22.10.18
Making good health a reality in Wigan
Source: PSE Oct/Nov 2018
Wigan Borough Council is leading the way with its innovative approach to integrated health and care. We hear from the Healthier Wigan Partnership about the work they’ve been doing to improve people’s lives and transform their health and wellbeing.
The ‘Deal for Health and Wellness’ is Wigan Borough Council’s response to Greater Manchester’s devolution and Wigan’s way of integrating services, with commitment to our locality plan being implemented within the Healthier Wigan Partnership. This ensures that everyone in the borough, workforce and residents, plays their part in transforming the health and wellbeing of the population.
The partnership is Wigan Borough’s Local Care Organisation (LCO) and brings together the main health and care providers in the borough across GP practices, hospital, community and mental health services, and social care to deliver joined-up, sustainable services that meet the needs of local residents and improve the population’s health in the longer term.
The health challenge
The health of people in Wigan Borough is varied compared to the England average:
- Life expectancy for both men and women is lower than the England average. However, people are living longer, with the number of over-65s forecast to increase by 30,000 over the next 20 years;
- 31% of children in Wigan are not school-ready for reception;
- 40% of working-age adults are at high risk of unplanned hospital admission, often with complex dependency on public services;
- Nearly 100,000 people in the borough are living in the most deprived quintile;
- A significant proportion of activity in our GP practices is socioeconomic – linked to debt, domestic abuse, loneliness, access to work, and cold homes.
Our Healthier Wigan aims
We need to tackle these areas of challenge differently, ensuring that we are helping our residents to be independent and enable them to live happy, healthy and fulfilled lives, where they can continue to do what they love to do.
For people with complex needs, and who may be vulnerable within our community, we are supporting these groups in a different way. We can prevent them from needing acute or crisis care by working with them at a much earlier point in time.
Rebecca Murphy, director of the Healthier Wigan Partnership, explained: “With all partners working towards an LCO, this enables us to improve services for residents by taking a ‘holistic’ approach to health and wellbeing and treating the individual as a whole person, rather than looking separately at their physical, mental and social needs – ensuring joined-up, affordable health and care in the future.”
Integration – the Wigan way
Allowing for “different conversations” between citizens and health and social care; building community resilience for health and wellness – the deal approach is integral to the development of the LCO.
In order to integrate services nearer to where people live, connecting them to GP practices, Wigan borough now has seven service delivery footprints (SDFs). These areas are based on naturally forming communities of 30-50,000 registered patient populations, with the heart of the SDF model being GP practices.
These footprints encompass health and care partners working closer together, alongside schools, police, housing and other public and voluntary and community sector partners, and giving access to services closer to where they live and feel safe. Our workforce feel supported with regular ‘huddles’ within SDFs, where staff look at how they deliver services in a better way for the people who live there.
Work on the ground
Some big-ticket services are leading the way in this work. For example, our Start Well and Integrated Community (ICS) teams are already co-locating; where previously local people were faced with multiple appointments and professionals, we have the ambition to increase coordination.
Murphy added: “I’ve already heard of many of our local people experiencing a real turning point in their lives from the way we are integrating services. One young family, identified by their health visitor as struggling, had one plan put in place within a huddle. The teams, including Start Well, were able to coordinate support on budgeting, mental health support, child development sessions, community cafés, and others. Once the family gained confidence and resilience for themselves, they were independently accessing the services within their area. They are a super family enjoying living in Wigan, supporting each other, and now wanting to share their experience to help others in a similar situation.”
ICS has a multidisciplinary team in the hospital working together to offer better integrated discharge from hospital. Community Response is also already showing huge results after only a few weeks, with fewer ambulances attending the Wigan emergency department: 143 less ambulances than in the same two weeks in 2017 (10 less per day on average). Based on an average of 30-minute turnaround times, that has created around 70 hours of additional ambulance availability in Wigan.
However, it is not just about diverting hospital attendances, but reducing them by preventing ill health in the first place – which is the big piece of the jigsaw. Professor Kate Ardern, director of public health for Wigan MBC, explained just some of the public health initiatives that are making Wigan shine: “The Heart of Wigan continues to promote physical activity through the utilisation of green spaces and active travel to improve the health of Wigan residents. Additionally, for our residents we have our ‘Health Movement for Change’ – all about involvement – ensuring individuals and organisations in our communities all support each other. Made up of members of the community, frontline staff, and volunteers from across the public voluntary and private sectors, it currently includes 1,350 Health Champions, 495 Heart Champions, 856 Cancer Champions, 10,000+ Dementia Friends, and 200+ Young Health Champions.
“Other recent developments include the roll-out of Autism Friends, In Mind Champions, and the recently launched Communities in Charge of Alcohol programme led by the residents of Hag Fold Wigan.”
Imagine if by one visit to the GP, a vulnerable young person with learning difficulties and physical impairments could not only access medical treatments, but also housing advice, leisure opportunities and peer support. This is our ultimate aim for Healthier Wigan, and we are already well on our way to achieving it!
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