Keep Well in NHS Lothian

1
Keep Well in NHS Lothian

• Katie Edwards
• and Dr Janet Murray

2
Lothians approach

• Practice based model with strong outreach element
• Focus on engagement, assessment, clinical
  management, sign-posting and one-to-one support
  to empower change

3
Participating practices

• 15 practices within Edinburgh (those in most
  deprived communities - measured by average SIMD
  for registered pop)
• 4 geographical clusters
• South East (eg Craigmillar) South West (eg
  Wester Hailes) North East (eg Leith)
• North West (eg Muirhouse)

4
Project team

• Nurse Case Managers (x3)
• - supporting practice delivery
• - managing outreach work
• - coordinating community based engagement and
  interventions
• Outreach Workers (x4)
• - providing one-to-one support
• - facilitation of sign-posting to relevant
  community based services
• - developing strong relationships with vol
  sector
• - supporting community based engagement and
  interventions

5
Project team

• Keep Well Nurses (x3)
• - working in a number of practices to deliver
  Keep Well and support
• practice teams participation in delivery of
  Keep Well

6
Start-up

• Phased approach to going live
• 2-3months planning activity per practice
• First assessments delivered Jan 2007

7
Engagement and assessment data

• Monthly activity data reporting from 31st May
  onwards
• Target population 23,621
• 7516 engagement efforts
• 1630 assessments
• High-level response rate 21.6

8
Local practice and learning activities

• Training needs assessment
• Keep Well training (Dec 2006)
• Health Behaviour Change training (4 cohorts 3
  days)
• Sign-posting to established local training
• Counterweight training

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Whats next?

• Ongoing work with practices (inc. engagement and
  assessment activity)
• Funding of Voluntary Sector initiatives (physical
  activity diet and cooking mental well-being
  alcohol consumption)
• Broadening scope to inc community based
  interventions and engagement activities
• Commissioning of training to support alcohol and
  physical activity related brief interventions

10
National evaluation

• Describe the different pilots and how Keep Well
  is expected to improve health
• Measure the impact of Keep Well
• using a Keep Well Core Data-set
• linking to routine primary care data sources

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Local evaluation- Aims

• Describe the implementation of Keep Well
• Evaluate roles of Nurse Case managers and
  Outreach Worker
• In depth examination of implementation in four
  practices
• Use results to inform development of the project

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Evaluate roles nurse case managers and outreach
workers Objectives

• To define expectations of these roles
• To identify perceptions of success.
• To identify factors which facilitate or obstruct
  the success of the roles.
• To identify their contribution to
• engaging individuals
• linking with community-based projects
• work with General Practice to provide
  anticipatory care

13
In depth examination of four practices -
Objectives

• To identify impact on practices
• resources required
• impact on other work
• staff involvement
• staff training
• To measure the reach of Keep Well
• To identify examples of good practice

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Contact details

• Katie Edwards
• Keep Well Project Manager
• katie.edwards_at_lpct.scot.nhs.uk
• Dr Janet Murray
• Locum Consultant Public Health
• janet.murray_at_lhb.scot.nhs.uk