A Public Health Approach to Social Care and Wellbeing Services
Tony McGinty
Joint Assistant Director for Public Health
Lincolnshire County Council and NHS Lincolnshire
The Approach
Understand Your Population
Understand Triggers
Evidence Based Modelling
Procure and Manage
• Joint Strategic Needs Assessment (JSNA)
• Evidence based demand forecasting
• Wellbeing Support Service model
Areas for discussion
• Establish JSNA as a continuous process;
• Improve level and quality of engagement;
• Produce a succinct annual JSNA report;
• Focus report on the health inequalities
Objectives for JSNA 2011
JSNA Objectives
• 35 topic areas identified based on the data.
• Each topic has an identified ‘Owner’.
• ‘Owner’ issued with a template upon which to provide commentary.
• Commentaries underwent a ‘peer review’ process
JSNA Approach
JSNA Approach (2)
What do we know?
• Indicator details
• Data, trends, profiles
• Targets and performance data
• Local views and engagement
• National and local strategies
• Current commissioned activity and services
• Key inequalities and equality impact
• What are the knowledge gaps?
• How are these impacting on effective service commissioning/delivery?
• What are the risks of us not delivering?
• What is coming on the horizon and what should we be doing next?
What is this telling us?
• New JSNA Website
• Joined up approach (IMD, Economic Assessment, etc)
• Additional ways of viewing the JSNA
• Brief Overview Report
Presentation of JSNA
Presentation of JSNA (2)
Presentation of JSNA (3)
• Promoting healthy lifestyles
• Improving health and wellbeing for older people
• Delivering high quality systematic care for major causes of ill health
• Improving health and reducing health inequalities for children
• Reducing Worklessness
Identified Priorities from JSNA
JSNA Priority/Marmot Objectives
Marmot Objective
Priority
Give every child the best start in life
Enable all children, young people and adults to maximise their capabilities
Create fair employment and good work for all
Ensure healthy standard of living for all
Create and develop healthy and sustainable place and communities
Strengthen the role and impact of ill health prevention
Promoting healthy lifestyles Improving health and wellbeing for older people Delivering high quality systematic care for major causes of ill health Improving health and reducing health inequalities for children Reducing Worklessness
• Linked to JSNA priorities
• Developed in consultation with stakeholders (e.g. via Excellent Ageing)
• Focused on triggers which:
– place people at risk of requiring more costly services; and/or
– Indicate people may need some support, advice or assistance
Evidence based demand forecasting
Areas of focus for demand forecasting:
Evidence based demand forecasting
• In receipt of supporting housing
• Long term health conditions (Stroke, CHD, COPD, Dementia)
• Out of work benefits
• Fuel Poverty
• House re-possessions
• Estimated unclaimed disability benefits
• Adult social care (people assessed as not eligible combined with people exiting reablement services with no further services)
• Frail Older Peoples Project
Evidence based demand forecasting
Category of NeedNumber
(2010)
People in receipt of Supporting People services 12,521
People with long term health conditions 70,926
Worklessness 48,170
Housing Need - Fuel Poverty 71,600
Housing Need - Repossessions 1,000
Unclaimed benefit claimants 97,420
Adult Social Care 4,045
Frail Older People Project 7,078
TOTAL 312,760
Limitations of the model:
Evidence based demand forecasting
• Some people will appear in more than one area
• Reliability/consistency when projecting and forecasting into future
• Other areas need to be forecast as well (Problem drug users, Smoking, Obesity, etc)
• Not all people will require the same level of support
Engagement
• A Little Bit of Help Please!
• Stay in touch with me
• Over lapping boundaries
• Accessible
• Acceptable
Next steps for the model:
Evidence based demand forecasting
• Delphi approach to obtaining consensus with regards the forecasting
• Development of a model of support which recognises the differing levels of support people require
• Agree with colleagues in other services (social care) overlaps, hand off processes, risk/benefit sharing, etc
Tier of Support
Level 1 - Local Advice Network
Level 2 – Brief Intervention
Level 3 – Ongoing Support
Example Interventions
Adapted from ‘Improving Care and Saving Money’, DH (2010)
Signposting & information
General Advice (1)
Specialist Advice
Supported Employment
DAAT Services
SmokeFreeLincs
Phoenix weight management
Health Trainers
General Advice (2)
Exercise Referral
Food for Life Play for Life
Fit KidsCommunity
Walks
Benefit Advice
Debt Advice
Form completion
Advocacy
Practical Support
Housing Support
Life skills
Emotional Support
Domestic Help
Telecare
Self care support
Community Equipment
Co
mm
un
ity
Vo
lun
teer
ing
Wellbeing Support Service Model
Sin
gle T
riage T
oo
lId
entificatio
n an
d B
rief Ad
viceW
ellbein
g H
ub
Man
aged
Cu
stom
er Relatio
nsh
ips
v.2 July 2011
Num
bers
of
Peo
ple
Service Need
Community
Support Acute
Time
Wellbeing Support
Managed Advice Networks
Stay in touch please
The Approach
Understand Your Population
Understand Triggers
Evidence Based Modelling
Procure and Manage