Live Blog: Integrating Care in Neighbourhoods

Welcome to the live event blog from the Salford Together Integrating Care in Neighbourhoods event held on Wednesday 16 October at The Lighthouse, Salford.

Today is all about making connections and sharing our neighbourhood priorities, initiatives and projects along with best practice and learning from our neighbourhood working.

Follow us on Twitter and use the #salfordnbhs and #salfordtogether to join the conversation.

Let’s get today started…

We’re starting the day with a warm welcome from Helen Kilgannon, Associate Director at AQuA.

Helen sets out the agenda for the day and hands over to June Roberts, Associate Director of Transformation.

June talks us through Salfords integrated care journey so far and where the future is heading.

June sets out the need for integrated care for a sustainable system within Salford to support all those receiving care and those who are working in the system.

June highlights the importance of the mix of partners within the growing Salford Together partnership and the vibrant mix between both health and volunteer partners that are involved in integrating care.

The integration journey has been innovative, but the focus now needs to be on care within neighbourhoods. June sets out the 3 bundles of work that now need to be focused on; urgent care, extended care and neighbourhoods.

With the event focusing on neighbourhoods, we hand over to our first neighbourhood team of the day to present.

Neighbourhood focus: Swinton

The team take to the mic to talk through their journey as a neighbourhood and how they identified respiratory health as a priority for their area.

The leadership team in Swinton is made up of a range of roles including; district nursing, adult social care, CVS, Primary Care, ICO and Mental Health.

To understand their role in the neighbourhood, the team created a mission statement to clearly set out their focus and the goals they want to achieve.

The team talk us through how they identified the local issues that those in the Swinton area were regularly seeking support for and how they could make a difference to this.

The team share why they chose to focus on respiratory health in the area, highlighting that this affects everyone across all age groups. The team provide an overview of the focus on self-care, to help improve physical and mental well-being across the neighbourhood.

The team then move on to the creation of the plan and the identified different levels of engagement needed to deliver the goals. C

Helen then hands over to Cath Gormally and Mark Albiston to talk us through strength-based approaches. 

Cath Gormally, Director of Adult Care, explains to the room what a strengths-based approach is and why services should be focused on prevention and early intervention, focusing on strengths and moving away from a deficit model.

“Whats strong? Not whats wrong?”

Cath highlights the importance of integration within the neighbourhoods and how a collective understanding of health and well-being can be applied to any intervention and profession.

Cath then goes on to talk the room through the model of a strength-based approach, community-led support, which has been selected to use in Salford.

Community-led support focuses on 7 principles, underpinned by co-production. Supports a change in the relationship between professionals and the people we support. This approach has a focus on community, looking at outcomes and not just packages of care. Cath highlights the flexibility of the approach and how this can be applied to the different needs of each neighbourhood.

Mark Albiston, Divisional Director of Adult Social Care, then talks us through the next steps of the strength-based approach within the system. Mark discusses the importance of testing the approach and the need for the workforce in helping to determine how the test of change is undertaken.

The floor is opened for a quick Q&A with Cath and Mark.

We then move on to our next neighbourhood focus.

Neighbourhood focus: Ordsall and Claremont

The team in Ordsall and Claremont are talking through their priority on high-intensity users.

The team start us off with their purpose statement.

“We think and act together”.

The team talk the room through their achievements so far and the challenges they have faced – highlighting competing drivers as the biggest challenge for their integrated team.

Behaviour changes in a system can take a long time and the team express how proud they are of the work they have done, despite the limited time they have had together.

The team then focus on why their priority is high-intensity users; they wanted to understand the characteristics and how they work with them. The team talk us through their journey to develop a priority area, including how they used locality data and the impact that is expected from their priority focus.

Next steps… the team recognise this is a journey and speak about how they are going to continue their work and revise how existing aims can support the services in place or new services that the team may want to introduce, such as holistic assessments.

Next up, the focus is on community cardiology clinic outcomes – Beyond 100 days…

Dr Gavin Freeman, Consultant Cardiologist, introduces the ‘Beyond 100 days’ community cardiology clinic. The 100-day challenge was used as a platform to pilot the project, which provided an opportunity to streamline services and deliver patient care closer to the communities that need it.

The project took place in the Ordsall and Claremont neighbourhood, with their team eager to proactively drive service improvement and an interest in expanding and rolling out the clinic across the system and neighbourhoods.  A number of clinics were ran as part of the project to assess a range of cardiology patients, including a palpitations clinic.

Gavin then talk us through the range of patient demographics that used the clinic and the involvement of over 50 GPs using the service to refer patients. He expresses his hope to involve respiratory medicines if the clinic service can be extended as the majority of onward referrals were for patients with respiratory conditions such as breathlessness.

The clinic has seen significant benefits to the system including over 400 saved trips to the Salford Royal site and over 1000 miles of patient travelling, as they can attend the clinic with a range of diagnostics within the community. Gavin highlights the benefits the clinic has had not just for patients, but for the health economy too, including quicker diagnosis and discharge rate, reduced administration needs and improved RTT performances for the Trust.

Gavin takes questions from the floor and we take a break before kicking off the mid-morning sessions.

The room is back with Deji Patel and Girish Patel who talk us through Primary Care Networks.

Girish Patel, Clinical Director of Swinton Primary Care Network, starts by talking the room through the role of a Primary Care Network (PCN) and what they are designed to do. A PCN focuses around neighbourhood working and providing proactive and personalised care.

Girish highlights the role of a Clinical Director of a PCN, the leadership they provide and the importance of them supporting the PCN to implement new agreed service changes, pathways and enhanced services.

He then goes on to provide an overview of the new staff and roles we can expect to see in 2019-2022 as a result of PCNs.

Deji Patel, Clinical Director of Ordsall and Claremont PCN, highlights the positive attitude from staff that supports the PCNs success and the adapted and enhanced services that can be offered as a result of this positivity towards changing working ways.

Next up, our third neighbourhood focus.

Neighbourhood Focus: Broughton

Scott kicks off the session by talking us through the 3 core themes that the team wanted to work on as a group to identify who they were, what they were there for and how they created ‘One Broughton’.

The team then present on how they chose to focus on their priority of self-neglect. Scott highlights that the number of people suffering and affected by self-neglect equates to approx. 1.2 million households in the UK.

Sarah from the team then focuses on a range of case studies, demonstrating the importance of the relationships the team build with the people they support and the wider services involved to support people to access the healthcare they need.

Sarah hands back to Scott, who talks us through the future plan for the Broughton Neighbourhood. Scott covers the plans for research into self-neglect, the development of a tool to help professionals better identify people at risk of chronic self-neglect and the ‘one Broughton’ support fund to allow people to be supported quickly and appropriately.

Next, we hear from Kirsty Marshall, Intermin Assistant Director of Health at the University of Salford, who focuses on integrated working.

Kirsty provides the room with a quick overview of the research study she is currently undertaking as part of her PhD on the integration of health and social care services in Tameside and Glossop.

Kirsty explains the need for learning from others and the three themes that were identified to cover in the research to understand the experiences of an integrated neighbourhood team and to develop an understanding of the relations within the wider system.

As a result of the research, a neighbourhood team development framework was developed. Kirsty talks us through the framework and the implementations for practice.

Next up, we have our fourth neighbourhood focus.

Neighbourhood Focus: Irlam and Eccles

The team start by outlining their neighbourhood priority:

By November 2021 no-one in Irlam and Eccles will be socially isolated

The team explain a range of reasons for reducing social isolation as a priority including the impact it can have on mortality rates, health risks such as high blood pressure and to ensure that people are able to access services in the community and the system.

The team then show two videos that have been created, covering just some of the work the team are focusing on.

The first video focuses on their community events initiative, which aims to reduce social isolation through events such as a Christmas dinner, and afternoon tea.

“It’s a really good opportunity to go out and meet other people”

“It’s nice to be given the opportunity to come out, have a nice meal and a chat”

Our second video of the session focuses on the neighbourhood team itself and the aims of the team. The video highlights the variety of skills and roles that work within the team to support the Irlam and Eccles community and how the team are working together to integrate care.

Next up, Mark Lupton talks to us about Healthwatch Salford.

Mark gives a quick overview of the Healthwatch scheme, and what has been done in Salford by Healthwatch as part of the NHS Long Term Plan project, such as the annual Healthwatch Salford survey.

Mark explains the four themes that the survey focused on; prevention, personalisation, care closer to home and technology. Over 296 people from Salford completed the survey, which helps influence decisions at local, regional and national level.

Mark shares some of the key results of the survey, including how the results apply to each neighbourhood:

  • Patients want the freedom and choice to be able to decide where to go for their health and care services
  • Decisions about care should include both the patient and the professional
  • Improved communication is needed between Primary and Secondary care
  • Respondents want to stay in their own home for as long as it was safe to do so
  • Services need to remember that not everyone is comfortable using technology

Neighbourhood Focus: Walkden

We now hear from the team working in the Walkden neighbourhood, who are focusing their priority on creating a community health and wellbeing hub to provide a non-clinical space for residents, support groups, statutory sector and VCSE to come together.

The team start by describing the problems they face within their neighbourhood, such as a spread out neighbourhood, difficult transport links and limited carer groups.

The team then go on to explain how and where the hub will be set up to enable people to easily drop-in, work together and support each other to deliver better outcomes for everyone.

We then move on to our World Cafe activity.

The World Cafe activity provides an opportunity for the room to hear about Salford city-wide opportunities.

The topic areas for the World Cafe are: Safer Salford, Salford Living Well, The Early Help Service, Wellbeing Matters, Innovation with Primary Care Teams, Frailty, Salford Integrated Neighbourhoods and Salford Delirium and Dementia Support.

Our teams come back together for the next session, with a focus on Locality Plans.

Peter Brambleby, Director of Public Health, Salford City Council, starts our final sessions on the day focusing on the Locality Plan in Salford.

Peter talks us through the re-fresh of the Locality Plan in place, which was developed 3 years ago. This re-fresh will look in greater deal at the stages of life; starting well, living well and ageing well.

Peter empathises the importance of co-production in improving each stage of the plan, in particular, the ageing well stage. He also highlights that greater emphasis will be put on place-based and neighbourhood working, determinants of health and wellbeing, along with Primary Care Networks.

Peter covers other chapters that will be included in the plan including innovation and enablers and strategic alignment.

Peter then hands back to Helen and Dr Richard Warner, Chair of the Integrated Care Division, Salford Care Organisation, to close the day.

Richard recaps the day and expresses his thanks to the team for putting the event together and to the neighbourhood teams for their time and commitment to their work throughout Salford.

Richard covers the next steps for neighbourhood working, including reviewing the work that has been done, where we are at now and embedding the changes and capturing the successes.

Thank you to everyone who joined us for a fantastic day sharing the integrated care in Salford neighbourhoods.

Integrating Care in Neighbourhoods

Thank you to Claire from More than Minutes, for this visual representation of the event.