Greater Manchester Health Partnership

Maximising the Third Sector’s Contribution to Health and

Addressing Health Inequalities

Neil Walbran, GMCVO

28th April 2009

Health Partnership Project

• Audit Commission review of Health Inequalities 06/07

• Improve commissioning arrangements with Greater Manchester’s third sector

• Initial project funded to scope out work necessary to build involvement of sector

HPP – Two Research Areas

• Informing Commissioning

• Supporting Commissioning

Informing Commissioning

‘Third Sector Health Services Directory’ • Ongoing piece of work

• Local providers at your fingertips• Reduce transaction costs

• Live document • Tracking survey

•Evidence-base for what Third Sector does best• Emergent pathways• Unintended outcomes

Care Pathway

TERTIARYCARE

SECOND-ARY AND PRIMARY

CARE

COMMUNITY CARE

SELF CARE

DESIREDDIRECTION

Mapping Example – BASIC #1

Care continuum/points of operation/referral

Specialist Hospital Services

Secondary + Primary Care

Community Care Self Care Prevention

Neuro-physiotherapy on referral from Hope Hospital

GP referrals from Salford, Manchester + Trafford

Body Basic – Assisted Exercise Gym

Cognitive Behavioural Therapy + Counselling

Brain Injury Education

Cognitive Rehabilitation

Dietetics Hypnotherapy

Pain Management

60% of referrals from the Dept. Behavioural Medicine

Community Reintegration

Mapping Example – BASIC #2

Public health priorities the organisation addresses

Public Health Priority Method

Obesity Assisted Exercise Gym, dietetics

Cardiovascular Disease

Assisted Exercise Gym

Cancer Providing activities for brain cancer patients

Worklessness Rehabilitation, e.g. advocacy for patients as employees, liaison with employers at early stage to prevent job loss, pain management, etc.

Examples of impact38 jobs saved in the last three years (Vocational Rehabilitation has an overall 74% success rate)245 people back to work in the last three years (giving an estimated £62 million in savings in benefits)4000 service users are kept informed and supported in self care via a mailing list.

Example 2 – Brook in Oldham

Care continuum/points of operation/referral

cont./

Specialist Hospital Services

Secondary & Primary Care

Community Care Self Care

Sexual health advisor referral

Sexual health services referral

schools referral

Self referral WOM

Connexions referral (YP Health provision)

Health visitors referral

GP referral

Social workers referral

Outreach clinics: Schools Colleges Youth clubs Supported Housing Care homes

One to one service

Third sector referral

Off the Record from Tameside use Brooks space and referral

Screening and treatment – Chlamydia, Gonn, will be expanding to include full screening

Counselling PC some CBT

Specialist support for eg learning disabilities

Ongoing training of professionals re working with young people around sexual health

Crisis intervention Pregnancy and TOP and other services

Outreach service has prescribing nurse and educational outreach worker

PCT stop smoking service based in house as a session

Training is accredited & commissioned

Work in clubs to promotes screening and testing

Prophylaxis provision

V early sex ed to younger people – HP tailored according to need and venue

Brook in Oldham #2

Public Health priorities the organisation addresses Public Health Priority Method Obesity Cardiovascular Mental Health Counselling service for young people – self-referral

and/or referral by professionals. Both drop-in and on-going provision. Can also be provided in other settings.

Alcohol Smoking Cancer Worklessness Engagement of vulnerable young people/young

parents not in education, employment or training. Delivery of accredited training and development of self-esteem and confidence through workshops and one-to-one work to enable young people to develop skills to progress into further education, employment or training. Train and deliver peer education and peer support.

Sexual health Provision of young people’s sexual health services from main Centre and provision of outreach sexual health and related education services through outreach work and satellite clinics. Accredited and non-accredited training delivered to other professionals to develop knowledge and skills.

Example of impact Services are holistic and are quality interventions. 13000 visits per year to existing clinic services Education team had high impact on pregnancy and signposting – need to be procured. Education team currently working with between 1000 and 5000 young people per year, dependent on procurement of services. Training with teenage parents – FE and taken out of NEET Piloted YP mentors as volunteers – now employed YP as peer mentors to enable longer term intervention

Supporting Commissioning • Report – ‘Commissioning: Possible’

(Third Sector Organisations’ experiences in Public Sector Commissioning)

• Qualitative analysis with recommendations

•Willingness to engage from both sides• No support framework for engagement

• Highlights good practice• No one shining example

• No GM consensus from commissioners & little flexibility

Research Outcomes

• Recommendations in ‘Commissioning: Possible’ used to inform local commissioning arrangements

• Through the ‘Third Sector Health Services Directory’ the ‘market offer’ has been described to a certain degree

Future work

• Directory becomes internet-based

• Consortiums

• Protocols for negotiated tendering processes

Contact Details

Neil Walbran (Health Partnership Officer)0161 277 1036neil.walbran@gmcvo.org.uk

www.gmcvo.org.uk/health

Any Questions?