West Wakefield Health & Wellbeing Active Signposting David Cowan Care Navigation Programme Manager

2. West Wakefield Health & Wellbeing Active Signposting David Cowan Care Navigation Programme Manager Twitter: @HealthyDaveC David.cowan@westwakefield.org.uk Twitter: @ConexusHealthUK LinkedIn: West Wakefield Health & Wellbeing Ltd Website: http://www.Conexus-Healthcare.org

3. Agenda • Understand what Care Navigation is • Care Navigation Learning points • Who we can Care Navigate to in Stockport • Local clinical template and dashboard

4. Active Signposting - Care Navigation Definition “A person-centred approach that uses signposting and information to help primary care patients and their carers move through the health and social care system as smoothly as possible to ensure that unmet needs are met”

5. Extended Primary Care Team Active Sign-posters • First Contact Physio • Community Pharmacists • Carers • MEC • Social Prescribing • Lifestyle Change

6. Learning points from our delivery

7. Learning Points

8. Best Practice Guidelines • Practices have call recording facilities. • To be backed up by the use of the clinical system template. • Useful phrases: • “If your condition worsens, please come back to us” • “If the service we have given you information on, does not meet your needs, please come back to us” • Supplying patients with detailed information. • Via leaflets, electronic information, etc.

9. Informing Patients Good patient experience helps to promote the Care Navigation service

10. Patient awareness campaign

11. Who can we Care Navigate to?

12. Provider 1 – Community Pharmacy

13. Community Pharmacy: Supporting Active Signposting in Stockport Dipesh Raghwani, Clinical Lead, Greater Manchester Local Pharmaceutical Committee (GMLPC)

14. Community Pharmacy in Stockport • In Stockport we have: • 73 community pharmacies with 6 open 7 days a week and in the evenings • Saturday cover 07:00 to 00:00 • Sunday cover 07:00 to 23:00

15. Minor Ailments and Active Signposting The Active Signposter when receiving a call will ask the patient to provide a little more details around their reasons for seeking a GP appointment, if any of the symptoms fall within the below, the patient will be sign posted to all options available to them. i.e. The community Pharmacy would be the most appropriate place to receive advice on x in the first instance. It maybe that a request is around medication, and again the best place for this to be dealt with would be the community pharmacy. Symptom Sore Throat Athletes Foot Fever Cold Sores Hay Fever Conjunctivitis Threadworms Thrush Blocked Nose (infants) Bites / stings Earache Soft Tissue Injury Constipation Diarrhoea Warts / Verruca Head Lice

16. Minor Ailments and Active Signposting Red Flag System Understandably many of the symptoms outlined could actually indicate something more serious that a Community Pharmacy would not be appropriate to treat. Therefore a Red flag system would be put in place to ensure the Active Signposter doesn’t inappropriately sign post.

17. Community Pharmacy referral form When a patient is directed to a Community Pharmacy, the GP practice may call the pharmacy to let them know to expect the patient, or the patient may self refer following the guidance. To enable a two way approach a PharmOutcomes module has been created to allow pharmacies to record the intervention and if appropriate refer the patient back to the GP.

18. Working Together • Liaise with your local pharmacies to see how you can work together to support referrals – visit local pharmacies to see how they deal with MAS • Have a common referring back mechanism if the pharmacist feels patients need to be seen urgently • Be aware of MAS restrictions – support document will be available • Ensure you have a registered nhs.net address with PharmOutcomes • Ensure PharmOutcomes emails to practice are checked regularly

19. Provider 2 – First Contact Physio

20. First Contact Practitioners (FCP) Physio

22. Provider 3 – Minor Eye Care

23. Minor Eye Conditions Service (MECS) Service Description - Patients of any ages with any of the following symptoms: Loss of vision including transient loss (if patient unwell then suspect stroke and book with GP) Flashes and floaters Ocular pain Differential diagnosis of red eye Foreign body and emergency contact lens removal Dry eye Blepharitis Epiphora (watering) Trichiasis (misdirected eyelashes) Differential diagnosis of lumps and bumps in the vicinity of the eye Patient-reported field defects (if patient unwell then suspect stroke and book with GP) Appointment booking service – patient is triaged in to urgent or routine appointment. List of providers available at www.gmpec.co.uk

24. Provider 4 - Carers

25. Support, advice and information for Stockport’s Carers • All services offered free (suggested donation for counselling service) • Referrals welcomed from professionals, or self referral • Contact trained, experienced carer support online or by telephone • Home visits available 0161 442 0442 www.signpostforcarers.org.uk info@signpostforcarers.org.uk

26. Provider 5 - START

27. START(Stockport Triage Assessment & Referral Team)Public Health behavioural change team

28. Lifestyle Change Pathway Primary Care ABL 12 wk programme Weight mgt18+ Smoking 12+ Physical Activity 18+ PARiS 18+ ABL specialist smoking service Telephone Triage 10 mins Life Leisure Lifestyle change identified Weight Mgt Smoking Physical Activity PARiS Drugs Alcohol START CGL Early Intervention Drugs 26+ Alcohol 26+ Pathfinder Pennine Care 1-1 assessment 45 mins CGL Recovery Able to self manage www.healthystockport.co.uk Substance misuse under 26 yrs direct to Mosaic

29. How to contact us We accept self referrals as well as professional ones Main number 0161 474 3141 8.30-5.30pmStockport.start@nhs.netprofessionalsEMIS form on CCG websiteSTART@Stockport.gov.ukpublic (online form)www.healthystockport.co.ukall

30. Provider 6 Wellbeing & Self Care

31. Wellbeing and Self Care Service Dominic Anderson (Project Manager)

32. The WB&SC Service Offer: Primary Care Connectors Assessment (needs-led): Holistic & comprehensive, unpicking complexity, identifying underlying issues, triggers, wider problems, current support, activation & mental wellbeing Connector: Linking people to appropriate community, social, psychological and clinical support via signposting or referral LTC Brief Intervention: Health Literacy, Non-clinical guidance, Motivational and Strength-based approach to improve skills and self-efficacy, Healthy behaviour strategies Mental Wellbeing Brief Intervention: Listening & Guidance, Improving engagement, Psychoeducation, low-level behavioural support and anxiety management techniques

33. The WB&SC Service Offer: Criteria

34. The WB&SC Service Offer: How to refer Primary Care Staff can access the service by booking directly into the Self Care Coordinator Clinics on EMIS appointment book. Practice Managers will know if there is a Self Care Coordinator in your surgery or coming soon. Sam Williams (Service Lead): s.williams47@nhs.net Enquiries: stoccg.viaduct.selfcare@nhs.net

35. The Importance of Recording Just like any interactions and discussions with patients, the Care Navigation needs to be recorded on the patient’s record on a clinical system. Principles • Record where the patient has been navigated to on their record using the template • If the patient does not want to be care navigated to an alternative service then record this as well. The next slides demonstrate an example of templates from Wakefield

36. EMIS System Template

37. EMIS System Template

38. EMIS System Template

39. Business Intelligence

40. Sharing Good Practice

41. The West Wakefield Model

42. Snapshot of Online Learning

43. Management Module • What is Care Navigation? • How do I support implementation of best practice in my surgery? • Information on the high impact actions, and emerging practitioners and services which can be care navigated to. • 25 minutes to complete • Download resources as you go along

44. Based on HEE Framework

45. Any Questions? David CowanCare Navigation Programme ManagerTwitter: @HealthyDaveCDavid.Cowan@westwakefield.org.ukTwitter: @ConexusHealthUKLinkedIn: West Wakefield Health & Wellbeing LtdWebsite: http://www.Conexus-Healthcare.org