Salutogenesis – in primary care?

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Transcript Salutogenesis – in primary care?

Salutogenesis – In
Primary Care….?
Dr James Fleming MBChB MSc FRCGP
College of Medicine September 2015
www.greendreamsproject.co.uk
Supported by:
Solutions to social problems when
no other agency can help
www.greendreamsproject.co.uk
Kate 30F
 ‘Am I depressed?’ sick/fit note
 Rock bottom, drinking
 Rent arrears, debt, poor housing
 Little self-esteem,
 Not worked for years
 Educational problems
 Repeated attendances at GP
What do you do?
www.greendreamsproject.co.uk
• Anti-depressants?
• Fit note?
• Counselling?
• Alcohol Services?
• CAB? Job Centre?
• Well-meaning Advice?
• Nothing?
GDP alternative
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Identify barriers to increased QOL
Contact JC+, go with her
Liaise c landlord, HMRC, DWP, Welfare Rights
Involve in one of our projects, build confidence
Documents, correspondence, CV
Access Training and coordinate
Lifestyle and health issues, Now self-employed after 6 years
www.greendreamsproject.co.uk
Triad of Support:
‘The underlying approach to the Green
Dreams Project is one of empowerment and
enablement … a reduction of just chemical
based intervention, to a more holistic view of
the person’. (UCLAN, March 2013)
www.greendreamsproject.co.uk
Elderly and Isolated
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Bingo, self funding
Day trips – self funding
Meet old friends, laughter
Health seek behaviour change
Also, home visit, befriending,
craft, voluntary organisations,
walks, computer, procure
space, Art Group, Theatre
Group, Knit and Knatter
Figures
• GDP well-being 22 surgeries 120,000 patient pop, 7 towns, 1000
referrals per year
• GDP nursing 17 surgeries Burnley East, West, Central
• Governance, partnerships, CCG, NHS East Lancs, Public Health, LCFT,
Local Partnerships, Police, Troubles Families, Princes Charities
www.greendreamsproject.co.uk
Outcomes
• Client outcomes
• Client satisfaction
• Stakeholder satisfaction
• Non-bias GP Data
• Commissioner outcomes
• Non-bias research
• Cost-benefit analysis – us and CCG
• Q Reports
www.greendreamsproject.co.uk
Intended outcomes:
17 common outcome headings:
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Health and wellbeing
Social cohesion and engagement
Social health
Work, education and learning
Mental health/prevention of deterioration
Physical health/prevention of deterioration
Financial stability/debt situation
Housing situation
Benefits situation
Demand on healthcare services
(re)offending
Resilience
Employment
Skills and experience for work
New skills / expanding knowledge
Sense of choice/autonomy
Social isolation
Relationships
Links with the community
Volunteering
Community services available
Stats
Improved:
• QOL:
• Mental health:
• Well-being:
• Engagement c others:
• Motivation:
• Life skills:
• Housing situations:
• Work, ready, volunteer
• Physical health:
• Financial situation:
www.greendreamsproject.co.uk
90%
85%
75%
44%
40%
14%
12%
20%
25%
33%
Reduced:
• Freq. GP/hospital appts: 37%
• Depression/anxiety med: 31%
Independent Evaluation
University of Central Lancashire
March 2013
Study completed by a team of researchers from the UCLAN ‘School of Health’ who independently
interviewed a range of key stakeholder and examining project data monitoring forms. Findings were cross
referenced with a literature review to support conclusions.
Stakeholders independently reported that the project is extremely beneficial to all
service users.
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Mood
Self esteem and confidence
Coping skills
Social isolation
Primary care attendance
Dependence on medical care
www.greendreamsproject.co.uk
We looked conservatively at what social costs might be
incurred if our intervention had not taken place…….
www.greendreamsproject.co.uk