This document summarizes presentations from a conference on shifting the focus and power of healthcare to communities. The first presentation discussed community engagement, resilience and health service development initiatives in Scotland's Annandale and Eskdale regions to better support older adults, those with long-term conditions, caregivers and people with dementia. The second presentation described a project in Clackmannanshire, Scotland that employs community development workers and an older adult support worker to map resources, gather community input, identify hidden caregivers and co-produce new support services. The third presentation was about a lifestyle management program for long-term conditions run by the Thistle Foundation. It is staff-led but co-facilitated

1. Reshaping Care: Shifting the Focus
and Shifting the Power?
22 June 2012

2. Chair:
Martin Sime
Chief Executive
Scottish Council for Voluntary Organisations
(SCVO)

3. Elaine Lamont
NHS Dumfries & Galloway
Community Engagement, Resilience &
Health Service Development
in Annandale & Eskdale

4. Community…
• Engagement
• Resilience
• Health Service Development

5. Support in the Community
• Identifying existing • Maximising use by
sources of support professionals and public
– Older People 65+
• Identify need – Long Term Conditions
• Strengthen existing – Self management and care
– Isolation
pathways – Care Planning
• Co-produce new sources – Carers
of support – Dementia
• Information &
Communication

6. ‘Tests of change’
1. Establish appropriate methods to ensure information is
accessible to those who need it.
2. Increase wellbeing and confidence to self- manage
through better provision and use of appropriate support
in the community
3. Create and co-ordinate health and wellbeing related
learning opportunities – individuals, communities and
organisations
4. Carers are informed, involved and supported

7. How are we doing this...?
• Community Agents and Strengthening capacity and
Development Worker resilience across all sectors
– Mapping – Cultural/attitude/behaviour
change
– Gathering and sharing
information and views – Connecting people,
communities, professionals
– Identifying hidden Carers and services Identifying
– co-production of support learning needs for health and
services wellbeing
– Signposting and enabling – Consistent and sustainable
access delivery
• Communication and information • Evaluation
– Information Hubs – Local measurement tools
– ALISS – Consistent measurement
– Broadband Pathfinder - Annan methods across projects e.g.
TV Wellbeing Tool, Carers
Assessment, Staff Survey,
Service User Questionnaire,
Story Telling and Focus
Groups.

8. Norrie Moane
Signpost Recovery
Community Development and Older Adults
Support in Clackmannanshire

9. Change Fund Older Adults Support Project
Community Older Adults
Development Support Worker
Worker

10. Project Methodology
• Delivered by Signpost Recovery through its CHL function
• Service has two distinct complimentary arms –Support &
Development
• Implementation – Moane (2012)
• Local Change Plan JIT Clackmannanshire (2012)–
Project Outcomes
• Interventions and Monitoring
• Evidence and Evaluation
• The Project in Action?

11. Clackmannanshire Older Adults Forum
Early Successes

12. Flora Henderson
Thistle Foundation
“We believe that life is for living.”
Lifestyle Management for
Long Terms Conditions

13. Lifestyle Management
• Lifestyle management addresses common needs,
concerns and hopes people have when living with a
long term condition.
• The service is staff led, but co-facilitated by peer
volunteers who have come through the programme and
have personal experience of a long term condition.
• The 10 x 3 h sessions are informed by person-centred
working, solution focused practice and medical
rehabilitation programmes.

14. Reach
• Thistle provides services in Craigmillar & across central
belt of Scotland.
• In 2011/12 we supported 233 people in 15 courses,
which includes 1-to-1 consults on a limited basis.
• The service supports ~ 15 active volunteers.
• . We receive 35 referrals per month (2011/12).
• 73% report at least one long term condition
• 13% report two or more

15. Outcomes
• As a result of our programme, people increase their
confidence, ability to cope, and mood.
• As a result of improving their situation, we notice that
people want to stay connected through volunteering.
• People who access our service value peer support highly,
and volunteers say it helps them maintain and continue
positive health behaviours.
• We notice that people use lifestyle management skills to
better manage relapses and sometimes use other
services differently

16. What Makes “The Difference”
• Personal outreach for people in complex situations: there
is a need for persistence and a personal approach.
• - encourage access of other services & follow up
• A non-expert approach which is about noticing small
changes and exploring what helps a person move on.
• An inclusive approach
• - it’s ok to drop out and come back later
• - it’s ok to stop volunteering and use the service
• - promoting choice (not exclusion criteria)

17. Irene Oldfather
Long Term Conditions Alliance Scotland
(LTCAS)
Active Ageing

18. Aims
• Promote positive attitudes towards ageing;
• Increase activity that empowers people to stay in good
physical and mental health and reduces social isolation;
• Raise awareness and disseminate information on the benefits
of physical activity;
• Support quality of life, independent living and self
management.
• Identify good practice and exchange knowledge.
• Harness the contribution of the third sector and the voice of
older people and unpaid carers.
• Encouraging inclusion of older people within local
communities;
• Scottish Contribution to European Year of AA and WCAA.

19. Benefits of Physical Activity
• Physical
– 20% lower risk of breast cancer;
– 30% lower risk of CHD and colon cancer;
– Activity can improve muscle function, reduce bone
– Loss, reduce falls and improve balance.
• Mental
– Reduces the risk of depression;
– Some evidence that it improves sleep;
– Can enhance psychological well being;
– Reduce anxiety.
• Social
– Reduce isolation and loneliness;
– Promote independence;
– Encourage people to adopt a preventative/self management approach to
their health.

20. How Much Physical Activity ? Key
Messages
• Some is better than none;
• More physical activity provides greater benefits;
• CMO Guidance – Over a week 150 mins of moderate intensity ( 30
mins walking over 5 days or 10 min walks x 3).
• Risks of sedentary behaviour (one week bed rest = 10years of
ageing on body;
• Following a week of bed rest – 1year to gain lost bone density and 6
months to regain strength and endurance.
• Break long periods of sitting has positive effect on health.
• Nursing home residents spend 80 – 90% time seated or lying down.
EVERYTHING COUNTS!!!

21. Conference Conclusions - Propositions
for Active Ageing
• Involve older people
• Raise awareness of benefits
• Role of GPs and Health Professionals
• Physical activity should be fun
• Challenge ageism and promote good practice
• Project location and accessibility
• Partnerships for learning and volunteering
• Intergenerational activity
• Empower older people with information
• Holistic approach in “Active Communities”

22. Gerry Power
National Lead
Community Capacity Building
& Coproduction
Joint Improvement Team