Transcript Person Centred Care Project 2013-2015

Physical Activity in
North Wales
Julie A Jones
Macmillan Services Effectiveness Lead
June 2015
Person Centred Care
Mrs Pat Pilkington, Person Centred Care Manager
Mrs Jo Garzoni, Health & Well Being Coordinator
Betsi Cadwaladr University HB
• Acute, primary, community and mental health
services – pop^ 676,000
• 3 district general hospitals; 18 community and acute
hospitals
• over 90 health centres, clinics, community health
team bases and mental health units.
• 121 GP practices and NHS services provided by North
Wales dentists, opticians and pharmacies
• Over 16000 staff
• > 27000 living with or beyond cancer, estimated to
rise to more than 48,800 by 2030
Recovery Package – Translating
Person Centred Care Locally in North
Wales
Person Centred Care in BCUHB
Holistic Needs
Assessment &
Care Planning
Key Worker
Patient
Treatment
Summary
Health &
Wellbeing /
Rehabilitation
PA: Aim Across BCUHB
To improve the health, fitness, and quality of life for
cancer diagnosis patients, increasing the potential to
live life actively and independently, and decrease
clinical dependency.
• To improve confidence and skills of HCP to provide
advice, and support patients to become more
physically active.
• To develop and promote PA/exercise opportunities in
local communities for PABC, their family and carers
• To work in collaboration with NERS, LA and third
sector organisations across North Wales.
Health and Wellbeing
• BCUHB are piloting Health and Wellbeing
events with a view to establishing such events
as an integral part of the cancer pathway
across North Wales.
• Developing and implementing rehabilitation
pathways across BCUHB for people living with
and beyond cancer.
• Maximising physical activity opportunities
and facilitating a cultural shift in the approach
of clinicians to education for patients
BCUHB PA Lead
• Project lead responsible for clinically
championing the importance of physical
activity to clinical teams across HB
• To facilitate and support training and up
skilling of clinical teams to enable a change in
clinical behaviour and
• To embed PA into the cancer care pathway for
patients.
Engaging with Professionals
Health care professionals working with adults with a
cancer diagnosis. These groups included :
• Multi-Disciplinary Teams
• Medical and Clinical Oncologists
• Surgeons and surgical teams
• Clinical Nurse Specialists
• Therapies and Clinical Support staff
• Radiotherapists
• Nursing and Healthcare Support Workers
Exercise schemes delivered by NERS Exercise
Professionals (level 4 Cancer Rehabilitation training)
Engagement
• Survey of health care professionals in
collaboration with Bangor University
• Attendance at clinical meetings, MDT,
individual staff
• NERS leads; 43 NERS volunteers trained at L4
• Survey of walk leaders across Gwynedd to
understand needs
• Awareness of people living with and beyond
cancer and consequences of treatment
• Integrated with Person Centred Care
Evaluation
• CaPASEF – to standardise evaluation
• NERS – number of referrals to determine
increase
• Collaboration with Bangor University – staff
attitude and behaviours towards PA
• Patients – via Health and Well Being clinics
Physical Activity: Exercise through NERS
Embedding physical activity into the cancer care pathway
for patients through the National Exercise Referral Scheme
(NERS) and local opportunities
North Wales NERS Cancer Referrals
60
55
48
50
39
40
34
32
April 2012- March 2013
30
April 2013-June 2014
23
20
10
9
6
0
0
2
0
0
Anglesey
Conwy
Denbighshire
Flintshire
Gwynedd
Wrexham
Opportunities
• A monthly walk in Denbighshire in partnership
with the Physical Activity Development Officer
from Denbighshire County Council.
• Activity walks in Wrexham in conjunction with
Actif Woods Wales.
• Developing a strategic approach to
understanding training needs of volunteer
walk leaders across Gwynedd in conjunction
with the Physical Activity Development Officer
from Gwynedd County Council.
Challenges/Opportunities
• Strategic engagement due to restructuring
within the health board
• Engagement of staff on the ground due to
competing priorities/increasing patient
activity
• Structure of the health board
• Engaging patients to reduce clinical
dependency
• Culture shift – core business
Successes
• Feedback from PABC
• Working towards sustainable change by
engaging all HCP (primary and secondary) – a
traditional therapist role
• Integration of PA into PCC across the HB to
embed PA into psyche of organisation
• Working with engaged/enthusiastic individuals
e.g. NERS exercise professionals, volunteers
Influencing Pathways
What has helped us / worked well?
•
•
•
•
•
•
•
•
•
Formulating a communication strategy
Utilising improvement methodology
Inform and educate
Raising awareness and effective marketing internal
and external to the organisation
Understanding “What’s in it for me?”
Tailoring information needs to your audience
Engagement with the MDT (via the patient pathway).
Engaging with primary care through locality
leadership teams, GP clusters, District nurses
Impact measured through routine monitoring
Patient Story
• Female with breast cancer
• Surgery x3, chemotherapy, radiotherapy, Herceptin
• Following chemotherapy, commenced ‘little bits’ at a
gym
• Exercise professional gave her advice and guidance
on what to do
• Exercise professional had cancer training which made
feel patient feel fully supported
• In turn, resulted in patient having confidence to
achieve her goals
Patient Story
“Because I had my surgery in the summer, over this
winter it has got me out of bed. It’s given me
motivation, it’s so easy when it’s a horrible day to
just roll over, and then you are sitting there feeling
sorry for yourself and I thought, no I am not doing
that, I’m going to move. “
“It [PA] has certainly motivated me to get out of the
house and meet different people.“
“I have changed my lifestyle now. I am doing more
things to keep me fit now, after the cancer, than I did
ever before.“
Thank you
[email protected]
[email protected]
[email protected]