Reimagining Community Services
There is a great deal of innovative work going on across the NHS and beyond to improve community-based care. This is mainly happening through innovative projects rather than system-wide transformations in care delivery.
According to the Kings Fund, ‘a radical transformation of community services is needed, making use of all the assets in each local community wherever these are to be found, breaking down silos between services and reducing fragmentation in service delivery’.
The full report can be read on the Kings Fund website.
Housing and Health
Last week I was able to attend DATAFEST18 - FIT for Healthy Living in Inverness, with presentations on FIT Homes and Fitsense.
Fit Homes, a collaboration between Albyn Housing, NHS Highland, Carbon Dynamic and Robert Gordon University, is creating new ways of living for people in the Highlands which has potential to transform the way health and social care services are delivered.
The central concept of the homes is that they will include ambient social, physiological and building sensors to collect data that can be monitored and responded to by a variety of agencies. These homes will be sustainable, affordable, highly adaptable and technology enabled, meeting residents’ needs at all stages of life and crucially supporting independent living at home for longer.
The concept supports residents to take charge of their own wellbeing as well as having access to an enhanced, more personalised level of support at home. The model is aimed at creating a viable, lower cost alternative to full-time residential care and prolonged stays in hospital, designed in partnership with service users, that can be replicated throughout Scotland, the UK and globally.
It's not only rural Scotland that’s recognised both the challenge and opportunity that exists in helping people live independent in the community. The Kings Fund has recently published a report about what’s been in done across England through Sustainability and Transformation Partnerships, NHS England and NHS Improvement to work with social housing providers.
Why is getting to the doctor such a hassle?
I came across this article in The Medical Futurist℠ Newsletter If you’re interested in emerging healthcare technology and future of healthcare, from a US perspective, it’s worth looking at The Medical Futurist℠.
Evaluation of Macmillan cancer information and services at Argyll and Bute libraries
This report details results from an evaluation of the remote and rural pilot MCISS sites in Campbeltown and Rothesay carried out by the Rural Health and Wellbeing team of the University of the Highlands and Islands between May and September 2014. This was carried out with an awareness that the service has been running for 12 months in Campbeltown (with drop-in operating from October 2013) and 4 months in Rothesay at the time of evaluation.
The full evaluation is available here.
Review and Analysis of the Digital Health Sector and Skills for Scotland
This report has been produced by the Digital Health and Care Institute (DHI), as commissioned by Skills Development Scotland, to investigate and analyse the Digital Health sector and its skills issues in Scotland.
A full copy of the report is available here.
Strategic Prospectus: Building the UKRI Strategy
Operating across the whole of the UK with a combined budget of more than £6 billion, UK Research and Innovation brings together the seven Research Councils, Innovate UK and a new organisation, Research England. Please see below link to the UK Research and Innovation’s Strategic Prospectus.
The Scottish Global Health Collaborative
The Scottish Global Health Collaborative (SGHC) is an inclusive multidisciplinary and cross-sectoral group established to work with the Scottish Government, and partners in the wider health community (including NHS Boards, royal colleges, third sector and academic institutions), to promote effective and coordinated health sector involvement in global health.
Chaired by the Scotland’s Chief Medical Officer, the SGHC aims to work to the following principles:
- Emphasis on the mutual benefit to Scotland and the host country
- No detriment to the workforce of the NHSScotland
- Work based on the need identified by the host country
- Work through partnerships.
- Sharing of information, knowledge, experience and opportunities.
- Work focussed on geographical and technical areas that maximise the impact.
- Work within the framework of the Sustainable Development Goals 3 (Health) and 17 (Partnership)
- Linkages with other Devolved Administrations and NHS England will be maintained for mutual benefit
All Scottish organisations actively involved in Global Health are invited to join the SGHC.
The SGHC will work with the Scottish Government, and partners in the wider health community (including NHS, royal colleges, third sector and academic institutions), to promote effective and coordinated health sector involvement in global health.
For further information and to join www.scottishglobalhealth.org
More Support Needed for Rural Dementia
People with dementia in rural communities are increasingly isolated.
The Alzheimer’s Society issued the warning as it launched a new guide urging individuals and organisations in rural communities to address isolation for people with dementia, take action and better support people affected in their area.
Some two thirds of people with dementia are based in rural areas, with the percentage of older people occupying rural areas as high as 56%, leading many to feel very isolated.
A significant development for rural health: The Delhi Declaration: Alma Ata revisited
The 15th WONCA World Rural Health Conference (APRIL 2018), under the theme 'Healing the Heart of Healthcare: Leaving No One Behind', brought together stakeholders of rural health and primary health care, to address current and future challenges in rural health.
The conference culminated with the unanimous adoption of the Delhi Declaration, calling for people living in rural and isolated parts of the world to be given special priority if nations are to achieve universal health coverage.
The Declaration identifies six areas as priorities to achieve “Health for All Rural People”:
- equity and access to care,
- rural proofing of policy
- health system development
- developing and educating a workforce fit for purpose
- realigning the research
- people and communities
Loneliness and Isolation
All the Lonely People: Loneliness in Later Life
I came across this September 2018 Report by Age UK, ‘All the Lonely People: Loneliness in later Life’, recently.
It highlights the importance of loneliness and how when this feeling persists it can have a detrimental impact on wellbeing.
Although this Report focuses on older people, we know that loneliness can be experienced by people of all ages at different points in their lives. However, the circumstances which increase the risk of loneliness differ by age. For example, leaving education is a common vulnerable time for young people whereas the death of a long-term partner, or the sudden onset of illness or a disability more affects older people.
Organisations, activities and support needs to be available for people who are lonely, and lonely people, and those supporting them, need to be aware of what services are available and how to be able to access these.
For more information:
‘Loneliness and Health’, NHS Highland
The 2016 Annual Report of the Director of Public Health, NHS Highland, focused on tackling isolation and loneliness in older age and set out a number of recommendations that could be taken forward as a society in addressing this challenge.
It highlighted the recognition that loneliness can affect wellbeing, quality of life, premature death and contribute to diseases such as dementia, heart disease and depression.
Its recommendations include:
- that more should be done to publicise the links between loneliness and poor health, and
- that public bodies should invest in interventions to tackle loneliness.
A copy of the Report can be found NHS Highland The Annual Report of the Director of Public Health 2016.
Loneliness is just one of the themes that will be discussed by the new Highlands & Islands Ecosystem for rural mental health and active healthy ageing. The Ecosystem’s first meeting is on 26th November in Inverness.
Online access will be available for participants who are unable to join in person on the day.
The Ecosystem will bring together a community of multi-sector stakeholders interested in developing and delivering a joint agenda around rural mental health and active healthy ageing. We’ll seek to identify and address some of the key challenges and ensure that we are ‘bid ready’ for opportunities as they arise.
Scottish Government: Suicide Prevention Strategy 2013-2016
Tuesday, December 3, 2013. ISBN: 9781784120603
The Scottish Government's suicide prevention strategy to 2016 sets out key areas of work that we believe will continue to reduce the number of suicides in Scotland.
In 2017 and early 2018, a series of pre-engagement events took place to help inform the development of a new suicide prevention action plan. These events were run by NHS Health Scotland, Samaritans and the Health and Social Care Alliance; the purpose was to allow people who have lived experience of suicidal thoughts or of bereavement by suicide - and those who directly engage with those affected - the opportunity to contribute their views on what could be done better or differently to reduce suicide and the impact it has on people, families and communities in Scotland. The report on these events is available Samaritans - Suicide Prevention Strategy Report
UK Standards for Public Involvement in Health Research
The Chief Scientist Office have published the final UK Standards for Public Involvement paper, which aims to improve the quality and consistency of public involved in research.
A full copy of the report is available UK Standards for Public Involvement_Nov19.
NOTSS Publication list.
The Royal College of Surgeons of Edinburgh have included a non-technical skills for surgeons publication list on their website.
'Bespoked' Cycle to Health Evaluation
Velocity is an Inverness social enterprise which promotes cycling as a way of helping people adopt healthier lifestyles, encourage sustainable travel and improve emotional well-being. Funded by the European Social Fund as part of the Social Investment Fund, the ‘Bespoked’ project aimed to develop and test an innovative outreach service to address the mental well-being needs of vulnerable groups such as people with enduring mental health conditions. By delivering cycling sessions in familiar, safe places within the community and tailoring the groups to specific needs, Velocity wanted to address disadvantage and extend the well-being benefits of their original ‘Cycle to Health’ initiative to a wider range of people. Aiming to overcome barriers to participation, the project focused on developing an effective and workable model to market to the NHS and the Third Sector as a social prescribing intervention. The cycling project was developed in the context of the increasing recognition of the link between physical activity and mental well-being which is currently reflected in Scottish Government policy including its Mental Health Strategy 2017-2027.
A number of Videos were also produced
Bespoked: Full Video
Bespoked: Aaron’s journey back to connection
National study of the impact of rural immersion programs on intended location of medical practice in New Zealand
New Zealand faces an ongoing shortage of rural medical professionals. In an effort to increase interest in rural practice, medical schools in NZ offer rural immersion programmes. This study compares the effects of long (>33 weeks) or short (5-week inter-professional) rural immersion with no rural immersion on the career location intentions of medical students.
Active Health Project Evaluation
The Rural Health and Wellbeing team at the University of the highlands and islands undertook an evaluation of the active health project, aiming to encourage everyday walking or cycling and sustainable travel methods for longer journeys. Velocity cafe and bicycle workshop manage the project operating for it cafe and workshop in inverness.
The Active People Project focussed on helping to motivate and engage patients who could gain individual health benefits though increasing their level of physical activity.
A new article has been published in Rural and Remote Health:
Social factors might bring about health inequities. Vulnerable population groups, including those suffering from non-communicable diseases such as type 2 diabetes and depression, might be more prone to suffering the effects of such inequities. This study describes the social and health inequities for type 2 diabetic patients attending primary healthcare centres in Malta.
Health service delivery and workforce in northern Australia: a scoping review
Delivering health services and improving health outcomes of the 1.3 million people residing in northern Australia, a region spanning three million square kilometres across the three jurisdictions of Western Australia, Northern Territory and Queensland, presents specific challenges. This review addresses a need for systems-level analysis of the issues influencing the coverage, quality and responsiveness of health services across this region by examining the available published literature and identifying key policy-relevant gaps.
Reimagining Primary Health Care Workforce in Rural and Underserved Settings
This Discussion Paper starts at the local level and reimagines primary health care (PHC) and the PHC workforce from the perspective of people living in rural and underserved urban areas of low- and middle-income countries (LMICs). Drawing on research evidence and successful examples, it presents a “start local” health service delivery model, health system design framework, and financing models intended to ensure highquality local comprehensive PHC is available and accessible to all. Core PHC team members (community health workers, registered nurses, specialist family physicians, and administrators) and other health practitioners are generalists in their disciplines, working together in collaborative practice as the frontline providers of care that responds to the health needs of the population they serve. The most successful model of education and training for local comprehensive PHC is socially accountable, immersive community-engaged education woven into a facilitated education and training pathway starting with recruiting local students from rural and underserved communities. Successful attraction, recruitment, and retention of PHC team members results from the systematic approach of the Workforce Stability Framework with the three main tasks of plan, recruit, and retain supported by a long-term strategy and five conditions for success. High-quality local comprehensive PHC is successful in improving local population health when it is part of an integrated health system that connects clusters of autonomous local health service delivery organizations through partnerships with regional referral centers and other specialist service organizations that value the expertise of local PHC providers. All levels of the health system (local, regional, and national) are enhanced by intersectoral collaboration with active participation of all Partnership Pentagram members (policy makers, health administrators, health professionals, academics, and communities), underpinned by a local health needs– focused national health strategy, up-front local investments in PHC infrastructure and personnel, and funding models that reward achieving health outcomes.
Contribution of nurse leaders to rural and remote health research in Australia: A non-systematic scoping review
Internationally, there is a growing body of literature regarding nurse leadership in health research, including the importance of programs to strengthen nurses in academic leadership roles. Nurse leaders provide a valuable contribution to global health research, influencing policy, clinical practice, and decision-making processes. Nurse leadership is important in rural and remote communities who generally experience poorer health outcomes and barriers to accessing services.
Contribution of nurse leaders to rural and remote health research in Australia: A non-systematic scoping review - ScienceDirect
How can rural community-engaged health services planning achieve sustainable healthcare system changes?
Objectives The objectives of the Rural Site Visit Project (SV Project) were to develop a successful model for engaging all 201 communities in rural British Columbia, Canada, build relationships and gather data about community healthcare issues to help modify existing rural healthcare programs and inform government rural healthcare policy.
Results 36 themes have been identified and three overarching themes that interconnect all the interviews, namely Relationships, Autonomy and Change Over Time, are discussed.
Conclusion The SV Project appears to be unique in that it is physician led, prioritises relationships, engages all of the healthcare partners singly and jointly in each community, is ongoing, provides feedback to both the policy makers and all interviewees on a 6-monthly basis and, by virtue of its large scope, has the ability to produce interim reports that have helped inform system change.
Full Article available through BMJ here.
Addressing rural and Indigenous health inequities in Canada through socially accountable health partnerships
Background There are few examples of the practical application of the concepts of social accountability, as defined by the World Bank and WHO, to health system change. This paper describes a robust approach led by First Nations Health Authority and the Rural Coordination Centre of British Columbia. This was achieved using partnerships in British Columbia, Canada, where the health system features inequities in service and outcomes for rural and Indigenous populations. Social accountability is achieved when all stakeholders come together simultaneously as partners and agree on a path forward. This approach has enabled socially accountable healthcare, effecting change in the healthcare system by addressing the needs of the population.
Innovation Our innovative approach uses social accountability engagement to counteract persistent health inequities. This involves an adaptation of the Boelen Health Partnership model (policymakers, health administrators, health professionals, academics and community members) extended by addition of linked sectors (eg, industry and not-for-profits) to the ‘Partnership Pentagram Plus’. We used appreciative inquiry and deliberative dialogue focused on the rural scale and integrating Indigenous ways of knowing along with western scientific traditions (‘two-eyed seeing’). Using this approach, partners are brought together to identify common interests and direction as a learning community. Equitable engagement and provision of space as ‘peers’ and ‘partners’ were key to this process. Groups with varying perspectives came together to create solutions, building on existing strengths and new collaborative approaches to address specific issues in the community and health services delivery. A resulting provincial table reflecting the Pentagram Plus model has fostered policies and practices over the last 3 years that have resulted in meaningful collaborations for health service change.
Conclusion This paper presents the application of the ‘Partnership Pentagram Plus’ approach and uses appreciative inquiry and deliberative dialogue to bring about practical and positive change to rural and Indigenous communities.
Full article on BMJ.