Project Description

Health partnerships

Over the course of 2015/16, Bromford worked with a number of external health partners to deliver a range of pilot services. These aimed to increase the physical health and wellbeing of both Bromford customers and users of other health related services.

A&E youth connector: Bromford placed a support worker in Accident & Emergency (A&E) and the clinical decision unit of University Hospital Birmingham (UHB) to deliver non-medical interventions to young, often socially excluded, individuals. The focus was on frequent users of the A&E department.

206 patients received a level of support during the pilot period. The main needs identified included a lack of safe and secure housing, a low level of positive relationships with families or partners, issues around self-harm, overdoses and anxiety or depression, financial issues including debt or access to benefits, and mental health.

Return home: Bromford and Staffordshire and Stoke on Trent Partnership NHS Trust (SSOTP) designed and tested a service aimed at improving health, wellbeing, choice and control. The overall objective was to enable patients to be discharged promptly from hospital and reduce hospital readmissions and placements into residential care.

In total, 46 patients were identified as potentially requiring support and 39 were supported to achieve positive outcomes. Patients had a wide variety of needs that can be categorised broadly into practical health and/or care needs and wellbeing related needs such as social isolation, fear of crime / not feeling safe and secure, not feeling positive and a low quality of life.

Many customers had issues around their housing situation with a number being homeless or unable to return to their previous property.

Renal failure service: Bromford provided a support worker to deliver non-medical interventions to patients experiencing renal failure.

The pilot was designed to improve the overall quality of life of customers accessing the service. Support included advice and guidance to apply for benefits and grants, help to access aids and adaptations in their home and general health and mental health support.

A further aim was to reduce the amount of time the medical team spent dealing with social issues and support that could impact on their patients’ health and wellbeing.

During the course of the pilot we worked with 273 patients.

These three pilots contributed to Bromford’s understanding of health and wellbeing and the protective factors we can influence through our services. Good wellbeing is key if our customers are to have positive outcomes and achieve their aspirations.

We can’t change health issues, however much we may want to, but the support provided could make life more comfortable, reduce stress, help set the right conditions for customers to regain control and reduce hospital attendance and admissions.

To this end, we consider wellbeing when developing new and existing services and we have introduced a range of wellbeing measures into our performance reporting framework. This will help us to develop our understanding of the specific challenges our customers may be facing and develop our services further to maximise wellbeing.

The key aim of the project was to reduce the readmission of young people into the hospital by addressing the issues that may have led them to them being hospitalised in the first place; these ranged from knife crime to homelessness.

Due to the short nature of support and high needs of the customer group, meaningful data was not available to provide a social value in monetary terms. However, we know that the support provided was able to resolve around one in five of the needs presented by the young people who used the service. For the remainder, individuals were signposted to a range of other services who were better placed to provide support.

Of those who just attended A&E, only one in three of those supported re-attended within 90 days. Of those who were admitted to hospital, less than one in five were re-admitted within 90 days which compared favourably to their attendance in the preceding period.

The pilot also highlighted the high level of non-medical needs experienced by frequent attendees of A&E and the ongoing need for a service within the A&E department.

It clarified the purpose and benefits of a youth connector role, identified and developed networks of support that patients and professionals could tap into and has enabled UHB to develop their own service model.

Furthermore, the pilot service gave clarity to the interventions that are required, the potential barriers and the most appropriate solutions, allowing future provision to be effective from day one.

The pilot enabled Bromford to forge stronger links with NHS professionals and has been promoted and recommended by NHS England and UHB as evidence of good practice. It also provided useful learning into the needs and desired outcomes of health professionals; learning that can be used in future to support our customers with significant health needs

The overall aim of the return home pilot was to enable patients to be discharged promptly from hospital and reduce hospital readmissions and placements into residential care. The two key outcomes were:

  • Improving patients’ overall health and wellbeing and.
  • Enabling patients to have greater choice and control over their own lives, care and support.

This joint pilot between Staffordshire and Stoke on Trent Partnership NHS Trust (SSOTP) and Bromford aimed to achieve these outcomes by providing three wellbeing support workers to work as part of the adult social care teams, in a range of acute and community hospital settings in North and South Staffordshire.

Overall, the services improved patient’s wellbeing; specifically financial wellbeing and reducing the fear of crime and improved feelings of being in control.

£59,488.41

Social value created
This is how we account for the wider value of our service offers.

£56,000

Total investment in services
This is how much it costs to provide these services.

£1.06 : £1

Return on investment
This is how we measure the success of investments in our services.

This return is conservative. Clearly identifiable other changes in wellbeing, health and housing situations were also recorded but could not be robustly quantified. The most notable benefit was improving the housing situation of those supported. Feedback from health professionals was that the service had contributed to speeding up discharges and reducing the risk of re-admissions although data was not available to support this.

The overall aim of the service was to increase customer’s quality of life by supporting the customers with social needs that could not be met by medical professionals involved in their care.

The single most common type of support required was around maximising the customers income – usually in the form of benefit or grant applications. An improved financial position for customers created a wellbeing value of £37,712.

Customers reported an improvement in their health as a result of the service, indicating that support to deal with other social needs can have an impact on physical health. This created a wellbeing value of £52,248. We also supported customers to access aids and adaptations to improve their health and wellbeing although specific wellbeing values have not been included at this stage.

In total, the wellbeing value created totalled £89,960

There was further value to society in supporting customers to access appropriate secure accommodation, which created a social value of £337,500.

£427,460

Social value created
This is how we account for the wider value of our service offers.

£49,852

Total investment in services
This is how much it costs to provide these services.

£8.57 : £1

Return on investment
This is how we measure the success of investments in our services.

Find out more about our value