for older people • Motivate and link older people into their community and networks of support • Offer activities in local communities using volunteers • Evaluate how we identify older people who are isolated and lonely so people who are functioning in their homes can also function in their communities Outcomes • Older people feel less isolated and levels of loneliness is reduced amongst disadvantaged older people • Older people need less health interventions because they are independent / have support networks in their community • The voluntary sector has a role in integrated health and social care teams Delivery Methods • Work with secondary care and integrated health and social care teams to identify older people in need of support to link into their community • Use LEAF (an outcomes assessment tool) to help older people assess their own needs, identify the changes they need to make to take control of their lives and their own health and wellbeing • Recruit volunteers to run activities in local communities Dissemination • To Age UKs nationally through national communication channels • Through national and regional networks of commissioners and publications • To older people through forums; Age Action Alliance and DWPs AGEnda Service Users • People over 50 who are at risk of being lonely or isolated. The risk factors could be they live alone, are recently bereaved or divorced, prone to falling, family lives far away, becoming a carer or giving up caring, retirement. AND • Their health is affected by their loneliness and isolation: they have been in hospital in the last 12 months; they are a ‘frequent flyer’ at their GP or A&E.
  • ARTWORKS CREATIVE COMMUNITIES PARTNERING WITH THE CARE QUALITY COMMISSION (CQC), UNIVERSITY OF CENTRAL LANCASTER AND THE SPEAKOUT NETWORK ENGAGE FOR CHANGE England Key Objectives • To empower users of services to influence the direction of health and social care. • To equip users of services with the skills to collect feedback and act as advocates on behalf of their communities. • To help to drive improvements in service quality and outcomes for users of services. Outcomes • Increase in the skills and knowledge and of service users • Increase in numbers of service users who provide feedback on health and social care services • Improved services resulting from improved feedback • Increase in the use of the SpeakOut network by other national and local organisations to consult with hard to reach and disadvantaged groups Delivery Methods Development of training package which: • Provides a number of easy to access and use routes for feedback into health and social care systems • Increases health and social care information sharing within communities • Provides individuals and communities with a range of skills to understand and challenge systems in relation to their access to health and social careDissemination The final report will be widely disseminated through health and social care networks using the access to these networks that CQC enjoys. It will demonstrate the impact simple creative techniques for consultation, engagement and feedback collection and the use of these tools in system design can have on allowing the voice of those most affected by health inequalities to be heard. The training will be available for further individuals and organisations to use. Service Users We will work with members of the SpeakOut network, a national network of over 80 groups who represent hard to reach and disadvantaged communities across England. We also hope to work additionally with members of Local Healthwatches across the country.
  • Bliss – The national charity of the newborn The Bliss guide for families of late pre-term and sick babies National Key Objectives • Building on the success of the Bliss Family Handbook we will provide a new publication which focuses on the needs of families with later pre term babies born after 32 weeks. • Drawing on evidence that the needs of this group of parents is not being met, we will provide an information resource which supports parents of later pre term and sick babies supported by online information. • Improving health outcomes for parents and babies born between 32 – 36 weeks. Outcomes • Improvements in health outcomes to babies born between 32 – 36 week gestation. • Increasing the confidence of parents. • Increased take up of information by ‘hard to reach groups’. • Enabling parents to take greater responsibility for the care of their baby while in the neonatal unit and to help them interact confidently with neonatal healthcare professionals. • Reduction in parental anxiety by providing practical support. • Healthcare professionals gain better appreciation of the needs of parents with babies in these categories resulting in improved outcomes for babies. Delivery Methods • Establish working group consisting of staff, parents and healthcare professionals to develop the new Bliss guide. • Writing and editing of new guide. • Series of short videos researched and produced. • Web based resources developed. • 40,000 guides printed. • Distribution to all neonatal units in England. Dissemination • Promotion of the new guide in all neonatal units across the UK. • Distribution of 40,000 guides per year. • Evaluation of the guide with relevant stakeholders and by external independent evaluator. • Disseminate relevant findings with our partners in Perinatal support networks. Service Users • Families of the 42,000 babies born between 32 – 36 weeks facing their own unique health and developmental challenges. This document and online resource will directly support the parents whose babies are born between this gestation. • Healthcare professionals. • Increasing access to support for young parents and BME groups.
  • + Books Beyond Words (BBW) Books Beyond Words Social Enterprise Working Nationally Key Objectives Over three years Books Beyond Words will build its capacity to assist more people with learning disabilities to understand their situations, access information and participate fully in making decisions. Books Beyond Words will continue to develop as a social enterprise, with sustainable core income, by: • increasing accessibility to our books • developing our training for using the books in different contexts • developing partnerships for collaborative work, including book clubs Outcomes Improved ability of carers and professionals to • recognise the needs of people with learning disabilities • understand their situations • develop person centred responses to needs of each person with learning disabilities More people with learning disabilities: • having access to in-depth communication tools • greater involvement in the personalisation of their own health and social care Books Beyond Words developing • a strengthened core team and finances, to build its capacity to fulfil its mission to support people with learning disabilities. Delivery Methods • Increasing the staff team to build the capacity of the organisation Creating eBooks of all 39 titles in 6 languages, including out of print titles, to increase accessibility. This includes over 50 healthcare scenarios being available for health professionals to access electronically • A variety of training courses to help careers and professionals use the books • Partnering with local libraries and organisations to develop Book Clubs Dissemination We will work with a university or research student to undertake a process of measuring the quantitative impact that Books Beyond Words makes in the lives of people with learning disabilities, and the help they offer professionals. We will also undertake qualitative research on how these books, and the method of picture story-telling, effect the situations, understanding and decisions of people with learning disabilities. Service Users The books, eBooks, clubs and training all benefit people with learning disabilities to access information, explore their own lives, and take part in the decisions and situations which affect them. The books are used by family carers, support workers, or health and social care professionals, who are trained through the books and/or training resources and workshops
  • Books Beyond Words PARTNERING WITH THE GLOBAL FOUNDATION FOR ELIMINATING DOMESTIC VIOLENCE (EDV) AND RESPOND BOOKS BEYOND WORDS: SURVIVING DOMESTIC ABUSE National Key Objectives • To develop and publish a picture book that will directly benefit those experiencing domestic abuse as well as their supporters and health and social care workers • The book will be a communication, educational and preventative tool that will focus on: • personal safety and reporting • giving people with learning disabilities a better understanding of abuse • helping people know when to seek help Outcomes Books Beyond Words: Surviving Domestic Abuse will • Improve the quality of care of people with learning disabilities who are in abusive situations • Provide health and social care professionals and advocacy workers with a book illustrating best practice • Be available in an eBook version from www.booksbeyondwords.co.uk Bespoke training will be provided for those working in a therapeutic setting. Delivery Methods • An Editorial Team of three authors and an artist creates the storyline with about 50 pictures . The team is supported by: • an advisory group of experts, including four people with learning disabilities who monitor the pictures and agree • an extensive picture trialling by individuals and groups of people with learning disabilities • the authors prepare the text, including a storyline and guidelines for supporters, health and social care professionals Dissemination The book will be available in all areas of the UK, and also worldwide. It can be ordered through bookshops and Amazon UK as well as from our website. It will be promoted by the websites of our partners EDV and Respond and at their conferences and seminars and, in the case of the latter, to individuals and groups of people with learning disabilities who are being abused. We will also advertise training workshops, focussing specifically on Surviving Domestic Abuse. Service Users Service users with learning disabilities in advocacy groups and NHS units in different parts of the UK play a vital role in the development of the book by trialling the pictures, making sure they will be understood by future readers. Pictures can be re-drawn if they cause anxiety or are not understood. Their comments also inform the text of the book which is written after the picture trialling.
  • Breakthrough Breast Cancer Embedding patient partnership and service improvement through the Service Pledge Key Objectives • To ensure patients’ feedback on their local breast service is embedded in the process of improving services • To understand patients’ experiences of their local services using comprehensive questionnaires and face to face interviews • To ensure improvement goals are set and reached based on this feedback • To ensure seldom heard groups of patients are involved in this process Outcomes • Breast cancer patients will receive the best possible care appropriate to their situation and clear information on what to expect from their local breast service throughout their treatment • Impact of improvements in patients' care will be maximised because they will reflect local patients’ key concerns. • A sense of joint ownership and a genuine culture of partnership between healthcare professionals and patients will be created. Delivery Methods • At each participating breast unit, patient surveys and interviews are conducted that enable patients to comment on the service they receive and recommend areas for improvement. • Breast units use the information gathered to review their existing services and agree feasible improvements with patient representatives. • A Service Pledge booklet is published for each unit and is given to breast cancer patients at the point of diagnosis. The booklet contains both the standards of care patients can expect to receive at every stage in their treatment journey and commitments to making a minimum of three improvements within a specific timescale. Dissemination Through active sharing of best practice and learning via Cancer Networks, events and the publication of a Pledge programme, other charities and NHS organisations could adopt Breakthrough’s model and apply it to services within their field of expertise – an efficient and effective method of achieving objectives and improving standards of service user involvement. Service Users 50,000 women are diagnosed with breast cancer each year in the UK. Breakthrough Breast Cancer works with hospital breast services around the country, aiming to ensure each of these women is offered the best possible care. We have spoken to 10,000 patients at over 50 hospitals so far, implementing improvements for up to 30,000 patients.
  • Bristol Drugs Project 11, Brunswick Sq, Bristol BS2 8PE Enabling independence and inclusion amongst older marginalised drug and alcohol users. Key Objectives Older drug and alcohol users are hidden, marginalised, socially isolated, have a high burden of ill health and under-consult primary care. We aim to develop a substantial service for this group to: • build confidence and enable re-enfranchisement • open doors to drug and alcohol treatment and promote Hepatitis C testing and treatment • promote life-long learning, access to training, work and pensions • improve relationships with families/concerned others We will recruit 90 people over three years and involve Peers with lived experience at every stage in planning and delivery. Outcomes (Arial 14) • Increased numbers accessing support for drug and alcohol misuse problems • Reduced substance misuse resulting in earlier consultations, and better outcomes in primary care for age-related and other complaints • Over 50% of injecting drug users in Bristol have Hepatitis C, very few are treated. We will encourage, facilitate and support Hepatitis C treatment. • Improved self-confidence, reduced anxiety and health gains leading to improvements in housing security, family and community relationships and access to learning, training and employment Delivery Methods A fulfilling ‘day care’ programme with the following components: • social group, building on existing weekly provision • topic-based ‘recovery’ groups for reducing problematic drug and alcohol use • arts and community engagement groups • supported by Peers with lived experience • key-working and care-planning for individuals Dissemination Training to local organisations working with older people to: • raise the profile of older drug and alcohol users in Bristol • understand the stigma and discrimination preventing access to services • identify and signpost older drug and alcohol users to our service Writing for national journals to: • inspire drug and alcohol services to establish age-specific projects • provide a mentoring role to those wishing to replicate the service • alert professionals working with older people to the hidden nature of substance misuse and the potential for change and recovery Presenting posters and an academic paper at the end of the project Service Users A group of hidden and highly marginalised drug and alcohol users aged 50 and over, who do not access services, under-report their substance use and delay consulting about other health complaints. They tell us they feel isolated, lonely, fearful of services for younger people and shameful of their on-going substance dependence. We know that older drug and alcohol users: • can have poor psychological and physical health and longer hospital stays • do well in treatment with age-adjusted detoxification and rehabilitation regimes • may experience late-onset substance misuse triggered by psychological and health problems associated with aging.
  • British Association of Dermatologists Psychological Support for Skin Conditions online resource Objectives • To create an interactive, mobile-phone accessible website for sufferers of skin conditions seeking psychological support. • To unite the specialties of dermatology and mental health, which have a significant overlap. • To bring together, and link to, existing disease specific resources, support groups, forums and help-lines. Outcomes By being able to see easily the range of options available, skin patients will be able to make better informed choices about their health and care and understand how to access the help that they need. We will provide guided, personalised access to self-help tools, information on support groups, and advice on types of guided therapies and other psychological interventions. Delivery Methods We will work closely with patient/service user representatives who will input into each stage and we will be working alongside a multi- disciplinary panel of medical professionals and experts. We will also involve the different skin condition-specific support groups and other patient/public stakeholders. The involvement of patients/service users and public stakeholders at every step of the development process and testing of the resource will create a body of advocates for the project and its aims. Dissemination • Parliamentary launch, press event, separate stakeholder event launches. • Reflective learning symposium. • BAD’s literature and at the BAD’s national events • Partner organisation’s literature and events • Key professional stakeholder groups • Key patient support groups Service Users • Skin conditions and their associated psychological burden affect all ages, ethnicities, genders and social demographics, and the website based resource would be available freely to all. • The website will also have an area for use by medical professionals.
  • The Child and Adolescent Mental Health Services (CAMHS) Evidence Based Practice Unit (EBPU) at the Anna Freud Centre CAMHSweb: Web Supported Care in CAMHS Working with CAMHS nationally Key Objectives • To develop an innovative interactive portal and support package to promote self-management and shared decision making in CAMHS. • To increase access to new and developing forms of information that promote choice and control so children and young people accessing CAMHS are actively engaged in their health and care at all stages along the clinical care pathway. • To enhance engagement and service efficiency Outcomes We anticipate the portal will aid the following areas: • Clinical outcomes will be improved in terms of both symptom change and functioning. • Collaborative working and shared decision making will enhance patient experience. • Increase efficiency in CAMHS in various ways including shortening the number of sessions needed to reach positive outcomes, enhancing interagency integration and reducing DNAs. Dissemination • All learning and best practice materials will be made freely available and accessible for use across the NHS and beyond. • Findings will be disseminated through a range of media including peer reviewed publication, conference presentation and research reports. • A major focus is to ensure the findings have real impact on the management of health services and on improving practice and service delivery in the NHS. Delivery Methods • Recruitment of services to test and use the portal • On-going consultation and iterative feedback process to enhance portal • Training in use of the portal • Delivery through range of mobile and digital technology platforms Service Users Service users are and will remain key contributors to this project: • A number of young people involvement groups have already been consulted on aspects of the design of this project and their views have been incorporated in shaping and refining the proposal. • Service user focus groups • Service users will form part of steering groups • The portal will support some of the most vulnerable and disadvantaged groups in our society to ensure their voices are heard and that they are central to the clinical interaction.
  • Council for Disabled Children PARTNERING WITH National Children’s Bureau Right to Voice Geographical area project will cover: England Key Objectives • To enable commissioners and those responsible for developing JSNAs to see how they can ensure that children and young people’s voice and priorities are woven into their work • Ensure that the concepts and rights enshrined in the NHS constitution are accessible to children and young people • Ensure that professionals throughout the health system understand what those rights mean in practice Outcomes • The effective involvement of children and young people in their own care will have a beneficial impact on their physical and psychological health, but will also lead to improvements in services. • With children and young people better able to understand how to make the health system work for them we would expect in the longer term to see increased treatment compliance and a decrease in ‘do not attend’ figures • Ensuring children and young people’s voice is effective will make the system safer for vulnerable children and young people. Delivery Methods • Desk research and advisory group to ensure project builds on existing knowledge and practice • Work with 6-8 CCGs and Local Healthwatches to understand the resources and additional support they need to enable them to effectively involve children and young people. Deliver support. • Work with children and young people to co-produce those resources • Work with young people to produce materials for young people informing them of their rights under the constitution; including an accessible version of the constitution Dissemination CDC and NCB have extensive membership networks which reach out to professionals, children and young people and parents. Dissemination will include children and young people themselves in terms of the materials aimed at them and professionals working with children and young people. Materials for CCG and Local Health watch organisations will be disseminated through local networks. We will also work with NHS England and appropriate Royal Colleges and Workforce and education Providers. Service Users Whilst this project is being led by the Council for Disabled Children (CDC) we are working closely with the National Children’s Bureau (NCB) and will be involving disabled children, those with long term conditions and those identified as vulnerable: young carers, young people in and leaving care, and those in the youth justice system.
  • Dementia Adventure CIC Connecting people living with dementia to nature Natural Leaders "Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has." 2 posts covering the Midlands and the South of England in 2013 Key Objectives  To recruit, train and manage two new members of staff for Dementia Adventure in 2013, 1 in 2014, 1 in 2015  Business development & delivery  Enabling many organisations which provide services for people living with dementia to improve their approach and outcomes  We assume that the benefits of nature are universal and that by connecting more people with nature we will bring more health benefits to people living with dementia, reducing co-morbidity and increasing longevity. Outcomes  Enabling thousands more people living with dementia to live healthier, more active lives, resulting in fewer crisis points.  Higher quality personalised services for people living with dementia both for those living in care and in their own homes.  Care providers have better staff morale, lower turnover and reduced use of anti-psychotic medication.  National Dementia Strategy quality of life outcomes.  Greater social inclusion and equality for people living with dementia and their carers; greater visibility in social and green space.  To enable Dementia Adventure to become self-sustaining. Delivery Methods  Dementia Adventure is a CIC which seeks to connect people living with dementia to nature. We do this by providing training to providers of care to people living with dementia.  We use an approach called thinking differently, and use experiential training as much as possible, in natural environments  Consultancy at a strategic level to improve the variety of services across the board.  Providing adventurous activities on a small local scale which are easily replicable.  Working on innovative offerings with our partners and keeping an open mind. Dissemination  Video  Events  Social media  DA website  Email newsletter  Qualitative evidence  Quantitative evidence  Objective studies carried out by 3rd parties  Articles and books  Conference appearances  Awards Service Users  People living with dementia  Carers for people living with dementia  CCGs  Commissioners of services for people living with dementia  Green space providers & managers  Housing Associations  Day Care providers  Residential care providers  Natural Heritage organisations interested in social inclusion
  • Disabled Living Foundation (DLF) Reablement resource suite National Key Objectives • Create an innovative suite of web and mobile device applications (apps) designed to support individuals (and their families and carers), before, during and after the reablement process. • Provide a reference point for reablement teams, newly qualified OTs and care home staff. The information will be accredited by the DH’s Information Standard. • Raise awareness of assistive technology in general and specifically the kind of aids and equipment that may be provided during reablement or recommended for self purchase. Outcomes • Improved access to impartial advice & information relevant to reablement techniques and equipment whilst at home, in the office, or in the community. • This information is accessible beyond the 6 week reablement course. • Reablement teams and care home staff gain confidence and use the resources to build care plans. • Families and carers will feel better informed about reablement objectives and treatment plans. • Improved cost effectiveness of reablement services e.g. a reduction in the care hours required to support an individual in the home and reduced hospital re- admission rates. Delivery Methods The resources will be available to download free of charge and will be designed to work on a number of platforms to suit a range of budgets. DLF will aim to address the digital divide by ensuring that the applications are easy to use and are more intuitive than a computer, with the older user in mind. The information on techniques within the apps will have a web based PC version optimised for printing. Reablers will be able to select specific techniques suitable for their service users and print these out to leave with service users who have no access to a mobile device themselves. Dissemination DLF will disseminate effective practice from the project through our partners and allies including local authorities. Several of these have already licenced DLF’s web technology in the form of AskSARA. DLF will share its experience of creating and using the apps with these partners giving them the opportunity to use similar platforms to disseminate their information and services. Delegates attending DLF training courses will be shown the Reablement apps thereby increasing dissemination among their colleagues and organisation. Details will also be included in training newsletters and on our websites. Service Users The main users will be: a) Service users who are receiving reablement services or have completed a course of reablement b) Health care professionals delivering or supporting reablement services
  • East Lancashire Deaf Society BSL Health Trainer Project Lancashire Key Objectives • Raise awareness, engage and inform the Deaf community of healthy lifestyles & self care • Improve interaction and engage existing health services with awareness of the Deaf community • Create & improve independence and reduce dependency • Educate on healthy lifestyle choices; providing courses/training/information in their first language of British Sign Language • Work towards improving health inequalities Outcomes • Health inequalities to be improved with better access and communication • Clients to achieve independence and gain new skills • Outcomes to be measured through monitoring attendance, progress reports, questionnaires and observations • Reduce dependency on GP’s/ Hospitals Delivery Methods • Regular advice/support on 1-1 basis or in group settings • Provide & produce information in an accessible format • Develop & signposting Deaf people with self-care support and to run health & wellbeing sessions • Regular forums on various health topics • Publish articles via monthly newsletters • Deliver workshops and preventative work on specific topics through exhibitions Dissemination We will share our research/ findings through publications and working in partnership and networking with other Health Professionals/ Commissioners. The information we collate from the Deaf community will be delivered in different formats. This will be a unique project enabling the Deaf Community to access all Health Services as an equal. Service Users Potentially, and with closely-monitored research, the tally of clients in this region alone, is over 5,000. This is mainly aimed for Deaf people who use British Sign Language (BSL) as their first and as our main culture of language. The various backgrounds of support will be tailor-made for as follows:Elderly people, isolated clients, single parents, Deaf adults (no independency), employed/unemployed, on benefits, low educational standards to degree level.
  • Guide Dogs Guide Dogs Children and Young People’s Habilitation Service For England. “No one should have to endure the hell I went through as a kid, and at present they still do” John Hillbourne Trustee, Guide Dogs Key Objectives • To train more children’s habilitation instructors to national standards. • To increase the number of children receiving habilitation support from an early age across England. Delivery Methods ! Recruit 8 habilitation trainees to start September 2013. ! July 2014 – able to work in their teams as habilitation assistants. ! July 2015 – qualified to deliver habilitation training to national standards. Outcomes ! Once qualified (Sept 2015) in total 400 children per year will receive habilitation support from this cohort of graduates. ! Individual outcomes will be measured both clinically and qualitatively to build the evidence for more support of this kind. Service Users ! 43% of parents surveyed said their children had received no mobility training at all. This rose to 80% for under 5’s. ! 79% of children with a visual impairment surveyed found it “difficult” or “impossible” to get around outside the home in unfamiliar places. (2008 Functionality and Needs Survey – Guide Dogs) Dissemination As the evidence grows we will disseminate best practice and evidence of the service impact through all our mobility teams. We will also work shoulder to shoulder with other providers and local authorities to develop stronger evidence based habilitation services in as many areas of the UK.
  • Therapeutic Addiction Networks Oldham Key Objectives • To demonstrate that meeting the needs of people in second stage drug and alcohol recovery is cost effective and of benefit to the community and service users. • To test and evaluate a network model of supported living plus easy access to therapists • To share learning and create a replicable model • To enhance the life chances of those whom we support Outcomes • Relapse rates decrease (frequency & duration • SU’s stability increases enabling recovery • SUs are ready to move on to no or less supportive environments (depending on their on-going needs) • The community benefits from reduced ASB • The model is evaluated Delivery Methods A Network of support which provides: • Multiple layers of formal support (incl from a local volunteer) • Mutual support • Group work & 1:1 therapy, tapering in year 3 • Community connections Dissemination • Communication plan – segmented messages & audiences • Local and national decision makers targeted • E-bulletins / newsletters • Presence at conferences • Use of existing networks • Briefings, reports and evaluation KeyRing Service Users Vulnerable adults with a history of substance and alcohol misuse
  • Lancashire Mind Partnering with Care Network Supported by Blackburn with Darwen Clinical Commissioning Group and Blackburn with Darwen Borough Council The Accessible Self Care Project (The ASC Project) working in Blackburn with Darwen Key Objectives The ASC Project is an innovative project incorporating the recommended elements of a risk stratification tool, roles devoted to motivate and sustain change and self care, a holistic approach to health and social care and integrated working systems. Inspired by the community orientated primary care approach, the project aims to improve the long-term care and support of people across the South East of Blackburn with Darwen and to reduce inappropriate use of statutory health and social care services. This will be achieved through improving individual self care skills and social capital. Outcomes • Improved quality of life for people with long term conditions • Increased numbers of people feeling confident in managing their conditions • Increased number of people with long term health conditions in employment • Reduced number of inappropriate primary care consultations • Increased number of Admissions prevented • Reduction in sickness absence • Increased number of volunteer opportunities Delivery Methods The proposal has two main elements 1) Self care facilitation and 2) Building Community Assets: • Self- Care Facilitators will work with individuals to support and motivate citizens to engage in and sustain healthy behaviors to improve their health and wellbeing by utilizing community resources. • Community Wellbeing Coordinators will work to generate new community solutions to improve wellbeing; increasing community support and resilience against the risks of poor health and wellbeing. Dissemination We will share our findings through regional and national networks including through the network of over 170 local mind associations. • We have also planned to develop training packages around the innovation project roles to assist the development of similar projects in other areas. Service Users Based in deprived areas of Blackburn the presence of multiple long term health conditions is common. Whilst resources to support healthy lifestyles are available residents lack the motivation and knowledge to access these resources. The ASC Project will not only offer information around community support but also one to one support to build motivation amongst residents to access these resources and develop self care skills.
  • Lasa Connecting Care Working across England Key Objectives • Improve the capacity of care providers to manage and use Information & Communication technologies (ICTs) effectively to deliver better services and increase efficiency • Develop care staff skills and confidence to use technology to support their care practice through e-learning and online peer support • Develop care staff ability to help service users engage with technology enhancing personalisation and choice of care and support • Develop opportunities for service users to use technology to increase access to peer support, knowledge and information; to increase communication, build confidence and manage care needs. Outcomes • Improved capacity of care providers to procure, manage and use ICTs effectively & strategically to deliver better services • Increased efficiency and effectiveness of administrative and business systems e.g. internal communication and reporting, supplies, care plans • Improved ability to share best practise and learning through relevant networks for the benefit of the care sector • Developed care staff skills and confidence to use technology to support their care practice through e-learning, online peer support and knowledge sharing • Increased personalisation, autonomy and reducing isolation of care service users through use of technology to increase access to peer support, knowledge and information, thereby building confidence and enabling users to manage care needs, finances, pursue hobbies and social activities. Delivery Methods • Telephone, email and web-based advice and guidance; • Consultancy visits to participating organisations; • Online and offline events - podcasts, guides and ‘Ask the Expert’ advice sessions; • Access to ICT Knowledgebase and Suppliers Directory; • Online peer support community signposting to relevant ICT information and case studies together with links to useful online services and a discussion forum for the sharing of good practice; • Use of volunteers to provide practical ICT advice. Dissemination We will share our findings with technology audiences through our ICT events programme, websites, publications and email lists, and through our close working relationships with Charity Technology Trust, AbilityNet, Go On, National Digital Leaders & KnowHowNonprofit. Social care audiences will be reached through the communication channels of national representative bodies - Skills for Care, SCIE, NCF, NCA & SCA. Service Users We will be working primarily with charitable providers of social care across England to build their organisational capacity to better use technology and respond to social change. For care staff access to ICT is essential for professional development. For care service users, ICT supports active citizenship, communication with services and personal advocacy.
  • Action for Blind People In partnership with blind and partially sighted people and local and national groups operating in the sight loss sector. Action for Blind People reg. charity no. 205913 (England and Wales) Living with Sight Loss Course Rolling out at locations across England Outcomes • Increased empowerment and independence of visually impaired people. • More people with sight loss reached at the point of diagnosis. • Improvements to the long-term health and well-being of blind and partially sighted people. Objectives • To develop a national operating framework based on a 6-8 week Living with Sight Loss course. • To provide timely information, advice, guidance and practical life skills for people diagnosed with sight loss. • To reach more visually impaired people by offering intensive group support with a focus on prevention and development of self-help techniques. Delivery methods • This is a modular, community based course, delivered one day a week for 6-8 weeks to approximately 15 visually impaired people, at each cohort. • Action is committed to working in partnership with people who are visually impaired, therefore, local blind and partially sighted people facilitate parts of the course - providing advice and sharing their first-hand experience. • The use of peer support empowers participants. • Other organisations in the health and well-being sector, both nationally and locally, deliver key aspects of the course. Service Users Blind and partially sighted people, families, friends and carers of all ages. The number of people in the UK with sight loss is set to increase dramatically. There is a strong body of evidence that many people diagnosed with sight loss do not get the information or support they need at the right point in their sight loss journey. People feel isolated at a time when suffering emotional turmoil and in need of practical support and information. Dissemination Effective practice from Living with Sight Loss course will be disseminated to Commissioners of health and social care, internal Action colleagues, service delivery partners, voluntary sector and blind and partially sighted people using an integrated communications and engagement programme.
  • MEN’S HEALTH FORUM PARTNERING WITH LB OF HARINGEY HARINGEY MAN MOT Working in London Borough of Haringey An online GP service designed by Haringey men for Haringey men: • providing online access to health professionals for men who don’t use traditional services • in partnership with Haringey Men’s Health Group, local borough public health team, CCGs, pharmacies and community organisations • working with local men, particularly those in hard to reach groups, on design, marketing and delivery • training local men’s health champions Outcomes • To design and pilot a model that works in Haringey and could be replicated in other localities or in other contexts such as the workplace • To help embed a gender-sensitive approach to health in all other aspects of local health service provision and public health messaging. Delivery Methods • Men are reluctant users of health services. So Man MOT uses ‘internet chat’ via website or smartphone to bring health services to men • Virtual surgeries could feature GPs, pharmacists, fitness advisors, nutritionists, counsellors, relationship counsellors and other services identified locally • Innovative on and offline marketing to target hard to reach groups. Dissemination • We commit to widely disseminating the findings of this project with a portfolio of best practice • Newsletter for stakeholders • Seminars locally and in other regions • Engage with the Department as well as other national agencies and think tanks. Service Users The service is for all men but will target those men who aren’t engaged with traditional health services connecting and demystifying local health services through a focus on prevention, early intervention and local signposting
  • Partnering with Manchester Mind, Oxfordshire Mind, another Mind (TBC) and VCS partner(s) (TBC) Service Transformation across One Mind Piloting in Manchester and the West Midlands, rolling out across England & Wales Key Objective Design, develop and test a new model for developing excellent, recovery focused and integrated mental health services and support that is proven to deliver greater impact on health and social care outcomes for individuals who have a long term physical condition and are therefore at increased risk of developing mental health problems. Outcomes 1. Produce an excellence model that ensures 100% of new mental health services developed using it are person centred, recovery orientated and holistic, involve service users in their design and support individuals to access timely and individual support to make their own choices. (Apr ‘14) 2. Mind’s new excellence model will enable us to reach 10,000 new users of Mind’s services 3. Create a range of core services and scale for national impact. Extend coverage and diversify income streams by working in partnership with local Minds and other external partners including statutory, private and other voluntary sector partners. (Mar ‘16) 4. Reduce the likelihood of people with long term conditions developing mental health problems (Mar’16) Delivery Methods • Develop methodology including training, testing, refining, co-designing and service user consultation. • Deliver pilot interventions consisting of: Initial training of staff (provided by Oxfordshire Mind); recruiting groups of local people with long term physical conditions in Manchester and the West Midlands; holding a 10 week intervention course to reduce their risk of developing depression; providing further training for those wanting to become peer supporters. • External evaluation, including baseline and post intervention outcomes measurement with pilot beneficiaries, qualitative interviews, and economic analysis of potential cost savings. • Develop plans for dissemination of findings Dissemination • Dissemination plans will be included in the excellence model and tailored for each service model developed. • Evaluation Report and key learning will be disseminated throughout the Mind network (154 local Minds across England and Wales) utilising our annual CEO conference, the Gentian Group (key CEOs) centres of expertise and regional structure. • Develop communications plan to key external audiences including commissioners, funders and other voluntary sector organisations. • Work with partners to disseminate to other local support groups and organisations supporting people with long term physical conditions. • Direct to service users via peer support roadshows and online, as well as through our voluntary and statutory partners. Service Users Pilots in Manchester and the West Midlands will work with 560 people with long term conditions who have an increased risk of developing mental health problems. Once developed, the new excellence model will enable us to reach 10,000 new users of Mind’s services by 2016. Co-morbidity of long term physical health conditions & mental health problems can lead to significantly poorer health outcomes & reduced quality of life.
  • MUSCULAR DYSTROPHY CAMPAIGN BRIDGING THE GAP: developing a model of patient-commissioner partnership for specialised commissioning Working across England Key Objectives • Ensure new NHS commissioning bodies are equipped to provide effective, integrated care for neuromuscular conditions – delivering improved health outcomes for patients and cost savings for the NHS. • Ensure people with muscle-wasting conditions have a voice in service development. • Increase understanding of neuromuscular conditions among NHS commissioners and non-specialist health professionals. • Ensure people with muscle-wasting conditions are fully informed and able to access health services. • Increase the charity’s engagement of beneficiaries and capacity for local grassroots activity. Outcomes • Effective commissioning for all stages of neuromuscular patient pathway thanks to co-ordination and information for commissioners through forum network. • Up-to-date, easily accessible online information supports effective commissioning and straightforward access to services. • Improved health outcomes for patients, with resulting NHS cost savings thanks to reduced emergency hospital admissions. • Larger and stronger network of regional beneficiary-led groups increases charity’s capacity for local reach and impact Delivery Methods • Bring together people with muscle-wasting conditions, NHS commissioners, health professionals, in a network of new neuromuscular forums. • Develop online map of services available regionally, supporting access, referral, and commissioning to fill gaps. • Meetings and webinars to share information. • Volunteers meet with patients at clinic to support, advise, and engage with the charity and with health services Dissemination Information will be shared through the forums, website and webinars, and through our range of networks: - Beneficiary-led Muscle Groups (to reach patients and their families) - Networks of clinicians and other health professionals (e.g. British Myology Society) - Clinical Reference Groups - Other charities working with individual muscle-wasting conditions - Coalitions supporting rare diseases Service Users 60,000 people in England live with muscular dystrophy & related neuromuscular conditions – complex, progressive disorders causing muscle wasting and leading to disability and often premature death. Streamlined specialist treatment covering a range of disciplines is vital to maintain health and mobility, and indeed prolong life. As the conditions are rare, with needs not fully shared by any others, awareness among non-specialist professionals is low, and people’s health often suffers because their treatment needs are not fully or appropriately met. The Muscular Dystrophy Campaign is the only UK charity supporting people with all forms of muscle-wasting conditions, and working with commissioners and health professionals to meet their needs effectively.
  • National Council for Voluntary Organisations (now merged with Volunteering England) Volunteering in care homes for older people Key Objectives • To increase and enhance volunteering in care homes for older people so as to improve the quality of life of residents • To demonstrate the value of effective volunteering to promote improved health care outcomes through personalisation and choice of support in social care homes • To identify and develop good practice though an inclusive approach involving staff, volunteers and service users • To develop a national standard of good practice • To disseminate the learning from this project to policy-makers and practitioners in social care and volunteering Outcomes • National good practice standard for volunteering in care homes • Greater understanding and evidence of how volunteering can contribute to improved personalised care outcomes and better quality of life for residents • Care providers from public, private and voluntary sectors confident and supported in developing volunteering in their homes Delivery Methods • Three-year project, with the care sector and national associations and through an advisory group, to explore and develop good practice • Five localities working with the clinical commissioning group and local volunteer centre (to be selected) to help broker increased numbers of volunteers in two care homes in each locality, and support staff and volunteers with training • Ten care homes to be demonstration projects for volunteer involvement, gaining Investing in Volunteers Dissemination • Suite of good practice documents and case studies (incl. video) to support care homes in working with volunteers and to support volunteers and volunteer centres in working in social care, embedded in Good Practice Bank on our website • Events, webinars and online communications to disseminate the good practice standard and champion improved volunteer involvement Service Users • Residents to benefit from enhanced involvement of volunteers, from their local communities • Volunteers recruited and trained to help with activities supporting staff and benefiting residents; recreational, social and care activities to be more satisfying; stronger advocacy for older people’s voices • Opportunities for development of volunteering by service users • Service users’ experience evaluated
  • Next Link Domestic Abuse Services PARTNERING WITH nia & AVA (Against Violence and Abuse) IRIS (Identification & Referral to Improve Safety) IRIS is a national project currently working in 8 areas of England Key Objectives • To establish a national, self-sustaining programme based on a social enterprise model to enable ongoing commissioning of IRIS, a general-practice based domestic violence training, support and referral programme • To grow IRIS across the country, support and develop new areas to implement the IRIS programme, grow and maintain the existing IRIS network and continue to support the eight localities already implementing the IRIS programme • To develop a sound business model allowing the project to be self sustaining by the end of funding cycle Outcomes • IRIS model commissioned and supported in 16 new areas and so an increasing number of Domestic Violence Aware Practices • IRIS exists as a self-sustaining programme beyond the grant period • Continuing improvement in the health care response to domestic violence and abuse (DVA) • Improved quality of life for patients with experience of DVA Delivery Methods • Promoting IRIS at a national and local level including to Clinical Commissioning Groups (CCGs), Health and Wellbeing Boards, Public Health and Community Safety teams • Supporting local teams to develop a business plan to promote and secure the commissioning of IRIS in their area • Running training course induction courses for each newly commissioned IRIS team • Providing ongoing support to local IRIS teams Dissemination We want out learning from IRIS to continue to inform policy and best practice at all levels. We are linked in to regional and national networks in both the health and violence against women and girls (VAWG) sectors. We will continue to write and publish articles and papers as well as speaking at conferences, delivering workshops and investigating promoting IRIS within other parts of the health service. Service Users Our service users range from frontline staff in DVA services to commissioners within CCGs and from health care professionals to the administrative staff who support them. We offer support to professionals from the health and DVA sector to enable IRIS to be commissioned locally and then support the local teams to deliver the IRIS model. This in turn leads to better trained and supported health care practitioners who are then better able to respond to their patients with experience of DVA.
  • Parents Against Child Sexual Exploitation – Pace Pace Business Development Working in England Key Objectives • Extend and improve Pace’s support to parents of children who are sexually exploited by perpetrators external to the family. • Strengthen Pace’s ability to evidence the effectiveness of parent involvement in tackling child sexual exploitation. • Increase the recognition and integration of affected parents into health and social care practice and the judicial process. • Diversify income streams through local authority commissioning of Pace support to affected parents, and through corporate sponsorship and online giving. Delivery Methods • Develop relations within national and local government, health and social care, and the judiciary to promote parent involvement in tackling child sexual exploitation (CSE). • Work with local partners and commissioners to adopt family-centred approach to CSE. • Develop the database record-keeping, online resources and social media capacity of Pace • Develop an effective communications strategy with external stakeholders Dissemination We will share our findings through Pace’s biennial national conference, through a national training programme for the police, social care, health, and education professionals, through publications and research, and by contributing to media coverage of CSE investigations. Service Users Pace works with parents affected by CSE. No parent wants their son or daughter to be raped, drugged, trafficked or exploited. Parents who work with Pace appreciate the vital role agencies play in safeguarding their child and in disrupting and prosecuting the perpetrators. They want to work with agencies confident that they will be treated as a valued partner and shown respect and empathy. Neither the parents not the child should be blamed for child sexual exploitation. The blame lies with the individuals who commit the crime. Outcomes • Improved online resources for parents e.g. online diary to record what’s going on with child, secure online parent forum • Improved communication with parents and external stakeholders • Integration of affected parents into health & social care practice and judicial process • Four areas commission Pace’s work parents • More donated income through online giving • infousing online parent forum online diary through online tools to assist parents e.g. online diary to log what is going on for child • Extending peer support through online parent forum
  • Pathway partnering with Bevan Healthcare Pathway Hospital Care Coordination For Homeless People – Can Primary Care Lead? Working in Bradford, West Yorkshire Key Objectives: o Test whether the Pathway coordinated care service can work by being based in a primary care setting o Extend the service to a more broadly defined group of vulnerable & excluded people in addition to homeless people and monitor the results o Prove that helping tri-morbid, complex patients being admitted to hospital is not difficult, is cost & quality effective & thereby benefit many more patients Service Users: Bevan Healthcare had 1,869 registered patients as at Aug 2012. Of these: o 51% were homeless, living in hostels or squats or were sofa surfers o 30% were refugees or asylum seekers. In 2011/12 Bevan Healthcare patients attended A&E 1,024 times including 568 ambulance call outs, the top eight patients attended A&E between 15 & 43 times in that year. Bevan Healthcare patients were admitted to hospital 250 times in 2011/12 at an estimated cost of more than £300k to the NHS. Using London data, we estimate that there are a further 25- 30% more excluded and homeless patients in Bradford who are not registered with Bevan or any GP service but who will be using A&E department and thereby generate more emergency admissions. Outcomes: o Approx 300 vulnerable and excluded patients to benefit from enhanced care of a Pathway hospital team o Provide support in A&E leading to improved treatment and outcomes for frequent attenders by producing bespoke health and social care summaries o Reduce the likelihood and length of a subsequent hospital admission by getting it right first time o 25% reduction in the number of in-patient bed days in first full year of service – financial saving >£100k Dissemination: o Local business case - prepared and shared with Bradford CCG, Bradford Health and Wellbeing Board & Bradford Royal Infirmary Trust Board o Learning shared across Pathway’s existing homeless health network & with the Faculty for Homeless & Inclusion Health, & findings fed into future revisions of the Faculty’s Standards for Service Providers & Commissioners Delivery Methods: o Dedicated Pathway trained Nurse employed in hospital to work with this group of patients o 3 sessions per week of specialist GP to work with hospital clinicians to coordinate treatment o weekly multi-disciplinary team meetings with other agencies to ensure appropriate treatment and discharge of patient with care plans
  • PLAY ENGLAND PARTNERING WITH PLAYING OUT, LONDON PLAY AND BRISTOL UNIVERSITY (WITH CENHS) STREET PLAY PROJECT Working in England Key objectives • Develop online networks and peer-to-peer support for residents to enable them to create more opportunities for street play • Enable resident–led street play in nine target communities with high levels of deprivation and health inequalities • Embed street play in local health strategies to address children’s health issues: to increase physical activity/ reduce sedentary behaviour. Outcomes The key outcome for the project is to reactivate a culture of children playing out on the streets, near where they live, so they can spend more time outdoors and increase the time spent in Moderate to Vigorous Physical Activity (MVPA). Service users This project will support children and families to take control of their own streets. Over the lifetime of the project: • 11,000 children will be able to play out on streets near their homes • 1,000 adults will become Street Play Champions • 10,000 adults will take part in and build resident-led Street Play projects. Dissemination Play England will lead a national campaign to generate public, media and political interest The Playing Out website and social media will provide a portal for parents and residents looking for support to help their children play out more London Play will promote the project in the capital Bristol University will evaluate the health and economic impact of the project. Delivery methods Provide residents with advice on street play through the Playing Out website and social media Develop packages of support and training for: local authority transport teams so they can develop the right legal structures and guidance to enable street play; health and well being boards so they can work effectively with transport, housing and planning teams and local community organisations to support resident-led street play.
  • Race Equality Foundation In partnership with Everyday Language Solutions & Mothertongue Improving the commissioning of communication services Working across the English Regions Key Objectives • To work with CCGs to develop better practice in the commissioning of communication services for disadvantaged, hard to reach and seldom heard groups. • Assist CCGs in developing effective commissioning models contributing to effective use of funds • Increase CCGs knowledge in assessing quality with different models of communication services • Contribute to CCGs addressing health inequalities and equality objectives Outcomes • Increased confidence from clinicians in dealing with hard to reach/disadvantaged groups • Improvement in patient experiences • Effective practice in use of interpreters • Development of models of commissioning communication services • More efficient use of funds • Case studies for wider dissemination Delivery Methods A programme of action learning will be undertaken with thirty clinical commissioning groups in six area clusters. Five facilitated sessions will take place using latest evidence on effective partnership as part of the learning programme for clinicians/CCGs. From the identification and understanding of communication needs; assessing quality of range of providers, CCGs will be enabled to develop models for effective commissioning of communications services. Evaluation of learning for participant’s pre and post programme participation and feedback from patients. Dissemination • Through a dedicated commissioning website • Electronic newsletter • Regional workshops directed at CCGs and partners in local authorities, social care, secondary care, patients groups and the voluntary and community sector • An evaluation report Service Users The focus is on those who are hard to reach or socially excluded including: • Black and minority ethnic communities • Disabled • Deaf people • New migrant groups
  • RECOVERY PARTNERSHIP RECOVERY GROUP UK, DRUGSCOPE, SKILLS CONSORTIUM SUPPORTING RECOVERY & TREATMENT Working across England Key Objectives • Inform and support policy and practice development for recovery from drug and alcohol dependency. • Improve service delivery and outcomes for people with drug and alcohol problems. • Address ‘barriers to recovery’ – e.g., opening opportunities for employment, tackling stigma and supporting ‘recovery champions’. • Informing and supporting the drug and alcohol sector on the new public health and funding and commissioning environment. Outcomes • Local drug and alcohol treatment and recovery services working effectively to support recovery. • Policy and cultural change (nationally and locally) addressing barriers and a ‘level playing field’ for people in recovery. • Improved service user, family and carer experience of treatment. Delivery Methods • Meeting regularly with Government officials, statutory bodies and others on achieving ambitions for recovery. • Facilitating the sharing of information, networking and best practice and providing ‘spotlight on recovery’ briefings. • Providing resources for employers and others on addressing barriers to recovery. • Monitoring and sharing findings on the new public health system. Dissemination We will share information (e.g., briefings and examples of good practice) and learning through our respective memberships, networks and publications – including DS Daily, a daily news bulletin on substance misuse. We will meet regularly with Government officials, provide updates for Ministers and facilitate local dissemination through regional events and public health agencies. Service Users The Recovery Partnership is supported by service users and people in recovery – e.g., in our memberships and participation in ‘expert groups’, consultations and events. We will support the development of ‘recovery champions’ and showcase and celebrate recovery in all aspects of our work – including with employers and service providers.
  • REGIONAL VOICES PARTNERING WITH SWF, RAISE, LVCS, ONE EM, COVER, RAWM, VSNW, VONNE, Involve Y+H and FaithAction Supporting Influence- Health and Wellbeing Boards Covering all nine English regions Key Objectives- This project will create regional networks that will: • Deliver effective VCS engagement with HWBs according to models developed locally • Create a learning exchange network to share good practice that supports individuals, board structures and government • Develop effective and robust routes for dissemination and collation of information to support HWBs Outcomes • VCS influence supported on HWBs, JSNA and JHWS, in areas where there is and where there isn’t a VCS representative on the board. • Accountability, understanding and routes to influence nurtured in each local area. • Close working between the VCS and Healthwatch facilitated to ensure that needs of the public, patients and service users are represented on HWBs. Delivery Methods • Support meetings across the 9 regions – bringing together VCS representatives with their relevant Healthwatch counterpart, when appropriate, to share learning and experience • Ebulletins and online networking • Resources and training on specific support needs identified by VCS representatives • Regular surveys to understand how representation and influence are developing and what support needs are. Dissemination The basis of this project is communication of good practice between localities- both peer support within regions and sharing learning across the country, through ebulletins. Resources produced and findings from surveys will be shared widely. Service Users • Voluntary sector representatives on HWBs (75) • Local Healthwatch reps on HWBs (150) • The wider voluntary sector and the communities it supports (20,000)
  • Royal National Institute of Blind People (RNIB) PARTNERING WITH Moorfields Eye Hospital NHS Foundation Trust Electronic Certificate of Vision Impairment A pilot in four locations in England Key objectives The overall aim of the project is to assess the impact of an electronic Certificate of Vision Impairment (eCVI) on the process of certification within the hospital ophthalmology department and referral to the local social services departments (SSD). The specific aims of the project are to: • Improve the effectiveness and efficiency of the certification and registration (C&R) process, resulting in increased integration of Health and Social Care (H&SC) provision and support. • Increase patient choice and control over their C&R so that patients are actively engaged in their own H&SC. • Improve access to information and support resulting in speedier referral to intervention services, promoting a positive approach to well-being. Outcomes • More timely referral of patients from hospital care to SSD. • Patients take a more proactive role in their H&SC following sight loss. • Greater access to new routes of information about H&SC services, advice and support, through the option for referral to other agencies. Delivery Methods • The project will be managed by a project manager based in the Certifications Office of Moorfields Eye Hospital. • Delivery of the project will be a collaborative process between the ophthalmology departments in the participating hospitals, the associated SSD, and RNIB and Moorfields Eye Hospital. • The project will run from July 2013 until March 2016. Dissemination Dissemination of learning, encouragement to replicate best practise and take up of the eCVI will be achieved via: • Presenting the findings at the major certifying hospitals and associated SDD. • Publication of articles in relevant bodies' new letters and open access peer review journals. • Presenting the findings to the All Party Eye Health Group. • Working with the Royal College of Ophthalmologists and H&SC to develop guidance on the key benefits of C&R, aimed at health professionals who advise patients during the process. • Dissemination of the report and findings via RNIB group and partners' websites. Service Users • Participants in the study are people certified as severely sight impaired (blind) or sight impaired (partially sighted) in the ophthalmology departments of the hospitals taking part in the study. • The study will also work with H&SC professionals in each site to test the feasibility and acceptance of the eCVI.
  • WRVS PARTNERING WITH Slivers of Time NHS Trust Hospitals to Community Care: Led by Volunteers42 NHS Trusts across England Key Objectives • Provide self-management websites for NHS Trusts to support the management and booking of volunteers. • Set up local volunteer-led health and care projects including preventative care schemes, volunteer recruitment initiatives, support leaving hospital and voluntary care for those in financial hardship. • Self-management websites enable NHS Trusts and the local voluntary sector to establish a shared volunteer platform and collaborate on joint projects. • Support locally developed approaches that build resilience against the risks of poor health and well-being. Outcomes • Enable NHS Trusts to manage volunteers & their activities more effectively through providing a funded self-management & administration website • Implement Slivers-of-Time systems in 42 NHS Trusts and local areas across England • Increase volunteer capacity in NHS Trusts by 25% • Increase in volunteer activity in each NHS Trust engaged by 25% • SROI – monetary value of the time unlocked by the volunteer self-management system Delivery Methods • Setting up 42 local volunteer-led projects across England that support the delivery of long-term care & support enabled through self-management websites • Implementation of shared self-management websites which improve the capacity of 42 NHS Trusts to: • Manage & track volunteer recruitment & approval more effectively • Find & book approved volunteers at short-notice • Recruit volunteers through new online channels • Record and report on volunteering activities • Open flexible volunteering opportunities to volunteers on their terms • Engage more volunteers and use them more effectively The proposal will enable the establishment of projects that support locally developed approaches that build resilience against the risks of poor health and well-being. Dissemination • An independent assessment and evaluation is planned to be completed by March 2016. • All learning from the project will be promoted through the press and umbrella bodies backed up by detailed reports. • Methods of dissemination are tailored to different stages in the project and a repository of learning will be created. • A group of national Volunteer Involving Organisations will be convened to share best practice & shape the project. Service Users • People with long term conditions • Older people • Carers • People with a disability • People with a learning disability • People experiencing social exclusion • Groups/communities experiencing health inequalities • 42 NHS Trusts, 8,400 volunteers, 21,000 beneficiaries in total over 3 years
  • SEND CONSORTIUM MADE UP OF CONTACT A FAMILY, SCOPE, MENCAP, NAS, AMBITIOUS ABOUT AUTISM, I CAN, DYSLEXIA ACTION and KIDS SENDirect England wide, children and young people with SEND aged 0 to 25 years and intermediaries Key Objectives To develop a new, intelligent online brokerage platform known as SENDirect, that will support parent/carers and their intermediaries to access and purchase health, education, social care and leisure services. To develop a quality accreditation system around featured providers that is influenced by those accessing them. To develop the specifications and build for SENDirect in partnership with a wide range of stakeholders. To identify and develop partnerships with local authorities and providers to enable the pilot and eventual launch of SENDirect. Outcomes: • Support parent/carers of young people with special educational needs or disabilites to access information and support about the services they want and need. • Provide online tools and information to enable them to manage personal budgets or direct payments. • Provide support across sector’s to develop products to meet identified needs and therefore create a sustainable marketplace of provision. • Improve the efficiency of commissioning by local authorities by providing needs led data to inform their decisions • Develop universal and commercial provision to embrace a culture of inclusion for children and young people with additional support needs • Improve collaboration within and across sectors Delivery Methods SENDirect’s specification and build will be informed by an Expert Reference Group made up of an extensive range of stakeholders, followed by four consultation events aimed at parent/carers and providers. Nine local authorities will also be recruited to drive the development and then pilot the service. Dissemination The online platform will feature open access to the public and enable providers and commissioners to view data and identify trends around the activities of those with personal budgets. An evaluation framework for the project will be developed and the results published.
  • Service Users As we age, our hearing and sight will deteriorate. Too often, people think this is just part of getting older and assume nothing can be done. Having both hearing and sight problems makes it hard for older people to have a conversation, read a book or participate in social activities they enjoy, to get out and about and to remain independent. This project is relevant for everyone who knows or cares for an older person who may be experiencing hearing and sight problems. Delivery Methods • Train public sector and private care providers on using our dual-sensory loss ‘early recognition’ screening tool and information about ways to help people in their care. • Community outreach to BME groups to talk about and tailor our information to better reflect their needs and care choices. • Meetings and seminars with MPs, health and care commissioners and regulators to influence sensory support provided to older people in care or living at home. • Meetings, seminars, articles, networking events with local, regional and national voluntary sector organisations to raise issues and solutions about ageing and dual sensory loss. Outcomes • Older people with hearing and sight problems will be able to choose the care and support that’s right for them using information and advice produced by Sense. • Families and professional care providers will be able to spot the signs of hearing and sight problems in older people and identify ways to help them to make the most of their senses. • Health and social care providers, commissioners and regulators are better informed about the benefits of early recognition of hearing and sight loss in older people. Supporting older people with vision and hearing loss (England) Dissemination In addition to delivering training to care providers, we will place tailored information on our website; actively share it with harder to reach groups using their websites and community networks; and share with the voluntary and public sector through articles, networks and conferences. Key Objectives 1. To raise awareness about signs of hearing and sight loss in older people to individuals, their families, and care providers. 2. To promote Sense’s screening tool and training package on the early recognition of sight and hearing loss in older people to residential care home providers across England. 3. To encourage health and care providers, commissioners and regulators to consider the long-term health and care options provided for people with age-related hearing and sight loss.
  • Social Enterprise UK Institute for Voluntary Action Research Social Value in Health Working in twelve regions over three years (regions tbc) Key Objectives • To support the implementation of the public services (social value) Act 2012 in health commissioning. • To support clinical commissioning groups (CCG) and health & wellbeing boards (HWB) to commission for social value • To improve the voluntary, community and social enterprise sectors understanding of their own impact on social value and increase their knowledge of the commissioning process Outcomes • Improved health commissioning and thereby health care which takes into account the wider social value for the community. • VCSE have a greater understanding and ability to demonstrate their social value. • CCGs and HWB commissioning health services taking social value into account Delivery Methods We are taking a facilitated partnership approach, using a series of workshops to bring together CCGs, HWBs, VCSE organisations, healthwatch and members of the community to jointly consider what social value means for their locality and how this relates to health outcomes. They will them be supported to develop a bespoke learning programme, including expert seminars and mentoring which over 12 months, will establish a local social value strategy and enable VCSE to measure and demonstrate their social value. Dissemination For each region involved in the programme an online ‘social value’ depository is being created as a means of identifying best practice, which will feed into a national depository. This will be promoted and accessible to all. This information and findings from the facilitated partnership work will input into the production of a practical toolkit, which will be shared nationally with all the CCGs and through our networks to VCSE organisations. Service Users We are working with CCGs, HWB and voluntary and community groups, local healthwatch groups and social enterprises, who all have a different understanding of social value and its implications. Ultimately it is the local community who will benefit from this work, with the wider social impacts of health commissioning being considered.
  • THE BRITISH SCHOOL OF OSTEOPATHY Clinical services based in South East London. Training osteopaths throughout the UK. Key Objectives OsteoMAP is a new service which integrates mindfulness and acceptance- based pain management with osteopathic care in a personalised programme of six individual treatment sessions. It will support people with long-term musculoskeletal pain, which is likely to be helped but not completely relieved by manual therapy alone. The programme aims to promote quality of life and well-being, despite ongoing physical symptoms, by increasing people’s capacity to respond more flexibly to pain and to engage more fully with meaningful, valued activities which are related to their personal goals. Outcomes Increase patient choice and access to low cost, integrated healthcare services within their local communities. Increase osteopaths’ abilities to offer effective care for people with complex long-term physical health problems. Improve care outcomes by decreasing the use of healthcare interventions with limited effects and encouraging appropriate self-management and active engagement with valued social roles. Delivery Methods In the first year, OsteoMAP will be based within the BSO’s Clinical Centre in SE1, as a service for existing patients, but in years two and three it will become available in selected GP surgeries and health centres in London. OsteoMAP training courses will be provided for student osteopaths at the BSO, and later in other UK osteopathic training schools. A series of training courses will also be provided for qualified osteopaths, who will then use the programme within their practices throughout the UK. Dissemination Information about OsteoMAP services will be shared with local GPs, health centres, self-help groups and the public through published and online information leaflets and inter-active seminars and meetings. Outcomes will be shared with osteopaths, other physical therapists and health practitioner training schools through publications in professional healthcare journals, multi-disciplinary and international conferences and via BSO website resources. Service Users OsteoMAP is for patients with complex, long-term physical health conditions and disabilities that are unlikely to be fully resolved by medical treatment. Service users will initially be patients who are already being treated in the BSO clinic or by practising osteopaths who have completed the training course. Later service users will include patients in GP surgeries, community health centres in SE London and clinics at other osteopathic training schools.
  • PROJECT: The creation of a standardised evaluative tool for the Butterfly Scheme for use by member hospitals all across the UK and by the Scheme itself Key Objectives of the Project • Post-launch: to enable hospitals to identify where the Scheme is embedding well and where it needs targeted support • Once embedded: to enable hospitals to monitor areas of continued strength and identify those which require additional input • To enable the Scheme itself to have a standardised system of quality control • To create an IT-based tool which supports this process Outcomes Where the Butterfly Scheme is embedded • patient well-being and safety are greatly enhanced through a personalised care approach • family carers are less stressed and are better able to work in partnership with hospital staff • care homes are encouraged to liaise with hospitals to enhance the care of their residents during hospitalisation • hospital staff enjoy delivering excellent dementia care and gain greater job satisfaction • where dementia care is appropriately delivered as part of a reliable hospital-wide system, length of stay is minimised; inappropriate dementia care actively extends length of hospital stay Delivery Methods The Butterfly Scheme was itself shaped using input from all user groups and it continues to apply a collaborative system for all developments and amendments. Butterfly Scheme Leads from member hospitals are therefore feeding into the creation of an IT-based evaluative mechanism, led by the project team, ensuring that the finished tool will be user-friendly, practical and will enhance reliable delivery of the Scheme. Dissemination • the tool created through this project will be used by all member hospitals across the UK • the Scheme actively shares its news about best practice via conferences, events and through articles in relevant publications • the Scheme’s own website will publicise findings Service Users The Butterfly Scheme allows people with memory impairment, assisted by their usual carer or an advocate, to request the Scheme’s specific care response whilst in hospital. Staff at Butterfly Scheme hospitals are taught this simple but very effective care response and apply it when they see the discreet Butterfly symbol the service user has chosen to display. Partnership working between hospital staff and carers is greatly enhanced by the Scheme.
  • THE LESBIAN & GAY FOUNDATION Ending Homophobia, Empowering People Ending Homophobia, Empowering People www.lgf.org.uk Registered Charity No.1070904 LGB COMMUNITY LEADERS Greater Manchester Key Objectives • Work with NHS organisations to better address health inequalities experienced by lesbian, gay, bisexual (LGB) people. • Train a pool of LGB Community Champion Volunteers to attend relevant local meetings, events and forums to champion the needs of LGB communities. • Encourage LGB individuals to have a greater voice within the healthcare system. • Engage with local Healthwatch organisations, Patient Advice & Liaison Groups, Clinical Commissioning Groups. Delivery Methods • Train 40 Volunteers (4 in each area of Gtr Mancs) to ensure LGB voices are heard. • Compile Case Studies around the impact our engagement has on design and delivery of services. • Ensure services can meet need via promotion of Sexual Orientation Monitoring. • Annual Impact Survey for NHS to measure awareness. • Annual Volunteer Survey to monitor involvement,influence. • Annual Impact Survey with wider LGB Community. Outcomes • Address health inequalities by improving services most relevant to LGB people. • Community Leaders advocate for LGB communities to ensure services are designed to meet LGB needs. • Ensure LGB people feel more able to access services • Facillitate authentic voice to bring to the fore issues experienced by LGB people. Services Users • Lack of Sexual Orientation Monitoring means there is a lack of information relating to health and social care needs of LGB people. • Health inequalities experienced are made worse by LGB people less likely to use mainstream health services for fear of discrimination. • Once trained we will ensure our LGB Community Leaders continue to build their skills and ability to influence . • Integrate with our standard volunteering. Dissemination • We will share our findings through monthly e-bulletin’s, involvement in consultations, attendance at seminars, feedback to health organisations, • At the end of each year publish a progress report. • Share best practice through linking up key contacts within the NHS Our vision is of a fair and equal society in which LGB people can achieve their full potential. We provide activities and support across four strategic goals: • Supporting Individuals • Strengthening Communities • Promoting Equality • Developing Excellence
  • THE NORTH WEST LONDON MENCAP CONSORTIUM LED BY EALING MENCAP MAKING THE SYSTEM WORK FOR ME EALING, HARROW, H&F, K&C, BARNET & BRENT Key Objectives • To put into practice the principles outlined in the ‘Caring For Our Future’ white paper • To assesses the quality of health and social care provision including services that are not currently assessed by other means. • To recruit quality checkers who are also users of health and social care services. • To report findings to Healthwatch, local commissioners, CCGs and CQC. • To roll the pilot out nationally. Outcomes • Improve the quality of health and social care services as defined by the Health and Social Care white paper by training and working with providers who have signed up to the Quality Mark scheme • Increase awareness of service quality among personal budget holders, commissioners, Healthwatch and CQC • Reduce the risk of abuse by identifying and alerting providers and local authorities to safeguarding concerns. Delivery Methods • A 3 year pilot quality checking service will be delivered in 6 NorthWest London boroughs and overseen by the NorthWest London Mencap consortium. • A team of paid quality checkers will be trained, supervised and co-ordinated by team leaders and a director who will be employed by the consortium’s delivery partners. • Quality assessment tools will be based on the white paper’s 8 statements which indicate a high quality service. Quality checkers will gather qualitative information about customer experience. • A Quality Mark will be awarded to providers when users of their services feel they working in accordance with the white paper’s principles. • Local authorities will endorse the scheme and encourage provider sign-up. Dissemination National Mencap is working alongside the consortium and will be involved in evaluating the project, promoting its achievements and disseminating information about learning from the pilot to heads of social services and providers nationally. Conferences will be held in Q5 and Q10. Service Users Making The System Work For Me will employ and train quality checkers who have direct personal experience of using health and social care services. They will use their own experiences to engage with personal budget holders in boroughs other than the one they reside in. Tools and systems will be adapted to take into account the needs of the quality checker and the customers they will be visiting. Feedback from quality checking visits will be published on Careplace and the MTSWFM website to help to inform the choices made by personal budget holders and the people who support them when selecting health and social care services.
  • TOGETHER FOR MENTAL WELLBEING PARTNERING WITH MENTAL HEALTH FOUNDATION Evaluating a new model of residential support ENGLAND WIDE Key Objectives: • To independently evaluate a new integrated residential service prototype model for people with complex needs, including people with forensic histories. • The model is based on a personalisation approach and is designed to improve engagement with and promote reliable, timely and positive outcomes for this often overlooked client group. • The model builds people’s confidence and capacity to take control of their own health and wellbeing so that they are able to move away from regulated environments and back into the community. Delivery Methods: • Evaluate the service model at six pathfinder sites to demonstrate that Together’s approach offers a significantly lower cost alternative to oversubscribed secure hospital and forensic settings, as well as having the additional benefit of bringing individuals back into their localities. • 48 new service users across the six sites will be interviewed to establish baseline data, then again at six month intervals to track individual progress. This data will then be aggregated to demonstrate the overall effectiveness of the approach. Dissemination: • The evaluation and learning will be actively shared and widely promoted, using a wide range of networks and consortia including the Mental Health Providers Forum, the NHS Confederation Mental Health Network, and the Ministry of Justice. • In addition we will use our involvement in the Ministerial Advisory Group on Equalities, and the Future Vision Coalition, to share learning with policy makers. Service Users: Our service users are people who have been given a primary diagnosis of serious and enduring mental health problems, and who may also: • experience substance misuse problems • be accommodated in medium/low secure hospital settings or prison • be subject to Community Treatment Orders • experience learning disabilities/difficulties alongside their mental health needs • have received a diagnosis of Personality Disorder Outcomes: • An evidenced alternative to costly, out of area specialist residential mental health services for individuals with complex needs. • Innovative use of personalisation within a restricted residential setting, resulting in greater engagement by service users. • Individuals moving through the service in a shorter timeframe, thereby freeing up beds • A community-based, safe alternative to forensic and secure hospital settings, thus ensuring that people’s needs can be met in the least restrictive environment.
  • TOGETHER FOR SHORT LIVES DEVELOPING CHILDREN’S PALLIATIVE CARE NETWORKS FOR BETTER HEALTH AND CARE OUTCOMES Key Objectives This work aims to ensure accessibility to children’s palliative care services at local level to meet the needs of individuals and their families through effective planning and commissioning of a range of services designed to meet local needs. It aims to develop a new approach to supporting the commissioning of children’s palliative care, for the benefit of children and families, providers and commissioners Outcomes Anticipated outcomes: • The further development of children’s palliative care networks to significantly improve the quality of commissioning. • The promotion of effective integration within and between health, community, primary, acute and social care services. • Approaches established to ensure that services are designed and commissioned focusing on the needs of children and young people and their families, carers and communities. Delivery Methods In year 1 we will work with two regional network pilot sites to establish sufficient capacity to undertake the activity representatives from each of the lead CCGs. 3 workshops will be held in both pilot areas with commissioners and networks. The children needing support in the pilot areas will be identified and we will work with the networks to identify how best to commission services for them. The pilot work will be evaluated during May 2014 before commencing wider roll out across England. Dissemination We will disseminate the learning in a number of ways including through a regular e-newsletter to share progress and evidence; via Relay, Together for Short Lives’ professional journal; through NHS England’s web-portal; at our regular Network summit events Through conference presentations; va media –trade and specialist press and social media channels and via our members Service Users There are 49000 children and young people living with a life-limiting condition in the UK, about 39000 of these live in England, it is predicted that about half of these will require palliative care at some point in their care journey.
  • TOGETHER FOR SHORT LIVES TRANSITION TASKFORCE England-wide Outcomes • young people and their families have more choice and control to make informed decisions about their care • children’s and adult services in the voluntary and statutory sector work together to support young people through transition • wider services, such as housing, education, employment and independent living provide services that meet the needs of young people with life-limiting conditions Delivery Methods • At national level, developing guidance, raising awareness, providing training and support for adult providers ensuring that the ‘push’ from children’s services is balanced by a ‘pull’ from adult services. • At local/regional level, supporting the development of services and partnerships between children’s and adult services, so that the research and good practice that exists is implemented on the ground and disseminated nationally. Dissemination Will include a PR campaign to raise awareness of the needs of young people with palliative care needs. We will also disseminate the findings widely through our professional networks, including: adult sector providers, key professional bodies, the Preparing for Adulthood programme, SEND Pathfinders and through our links with the Parent Carer Forums. We also plan to publish in appropriate academic journals and produce regular newsletters and a Transition Taskforce website. Service Users Recent research from Leeds University shows there is a far greater number of young people who would benefit from palliative care, than previously believed. The number of young people aged 16-19 with life-limiting conditions is growing and has increased by 44.8% over the past 10 years. Services, including hospices, do not currently serve this growing population of young people and their families well. • Key Objectives • To build a forum to drive a strategy to improve transition for young people with life- threatening or life- limiting conditions moving into adulthood. • To Influence the policy and funding agenda and provide support to commissioners of services in relation to transition. • To stimulate new service developments and partnerships between adult and children’s service providers at national and regional levels • To develop an online hub of information, training, research and good practice in relation to transition • To develop and support the implementation of evidence-based best practice guidance and tools • To involve young people and parents
  • Women’s Sport and Fitness Foundation (WSFF) PARTNERING WITH (Arial 18) – Delete if not applicable Changing the Game for Girls – In Action Working across England Key Objectives 1. Raise awareness of girls physical inactivity amongst Health and Wellbeing Boards and Clinical Commissioning Groups 2. Create a network of 25 'gold medal' schools who are delivering best practice to increase girls' levels of physical activity 3. Provide the network of 'gold medal' schools with the tools that they need to thrive and increase physical activity of girls 4. Disseminate learning and best practice from network with wider educational environment Outcomes • Girls better understand the benefits of being physically active and are inspired to get active • Gold Medal schools commit to making physical activity an integral part of school life • Greater participation by previously non- sporty/disengaged girls • Schools create more opportunities for girls participation Delivery Methods • Create a cross-curricular approach engaging whole school commitment to increasing PE and School Sport participation amongst girls • Complete a review and consultation with girls and schools on their needs to help deliver a curriculum that is individually tailored • Provide specific information and guidelines to improve school provision and ethos • Facilitate discussion with HWB’s and CCG’s and encourage schools to become active partners in these discussions Dissemination • Establish an online ‘Gold Medal’ portal, providing case studies and guidelines so learning resources are available to all schools • Present at conferences and exhibitions to share best practice with schools outside of the network • Share success and experience with the non-school education sector Service Users • Health and Wellbeing boards • Clinical Commissioning Groups • 25 Gold Medal Schools – areas of high level deprivation and low levels of sport participation • Specifically focussed on girls • Focus on transition from Primary to Secondary school to avoid drop off rates • National Governing Bodies • External providers of school sports