Download East Renfrewshire – Older people and equalities work

East Renfrewshire – Older people and equalities work
East Renfrewshire CHCP priority groups for action on inequalities include
older people and young people, in conjunction with a consideration of other
protected characteristics.
Under the auspices of the Reshaping Care for Older People Change Fund, a
comprehensive improvement plan has developed over the last few years,
based on a 10 year vision, which echoes the Scottish Government’s vision
that:
“Older people in Scotland are valued as an asset, their voices are heard and
older people are supported to enjoy full and positive lives in their own home or
in a homely setting.”
There are many examples of good practice, which indicate real change in
addressing inequalities of access, participation, outcomes for older people
and efficiency savings as services move to a more preventative approach.
The evidence indicates a real shift in use of resources to meet patient needs
with a much higher focus on the social aspects of health, with greater
efficiencies. Initiatives and tests of change under Reshaping Care for Older
People (RCOP) have, taken together, resulted in a reduction in delayed
discharges from 4,829 days in the baseline year 2009/10 to 2,445 in 2013/14.
This amounts to a reduction in delayed discharge bed days of 2,384 or 49.4%.
The estimated value of this to the health and care system is £763,595 (at
£320.30 per day). Further added value has been achieved through
prevention of admission and better supporting people at home.
Disinvestment has centred on shifting from reactive to proactive and
anticipatory models of care supported by developing community capacity.
Specific examples of disinvestment and reconfiguration during the course of
the Change Plan and Joint Commissioning Strategy to-date relate to home
care reablement, day opportunities and specialist community based
professionals.
Most older peoples’ services in East Renfrewshire can provide service usage
data disaggregated by age, sex and SIMD. This is used to inform planning
around demand for future services. A range of services have considered the
needs of different protected characteristics. Statistical analysis incorporates
use of the patient outcome measure ‘Talking Points’, which was developed by
the national Joint Improvement Team. This measure is used by most services
and includes equalities and social model of health items such as:

Stigma and discrimination

Being treated with dignity and respect

Being treated as an individual

Being able to see family and friends
The work in East Renfrewshire with Older People has incorporated a range of
community engagement, overseen by an Older Peoples Reference Group.
Two good practice examples of service change are provided below.
Good practice example: Community Capacity Building
Investment in Community Capacity Building has been a key change fund
commitment by the partners in East Renfrewshire; building on existing
relationships between CHCP and Voluntary Action East Renfrewshire
(VAER). Participatory and co-production methodologies, including
appreciative enquiry, are central to the ethos and practice of VAER so the
Change Fund investment and wider reshaping care for older people agenda
provided impetus and opportunities to further develop strong collaborative
relationships with other third sector organisations and the independent sector
as well as CHCP partners.

Targeted promotion of the benefits that volunteering brings to over 50s
has resulted in 328 over 50s being supported and matched to local
opportunities – with 124 directly engaged in change plan activities over
the life of the fund.

Change fund investment has enabled demonstrator projects that used
co-produced, volunteer-led approaches resulting in a marked increase
in the number of such initiatives including: Keep-fit, Mouse-mates, craft
group, computer club and reminiscence groups.

Work with local sheltered housing complexes, care homes, churches
and community groups has resulted in trained volunteer managers
recruiting their own volunteers – where previously care homes and
sheltered housing complexes would have not had any volunteer
involvement.

Enterprising capacity-building supports have helped a wide range of
groups to develop a successful, sustainable model – one example is a
local BME group with 20 members when initially referred, to now
having 124 members.

Development of a local signposting partnership, made possible as a
result of wider CCB networks and relationships has provided
accessible information to health professionals and the public about
local activities for older people as an aid to a social prescribing model.

Successful third sector funding applications to bring match-funding that
complemented change plan investments and also helped develop
cross-referral processes across partners.
To further explore social impact, Voluntary Action is working with the
ALLIANCE and Evaluation Support Scotland around the investments made in
community,
Good practice example: Meeting the needs of carers
Gender issues can often be hidden in NHS service responses. East
Renfrewshire was the first area in NHSGGC to test a gender, inequalities and
carers improvement template. A range of good practice was found on service
provision and workforce development. For example, equality and diversity
training is provided as part of core training to the homecare team; the CHCP
is rolling out ‘carer aware’ training to its staff, using the national ‘EPIC’
materials, self reported ill health and stigma were found to be local issues for
male carers and the needs to young male and female carers are considered.
Stress management courses and community capacity building groups are part
of the response to these issues (e.g. Male Carers Support Group; particular
support to girls under 18 with Aspergers syndrome as most information is
directed to boys; Young Adults Carer Peer Support for girls).
Using the Scottish Government recommended Social Return on Investment
Application model for Carers’ Centres an estimated £508,670 benefit has
been realised, where the social return on investment ratio at £6.20 gained for
every pound spent. East Renfrewshire Carers’ Centre has provided short
breaks to over 131 carers supporting positive carers’ personal outcomes and
improved support for carers through the hospital discharge process.
East Renfrewshire will continue investment in successful Reshaping Care
initiatives in their Integrated Care Fund Plan to consolidate good practice and
extend in scope to adults with a long term condition. Themes from an EQIA of
the Reshaping Care for Older People Joint Strategic Commissioning Plan are
being revisited to assess further opportunities for action on inequalities.
Feedback from lead staff indicates a gap around workforce development
around hate crime / prejudice directed from patients to other patients and
staff.