Bcda Conference 22nd February

• 1. The New World Prediction, Prevention and Public Health Strategies in Social Care Jim McManus Joint Director of Public Health bcda, 22 ndJanuary 2011

2. The World

• Health White Paper

• Social Care Reforms

• Public Health Changes

• Health and Wellbeing Boards

• GP Commissioning Consortia

• JSNA

• Less Money, more outcome

3. Domains of Public Health HealthImprovement Health Protection Service Quality & ImprovementPrediction and Prioritisation sit here What does this mean in social care? What is your role? Prevention sits here Prediction and Prioritisation sit here 4. Contin u ous Process RFBC Prioritisation What do we need to do? For whom? When? Who is most likely to benefit? Who is most in need? C.S.RJSNA5COUNCIL Outcomes 5. Why Prediction and Prevention

• Quality of Life

• Reduction in Cost

• Avoids escalation in care

• New Model of Care

6. Prediction forecast / target services Secondary Prevention Primary Prevention Universal & Well-being LOW MODERATE SUBSTANTIAL CRITICAL Reduce numbers of people coming into high-cost services and moving alongFACS banding Intensive Home Support Residential Care Community Equipment Services Telecare ServiceTertiary Prevention 7. Example - Falls Prevention

• In Birmingham, over 40,000 older people have falls every year.

• 35% of over 65s experience one or more falls.

• 45% of over 80 who live in the community fall each year.

• By reducing the common risk factors and by providing appropriate equipment, falls can be reduced by between 10 -40%.

• A persons home environment can also contribute to the risk of falling.

• The prevention of falls scheme supports a proactive approach, to target individuals with low level prevention interventions which can have a measurable impact on individuals quality of life and wellbeing.

• Low /moderates savings

8. Fora typical PCT

• For each 10,000 people over 65

• 3,500 will fall each year, 1500 twice or more

• Most will not call for help

• 700 will attend A&E or the MIU

• A similar number will call the ambulance service

• 250 will have a fracture

• 80 are hip fractures

• Ageing demography means all this will increase 50% by 2020

9. KeyRisk Factors includepeople who have had a Previous fall 1 2 3

• • • People who have a Long term condition

• • • muscle weakness/balance/gait orwho are taking multiple medications

10. Three levels of focusDefined OutcomesProcess & ProceduresService User EvaluationTargeted interventionBenefits 11. Falls Prevention multi-factorial toolkit

• checklist to identify people at risk at falls and link to services and information

• Working Neighbourhood Fund funding secured until March 2011

• Start date of project 20th November 2009- sort tools , plan etc

• Multi-agency: Birmingham City Council, Health Services, Third Sector

• Training for participants

• Programme management part of wider prevention

• Public health evidence based

• Referral to a selection of agencies

12. Prevent Falls project aim

• • By providing a pathway for people who may be at risk of falling to get the help they need :-

• • Raising awareness of falls and how to prevent them

• • Referring on to services to help prevent falls e.g. equipment, handy persons scheme and/or footcare

• • Referring on to Telecare equipment (falls monitor) which mitigates the effects of falls

• • Referring on for benefits entitlement guidance

• • Sign post to social activities and exercise classes such as, Keep Moving, orchi to improve their balance and to prevent falls and fractures

• • Internal process ( timelines )

13. The Processlow/moderate

• Falls Checklist

• • Usually new to A and C- Unique numbering

• • Specific requests

• • Client to sign

• • Leave client with note

• • Send form to Co-ordinator

• • Destroy original when receipt confirmed

• Service Request Form

• • Details copied by Co-ordinator from Checklist

• • Sent to Service provider -5 days

• Visit /contact Follow up letter

• • Details copied by Co-ordinator from Checklist

• • Sent to Client

14. Prevention of Falls -Process

• Target Population

• Persons over 50 years living in Birmingham

15. Results to date

• Over 500 people supported

• All received information on preventing falls

• Average number of services requested per checklist 2.6 requests per person

• Number of people having a fall since 14% (46% before checklist)

• Over 66% were very confident that the information and services they received would help them prevent falls in the future

• There was a reported 3.7% improvement in quality of life

• Onewoman 11k

• Service User evaluationcommencing

16. Next Steps

• Ensure Benefits realised

• Evaluation with Citizens

• Explore other roles that maybe abledeliver this for low and moderates .

• Shift thinking to Primary prevention

• Embedprevention score cared

• Support delivery of Peters New Offer

• Build into GPs pathfinder