Heywood Integrated Care
Organisation
(HICO)
Demonstration Site Update
15th December 2010
Dr Michael Taylor, York House Surgery, Heywood,
OL10 4NN
Email: michael.taylor3@nhs.net
Heywood Integrated Care Organisation
The Glass That is Half Empty
Heywood Integrated Care Organisation
Introduction: Aims
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Clarify wellbeing services
Increase public awareness
Facilitate easier access
Help the work vulnerable
Maximise self care
Guide people to appropriate support
Heywood Integrated Care Organisation
Introduction: Objectives 1
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Use population approach
Improve physical care of those with
wellbeing issues
Improve liaison between GP and
PCMHT
Reduce stigma
Heywood Integrated Care Organisation
The Population as a Patient
Heywood Integrated Care Organisation
Introduction: Objectives 2
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Reduce frequent attenders
Reduce frequent flyers
Sign post to wellbeing services
Heywood Integrated Care Organisation
Process Outcomes
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Complete de-stigmatisation
Paperless referrals
Short waiting times
Seamless care achieved! No, really!!
Attendance rates of 82%
Simple feedback loop to adjust the
volume of referrals.
Heywood Integrated Care Organisation
Methodology: Organisational diagram
Senior Commissioning Team
NHS HMR
Mental Health Commissioning
Team
HICO Stakeholder Group
HICO Mobilisation Team
Heywood Integrated Care Organisation
Methodology: Team
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Two Heywood GPs
A Project Manager, Public Health, (Chair)
An Operational Manager, PCMHT
A Graduate Mental Health Worker
A Practice Manager
A Senior Commissioner, Rochdale MBC
A Lead Commissioner, NHS HMR
Heywood Integrated Care Organisation
Methodology: PDSA
Heywood Integrated Care Organisation
Methodology: Questionnaires
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Warwick-Edinburgh Mental
Wellbeing Scale (WEMWBS)
Patient Health Questionnaire 9
(PHQ9)
General Anxiety Disorder
Assessment (GAD 7)
Heywood Integrated Care Organisation
Patient choice of treatment
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Mental health worker
Nil
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Wellbeing worker
1/3
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Medication
1/3
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Watch and wait
1/3
Heywood Integrated Care Organisation
Evaluation: Problems
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Rochdale MBC support difficulties.
Cultural differences especially
PCMHT and GP.
Wellbeing Worker overwhelmed.
Scarcity of Wellbeing Worker.
WEMWBS completion difficulties in
waiting room.
Heywood Integrated Care Organisation
Evaluation: Lessons Learned
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Wellbeing is not stigmatised.
GP practices are suitable
environments for wellbeing workers.
Wellbeing leaves responsibility with
the citizen.
A better, quicker, cheaper service is
realistically achievable.
Roll-out is easy.
Heywood Integrated Care Organisation
Evaluation: PCMH perspective
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60% of patients referred complex.
WW reported being overwhelmed.
WW compared and contrasted the
cultures.
Better liaison with the GP practice
about patient population was a
learning outcome.
Invaluable learning experience.
Heywood Integrated Care Organisation
Evaluation: Academic 1
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Services provided are seen as positive
alternatives.
Access to psychology via Wellbeing
Worker is more acceptable.
Relational and cultural tensions were
addressed.
Understanding was improved.
Increased awareness of wellbeing
services.
Heywood Integrated Care Organisation
Evaluation Academic 2
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Speed-dating event was innovative
and cost effective.
Regular PDSA meetings were
challenging and important.
The WW role should be reviewed.
WW’s should be more involved with
the GP practice.
GPs to realise to abilities and
limitations of the WW.
Heywood Integrated Care Organisation
Conclusion: Patient perspective
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No stigma
Full consultation
Choice
Quick help
Local help
Place of comfort
Seamless care (“no glitches”)
Heywood Integrated Care Organisation
Conclusion: Practice Perspective
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In house
Need to understand the WW
Need for signposting
Reduced DNAs
Prioritisation of work-vulnerable of
great help
Heywood Integrated Care Organisation
Conclusion: PCMH perspective
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Location crucial
More capacity needed
Different solutions for different
practices
Incorporation of learning into IAPT
Heywood Integrated Care Organisation
Conclusions: L.A. Perspective
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Can include greater numbers of
citizens.
Responsibility for self-improvement.
Builds up community assets.
One stop health and social care in
citizens interest.
Demonstrates benefit of joint
commissioning.
Heywood Integrated Care Organisation
Conclusions: NHS Perspective
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Better, quicker, potentially cheaper.
Transformation not additional.
Different ‘populations’ may have
different needs.
Uses assets as well as services.
May reduce secondary care
demand.
Heywood Integrated Care Organisation
Next Steps:
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Five Ways to Wellbeing website.
Supporting community assets.
Commissioning in-house services.
Incorporating wellbeing into IAPT.
York House Surgery
Website:
www.5w2w.org
Heywood Integrated Care Organisation
HICO Outcomes
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Wellbeing score
39.6
Regional average
55.5
Wellbeing not stigmatised
Seamless care
Opportunity to be better, quicker, cheaper
Heywood Integrated Care Organisation
Relationship between WEMWBS
scores and PHQ-9 scores
70
60
40
30
20
10
PHQ-9
26
24
22
20
18
16
14
12
10
8
6
4
2
0
0
WEMWBS
50
Heywood Integrated Care Organisation
What WEMWBS Scores Mean
60-70
50-60
40-50
Life treats you well
No big worries
Life has its ups and downs
30-40
Life can be a worry
20-30
Life’s a big hassle
14-20
If you are not already in
treatment see your GP now
Heywood Integrated Care Organisation
The Glass That is Half Full
Disorders of mood
Wellbeing
Focus of treatment
Focus of recovery
Heywood Integrated Care
Organisation
(HICO)
Demonstration Site Update
15th December 2010
Dr Michael Taylor, York House Surgery,
Heywood, OL10 4NN
Email: michael.taylor3@nhs.net