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387 Health: The NHS in action


A quiet revolution


in Cornish healthcare NHS Kernow’s Living Well programme is helping to transform lives and reduce dependency on services


to unite healthcare resources with people and communities. It’s an entirely new approach by NHS Kernow Clinical Commissioning Group—and, so far, has had a positive impact on the lives of more than 1,100 people. “Te first step taken by GPs is to identify individuals that would benefit from a home visit by a voluntary Living Well coordinator—who is part of the practice and community team,” says NHS Kernow Programme Director, Tracey Roose. “A conversation is then had with the person, pinpointing two or three goals they would like to achieve—which may be as simple as buying their own food or washing their hair.” Roose is also Chief Executive of Age UK Cornwall and the


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Isles of Scilly, which is a partner in the scheme, alongside GPs, nurses, social workers, NHS Kernow, the voluntary sector and members of the local community. “It’s collaborative,” she says. “We want to see whether supporting people in new ways and providing community care can improve quality of life and the experiences of those working with them, as well as reduce health and social care costs.”


Out and proud Living Well began in Newquay in 2013, initially targeting 100 people. Over 70 per cent of them hadn’t left their home in a year; more than half hadn’t in three. Engaging with the programme saw their quality of life improve by 18 per cent, assessed using the Edinburgh-Warwick Mental Well-being Scale. Living Well was then introduced to West Penwith in 2014, where it has reached an additional 800 people so far. Early reports suggested a 25 per cent reduction in hospital visits and an 8 per cent reduction in social care requirements among those supported by the programme. Living Well has now also reached East Cornwall and the Isles of Scilly, and a further 200 people. Dr Matthew Boulter, a Penzance-based family GP, has witnessed its impact first-hand. “I was on a home visit to a patient in her 90s who was having dizzy spells. Her family lived far away; she hadn’t left her home for months and she was lonely. Usually I’d


here’s a quiet revolution bubbling up across Cornwall and the Isles of Scilly. Known as Living Well, the programme works


“We want to see whether supporting people in new ways can improve their quality of life”


have prescribed something for her vision and ensured that her health needs were looked after. Instead, I also referred her to the Living Well team, who put her in touch with various community groups. Without this help, it’s likely she’d have become dependent on healthcare services. You always know there’s more that should be done—and now, we have the ability and resources to do so.” Te Managing Director of NHS Kernow, Joy Youart, is also


evangelical about the initiative. “Living Well is completely changing the way that healthcare teams work with each other,” she says. “We have a fragmented health and social care system in this country. If communities and commissioning groups work together around individuals, we can resolve some of the issues that this inevitably throws up.”


Quality of life Te impact on patients has proved substantial—socially, as well as medically. “When we started this project, GPs were visiting individuals who were housebound,” says Dr Tamsyn Anderson, a family GP from Newquay, “but they needed more from us. Often, they were looking for social contact in addition to help with their health.” Living Well answers this call. “It’s been brilliant to deliver something so meaningful. It’s a quiet revolution that’s making a big difference.” “When an individual wants to go to a lunch club, we now


know who to contact,” adds Youart. “Tere’s a community that underpins Living Well and the programme helps everyone see the value of what they do. We’re linking people together and changing behaviours in a supportive way.” Te results are financial, too. “By increasing individuals’


quality of life and improving practitioners’ experience, savings are made because people use resources less,” says Roose. “As a nation, we usually look at cost-saving first. Living Well, however, starts with quality of life. Tat’s the difference.” — www.kernowccg.nhs.uk/about-us/pioneer


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