“It all starts with a phone call and a cuppa”

The High Intensity User (HIU) service (developed by NHS Blackpool CCG) has been rolled out across Dudley borough by the Integrated Plus social prescribing team as part of Dudley CVS. The service offers a robust way of reducing avoidable frequent user activity to 999, NHS 111, A&E, and hospital admissions, freeing up front line resources to focus on more clients and reduce costs. It uses a flexible and innovative non-clinical approach, targeting high users of services and supports the most vulnerable people within the community to flourish and find purpose in their lives.

With information given from the Blackpool HIU service, the Integrated Plus team were able to adapt the approach and develop a HIU service in Dudley, match-funded by Dudley Clinical Commissioning Group and the Department of Health.

Danielle and I (Kelly) have been working on this service from its inception in 2018.

Before taking on the role of Urgent Care Link Worker at Integrated Plus, I worked as a substance misuse worker across the Sandwell Borough for 13 years where I developed a good understanding of the skills and attributes needed to work with some of the most vulnerable and complex members of the community. Within that role, I gained experience working across the criminal justice system, child protection, safeguarding adults and children, mental and physical health and domestic abuse. Prior to this, I worked in the community as a carer for the elderly with mental health needs.

My colleague Danielle comes from a background in NHS and private mental health services. For over 10 years Danielle worked in the occupational therapy department within the male and female psychiatric rehab units, working with patients with complex mental health needs, substance misuse, and learning disabilities. From this, Danielle went into hospital discharge learning the pathway patients go through when they are being discharged from hospital and following them through the process. She was then able to use these skills to work alongside GPs in the community co-ordinating patient care, ensuring their discharge from hospital had been completed correctly and they had returned home with all relevant services in place.

In my current role in the HIU team, it all starts with a phone call, from which I am able to actively listen and find out the full extent of the problem/issues that they are facing in their lives. I like to arrange a face-to-face appointment as soon as possible to gain a better understanding of their situation. On the first visit, I try my best to make it very relaxed to allow them to tell their story.

It’s surprising how many people say after the visit it’s the first time they have been really listened to.

From here I give my direct work contact details, agree an action plan with the client and liaise with other agencies involved to ensure that a non-clinical holistic and person-centred approach is taken. The service I then provide is bespoke to that individual, for example, accompanying them to groups, shopping trips, lunch, coffee and medical appointments. I keep my approach relaxed, initially; this may start with speaking to the client two or three times a day as well as out of hours to de-escalate situations that could result in either a 999 call or an A&E attendance.

I will continue to work with a client for up to 6 months intensively with the aim that the support will come to a gradual end and the client no longer feels in crisis. At the end of the service, the client is informed that should they require any further support I would give assistance.”

One service user said,

This service, in my opinion, is vital to help other people from utter despair, I cannot explain in words what this service has done for me.

After another attempt to end it all, I was given a lifeline, introduced to my link worker from Integrated Plus, always at the end of the phone, caring and understanding, non-judgmental who listens to my every need in my recovery. My link worker takes me out for coffee and shopping and has enabled me to laugh again and understand a future without pain. I look forward to her visits helping me to feel normal again”.

If you would like to find out more about the Integrated Plus service visit www.integratedplusblog.com

Integrated Plus Service – evidencing the value of social prescribing for people living in Dudley borough

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During late 2018, Dudley CVS appointed an external consultant, David Waterfall, to work alongside the team to collate and analyse data regarding the Integrated Plus social prescribing service, and to use this information to produce an evidence-led evaluation report.

Dudley CVS has been delivering a social prescribing service for the nearly 5 years. In early 2014, Dudley CVS with support from Dudley Clinical Commissioning Group (Dudley CCG), identified an opportunity to develop and deliver an innovative, flexible and complementary service called ‘Integrated Plus’.

The service was set up to trial a different approach to supporting people in their own homes to ensure the non-clinical needs of patients are taken into account at the GP-led Multi-Disciplinary Team meetings (MDTs) established in 2014. Integrated Plus offers 1-2-1 social prescribing support to patients aged 16 and over who are:

  • At high risk of hospital admission;
  • Frequently visiting their GP;
  • Vulnerable and in need on non-clinical, social support.

Key findings from the report:

  • 2,720 out of 3,756 clients have connected with the service during September 2014 – August 2018.
  • In terms of a typical patient referral to Integrated Plus; 60% are aged 64 and over, 37% are aged between 24 – 63, 58% are female, 71% have no caring responsibility, 25% are referred due to feeling isolated, 17% because of a long term health condition and 16% due to feeling that they have mild to moderate depression. There is a high correlation between clients feeling isolated and feeling that they have mild to moderate depression.
  • 94% of clients rate the service as 4 or 5 stars (out of 5), 96% consider Integrated Plus has had an impact on them (of which 28% consider this to be significant), and 79% feel that Integrated Plus has helped connect them to services and activities suitable to their needs.

 Performance

Following Integrated Plus, client change for each of the seven core outcomes was:

  • Finance; an 81% reduction in those patients that were not managing, and also an increase of 48% for those who were managing. The greatest enhancement in an indicator was “I have enough money to meet basic needs
  • Physical Health; an 82% reduction in those patients that were not managing, and also an increase of 29% for those who were managing. The greatest enhancement in an indicator was “I am managing long term conditions well”.
  • Mental Health; an 76% reduction in those patients that were not managing, and also an increase of 58% for those who were managing. The greatest enhancement in an indicator was “Feeling optimistic about the future
  • Social Contact; an 80% reduction in those patients that were not managing, and also an increase of 35% for those who were managing. The greatest enhancement in an indicator was ““I regularly have face to face social contact with people who are not family members”
  • Housing; an 82% reduction in patients that were not managing, and also an increase of 24% for those who were managing. The greatest enhancement in an indicator was “I feel able to keep up with my rent”
  • Safety; an 83% reduction in those patients that were not managing, and also an increase of 24% for those who were managing. The greatest enhancement in an indicator was “I feel I have people I can contact”.
  • Learning; an 72% reduction in those patients that were not managing, and also an increase of 10% for those who were managing. The greatest enhancement in an indicator was “I feel happy in my retirement

In broader terms, following the intervention 46% fewer clients report poor quality of life, and 45% fewer clients report poor wellbeing.

  • For hospital data, there are significant reductions in A&E attendance after Integrated Plus with a 14% reduction after 6 months, increasing to a 17% reduction after 12 months. Regarding inpatient admissions, after Integrated Plus there is a 14% reduction after 6 months, increasing to a 15% reduction after 12 months. In terms of hospital cost avoidance, data shows £751,400 for reductions in Inpatients, and £58,305 in reduced A&E admissions; totaling £809,705
  • For GP data, of the 43 surgeries engaged; 34 had a decrease in surgery consultations, 21 had a decrease in telephone consultations, and 26 had a decrease in home visits. In terms of GP cost avoidance, data shows £73,115 in fewer GP Consultations, and £16,400 for fewer GP Home Visits; totaling £89,915. The surgery with the greatest extent of cost avoidance was Wychbury Medical Centre/Cradley Road Medical Practice, with a cost avoidance of £11,135 (from 306 referrals, of which 189 supported)
  • Through surveying of GPs, 100% of surgeries rated Integrated Plus as good or excellent, and 89% felt that the Link Officers added value to the current Multi-Disciplinary Team meetings. All surgeries agreed that Integrated Plus had helped to reduce inappropriate GP consultations, and most surgeries felt that “Reduces isolation and loneliness” was a key benefit for patients. Wider benefits included, “Our main Link Officer has an excellent rapport with our patients, nothing is too much trouble for him and he is literally only a phone call away. He attends all MTD meetings and has good input from the patients he sees.”

For more information you can read the full report here:

For more information, please contact Kate Green. Tel: 01384 573381.

Email: buildingblocks@dudleycvs.org.uk

The Big Lottery Fund invests in CoLab Dudley

We have good news. The Big Lottery Fund has agreed to invest in our Colab Dudley work. CoLab Dudley is a social lab in Dudley town centre which has developed through work led by Dudley CVS over the last eight years, and has been made possible through a collaboration with Gather Dudley CIC and UnLtd.

The investment from the Big Lottery Fund means that we can continue to build a platform of trust in the town, one which makes it easier for people to grow and maintain fruitful relationships.

The money will help us over the next three years: in part with resources, but also it gives us a boost to know that Big Lottery appreciates this way of working.

We’ve been talking to the Lottery team for nearly a year. The funding is not for us to provide services but to support the skills, approach, ideas, space and lab team that help connect people in Dudley.

Emergent Cultures

For the last two years, CoLab Dudley has been experimenting and making that case to build this platform, starting in the town centre. Together we make it easier for people in Dudley to create, share, make, do and learn things together.

This means that at the heart of our work is relationships. The friendships formed when care is taken to welcome everyone. The pleasure people experience in passing on knowledge and practical skills to others. Connections between local creatives who make, perform, exhibit and trade spaces which are open to all. Support and encouragement shared between emerging and established social entrepreneurs making change in the same town. Our powerful relationships with place and the natural world. A collective sense of possibility nurtured when we turn ideas into experiments and learn together.

In the last year CoLab has helped with: Trade Schools, Crafternoons, Make Fest, Do Fest, Edible Dudley and many other ways in which people come together. It takes time, effort, ideas and persistence and helps people shape their lives in many ways, as the audio clip below highlights.

These are some of the elements of the platform:

Place and Spaces: We create access to all kinds of spaces and support for people to connect, collaborate, test and incubate activities, projects and social enterprises. Our focus is currently on the High Street and St Thomas Quarter.

Inspiration and innovation: The lab draws on and shares inspiration from anywhere where people are collaborating and sharing to create social good. The inspiration acts as a curio and a catalyst for people who want to try something new or change things around them and their family or friends.

Design and Detectorism: The platform approach brings together two very conscious ways or working: we use simple design methods to help people explore what they want to do and test and experiment with their ideas. We also encourage people to actively watch what is happening, record it and learn from that, a method we call this detectorism.

Network Weaving: The spaces and the things people do together help create relationships. In the lab we also deliberately think about networks of people and consciously connect people up.

You can follow progress with our lab experiments and interact with our research through the CoLab Dudley publication on Medium.

Bored to Tears

There are over 6000 people in Dudley who have been diagnosed with COPD, or Chronic Obstructive Pulmonary Disease, and most likely many more undiagnosed. COPD might be something you have never even heard of – or might affect you personally, but it is a condition that is supported by the Dudley Airtime group. The group is facilitated by Integrated Plus, a Dudley CVS social prescribing project,  have been meeting since 2016 at DY1 Community Building on Stafford Street, where the group is held each Thursday from 1pm. The aim of the group, funded through The Health Foundation, and most recently through Dudley Clinical Commissioning Group and Public Health, is to provide a peer-led group supporting people with respiratory conditions, to reduce social isolation and take pressure off the NHS by reducing hospital admissions and GP surgery appointments that relate to the disease, by providing a safe, caring environment for people to learn how to control and manage their condition better, meet with others experiencing similar challenges, and to take part in enjoyable activities, with lashings of tea and cake of course.

Airtime Dudley has made a particular impact on the life of Angela, who has been attending the group since August 2016. At this time, Angela was feeling increasingly low in mood, had become very isolated, and had no peer groups – in fact she was, in her own words, “bored to tears”.

Angela has made many friends through attending Airtime, and being part of the group has had a wider impact on her, and others. She now supports Airtime through identifying speakers to attend and present to the group. Through Airtime, Angela came into contact with Healthwatch Dudley and gave a talk to The Peoples Network about Airtime. She went on to become a member of The Peoples Network and now supports recruitment within the NHS, and sits on the Voluntary Sector Innovation Fund panel. She was also part of a team tasked with simplifying Dudley Safeguarding online process. Angela keeps a portfolio of all the work she does with Dudley Healthwatch and The Peoples Network, and explained that ‘I would never have been connected with the if it wasn’t for Airtime’

Angela has also gone on to support the creation of a general social group – ‘Friday Friends’, and has supported people with other conditions, such as ME, to make friends and connect. She has even completed a sponsored walk for The Lung Foundation, raising £100. Angela also has begun to meet some new friend’s she has made at a local social club.

Along with some other members of the Airtime Group, Angela worked on simplifying information for Dudley Council employees. A large book, detailing many long term health conditions and illnesses. These are now condensed to a simple A4 handout, giving a brief explanation of each condition or illness.

Through Winter Warmth attending Airtime to give a talk on their services, Angela has had a new boiler installed at home, as well as a wet room and stair lift installed into her property after Winter Warmth put her in contact with Dudley Home Improvement Service.

Angela has kept a portfolio of all the work she has been involved in with the council and Healthwatch Dudley, and is very proud of the changes she has helped to implement. Angela said that she would never have been in a position to be asked to do this work without being a member of Airtime. It was due to Airtime that those connections were made and cultivated.

The Airtime project was evaluated by Coventry University, who has produced a short video on their findings, in which Angela, and other members of the group feature below.

 

Angela feels coming to the group have transformed her life. ‘Airtime has given me quality of life, has built my confidence and I have made lots of good friends. We’re not labelled at no good, not fit for anything…I’ve had a new lease of life.

Airtime Dudley is free and runs each Thursday from 1pm – 3pm at DY1 Community Building, Stafford Street, Dudley, DY1 1RT and is open to anyone suffering with a chronic ling conditions such as COPD, pulmonary fibrosis or bronchiectasis.

Friday Friends is also based at the DY1 Community Building, and runs on the second and last Friday of each month from 1pm – 3pm. A small charge of £1 is asked to cover refreshments and is open to the general public looking to meet with others and socialise.

New members are welcome, and for any further information please feel free to contact Terry Gee on 01384 217056

How many expectations? or 7 years of Social Media Surgeries in Dudley Borough (part one)

There have been social media surgeries in Dudley for more than 7 years.

Since Melissa Guest organised the first on Dec 8th 2010 a varied group of volunteers have run 65 different events in Dudley, Halesowen, Stourbridge and Brierley Hill.  We really didn’t expect this, in fact we expected pretty much nil, nada.

327 of you have signed up for some sort of help,  and we’ve recorded 45 website and social media sites we’ve helped you set up and run. (although we reckon it’s much more than that).A network of committed people have run social media surgeries in Dudley, Stourbridge, Halesowen and Brierley Hill. We even made the news.

Life is likea cup of tea. (2)

These posts are a chance to look at three things…

  1. What is a surgery and how does it fit in with other support for community groups in Dudley and..
  2. What you make of the format – the way of working
  3. What some of you have gone on to do, resting on the skills and confidence you’ve picked up through the surgeries

So lets start with the first…..

Alison Mel and Becky at a social media surgery in Dudley

Alison Mel and Becky at a social media surgery in Dudley

What are they?

A social media surgery is deliberately informal.

  • It’s a place and a time where people with some experience of using social media can sit alongside local community groups, volunteers and charities and help them make better use of the web.  These places are deliberately relaxed, typically a cafe, where you can talk and think and explore and learn together, and say thank you by buying the person who helped you a quick cuppa.
  • It’s the opposite of training.  You don’t get lectured at. Instead someone will ask you what you are trying to achieve, listen to how you already use the internet and offer suggestions.  If something appeals to you you can dig deeper, together. And it is practical. People will help you set things up, there and then, wwhether on facebook, twitter, a new website.
  • A social media surgery is a loop of generosity.  The surgeries are much more than an expert volunteer surgeon supporting a local community group. They  recognise that helping each other can be far more rewarding than passively receiving help. Whether you think you’ve come to learn or to teach everyone tends to end up sharing what they know with each other.   This is a intentioanl, it’s the loop of generosity.
  • They shrug off key performance indicators and unrealistic aspirations.  Surgeries are run with zero expectations.  They are built on a principle that expectations often lead to disappointment.  If you think 20 people ought to come, but ‘only’ 10 do then you end up demoralised. You may even give up.  Zero expectations means that even if one person is helped that’s a win, 10 turning up is a spirit-lifting-humdinger-of-a-fantastic-thing.  By taking this approach they are more fun to do, so more likely to be there, so better able to help.
  • A social media surgery is a platform.  By providing a space for people to share skills the surgeries underpin so much other work. They help boost the flow of civic information within a neighbourhood and across the internet.  This can be about local services, activities, events, campaigns. It can be information from the third sector or the public sector. It can also be the possibilities tied up in relationships people nurture through being able to share and support each other online.  It can also be the unexpected happenings that spring up because people get to be in the same space and learn together.    All this nurtures connections and grows the civic conversation online.  Upon those connections and those conversations can rest a more vibrant, richer place to live.

The surgeries are run by a group of committed people, some may happen to work for the CVS, but the surgeries sit in a wider movement of people who simply want to share digital skills, for free, with local active citizens.

For your next social media surgery please look at www.socialmediasurgery.com. 

 

 

Nurturing caring, vibrant and caring communities – A snapshot of our story over the last year

We are really pleased to share the work that our Dudley CVS team have been doing over the past year in our most recent annual review. The 2016-17 review is a snapshot of the work we’ve done between April 2016 and March 2017 to support individuals, communities and organisations across Dudley borough.

Take a look at our annual review website and read about how we’ve been connecting and inspiring people and organisations to achieve positive change and championing their work.

Visit www.dudleycvsreview.org

Or, if you would like to read a short snapshot of our story, you can download our pdf version by clicking on the image below:

I hope you enjoy learning about the work we’ve been doing over the past year. If you’ve any feedback please feel free to leave a comment!

Be part of our collective story and share how you’ve been involved in our work or how you would like to get more involved! #dcvstory

Reflections from DoFest Dudley

DoFestLast Monday-Wednesday I took part in DoFest Dudley, an inspiring festival of doing and creating.

The festival was packed with activities to get people thinking about the skills, resources and passions that they can share to bring vibrancy and real wealth to their communities; from learning labs, lightning talks, bartering skills and knowledge to making things together. It was infectious! In fact, I’d only booked for Monday’s activities and ended up joining in for parts of Tuesday and Wednesday, such was the contagion!

I saw lots of smiling and sharing, people supporting each other and having a go. A bunch of us put together a wiki wendy house, a fun, exhilarating (and noisy!) activity that demonstrated how open source design can help provide solutions to housing (visit DemoDev for more). We quickly organised ourselves and shared hammering duties to create a cosy little space in Gather Dudley.

It was lovely to join the Coseley Crafternoon session, where we made cards. I’ve never been particularly crafty, so it was good to be gently helped with ideas and suggestions from someone who’s an expert. In fact, I found that dynamic to be analogous across the whole three days – one moment someone was learning a skill, the next, they were sharing it with others.

For me, all of this culminated in Pam Warhurst’s wonderful and provoking talk at the DoFest Dudley Summit about the power of small actions, of getting on and doing things without waiting for money, without complaining about the status quo or waiting for someone else to do something (incredibleediblenetwork.org.uk). This was really powerful stuff, demonstrating a clear link between growing free food for all and resilient communities and wider system change; and I’m sure many of us in the room were inspired to do more in our neighbourhoods. Thanks to Anneka Deva and Andrew Lightheart for getting me along to this!

Since DoFest (and at times during it), I’ve been thinking increasingly about how I can relate this to my work supporting groups, and I’d love to have more conversations about how we can encourage and nurture this kind of activity. In some ways, perhaps I have already started: I often say to groups ‘Let’s imagine there is no funding’ because traditional funding can encourage deficit thinking (needs, gaps, insufficiency of something), competition. Funding can create dependency in some cases, and what happens when the grant comes to an end? It also creates bureaucracies and red tape that could be avoided when all sorts of people come together to make something happen – whether it’s someone with a bit of space going spare, skills, knowledge or equipment. The Incredible Edible movement didn’t begin with a need for funding. Instead it began with people and their willingness.

Of course, some things do need to be paid for. But through starting something lean that’s free to do, making the most of what’s already there, perhaps you could start to make a demonstrable difference and create an impact that will resonate with people, maybe even people with money!

DoFest Dudley has certainly given me lots to think about! Please feel free to share your thoughts with me too.

A snapshot of our work supporting people, communities and organisations over the last year

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I’m really pleased to share the work that my colleagues and I have been doing over the past year in a our most recent annual report. So new, it’s not yet hot off the press, the 2015-16 annual report is a snapshot of the work we’ve done between April 2015 and March 2016 to support individuals, communities and organisations across Dudley borough.

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Trade school – barter for knowledge

jam making 2Have you ever wanted the chance to try something new? Do you know someone that can shabby-chic, build or mend and do you think ‘Oh I wish they would show me how to do that!’? Do you know any amazing makers, bakers, growers, creators and think they are so awesome they should share their skills and knowledge to inspire others? Can you do something amazing and would love the opportunity to share how to do it with others? If so Trade School Dudley is just the thing for you!

Be a teacher, learner, co-founder or all three! Join me on Tuesday 7 June 10am-1pm at DY1 Stafford Street, Dudley to find out more!

Trade School is a non-traditional learning space that runs on barter where anyone can teach a class! People with a skill or talent that they can teach to others propose a class and ask for a small barter item from learners. For example, if you teach a class about making butter, you might ask students to bring cream, jars, bread, recipes, music tips, or help with something like finding a flat.

Learners sign up for classes by agreeing to bring a barter item for the teacher. Everyone has something to offer!

You could learn how to bake bread in exchange for potted herbs, teach basic bike maintenance in return for recipe suggestions or books, and learn how to use social media and the internet by bringing wool or materials. You can teach a class about anything you are passionate about –and say what you’d like to receive in exchange.

The Trade School network is made up of self-organized barter-for-knowledge schools across the world. It started in 2010 with a small group of friends in New York, but they now have Trade Schools in over 50 cities internationally. You can read more about trade school by visiting their website.

trade-school-postcard-ann

Residents in Wrens Nest, Dudley have run a number of pop up trade schools and how to session over the last 3 years. This summer we are hoping you will help start Trade School Dudley and Trade School Coseley, because wow people can do incredible things and have the most amazing skills to share!

A magic moment for me is when Wrens Nest ran a trade school so people could learn how to make jam. I got chatting to Stuart, a local resident, about growing and he explained how his garden is overflowing with plums that he didn’t know what to do with. I told him about a baking project that a seven year old girl had started and said that I was sure we could make use of his surplus supplies!

The following week whilst the Seed and Feed growing gang were meeting, Stuart popped along with bags and bags of plums. One of the gardeners had harvested some beans from his garden and shared these with Stuart as thanks for the plums. We all sat staring at the ample pile stacked before us and thought ‘Right, what can we do… ‘ Steve, one of the gardeners, suggested that they would make great jam and it just so happened that he knew how to make it, which was a good job ’cause the rest of us didn’t have a clue! So Jam Trade School popped up.

Steve asked that learners brought barter items that included jars to put the jam into, anything that supported the gardening project, anything useful for baking or a surprise. People brought barter items including jars, tomato feed, pots, flour and one lady shared her grandmother’s recipes.

jamOur youngest learner was just five and our oldest was in their seventies but everyone came together to learn, have fun, share and take home some of the best jam ever tasted! There was even time to make upside down plum pudding! And Stuart who had donated the plums in the first place got a bowl of pudding, a jar of jam and some new friends in his community.

Other Wrens Nest Trade Schools have included gardening, crocheting, seed balls, how to make an insect home and relaxation techniques. There is something magical in seeing someone who has a skill like crocheting or jam making showing someone else how to start, the spark of passion being passed from one person to another, the patience and encouragement, the laughter and fun. It really is quite wonderful!

So come on, who’s up for bartering knowledge and getting Trade School Dudley on the go?!

Join me on Tuesday 7 June 10am-1pm at DY1 seed ballsStafford Street, Dudley. This session is for anyone interested in being part of starting, or teaching or learning at Trade School Dudley or anyone simply curious to know more. It will be a friendly, informal chance to find out about how Trade School started. Find out what types of activities you might do as part of a Trade School founding team or join a conversation about what the first season of classes could be.

Growing Inspiration, perspiration and change!

gardeningCalling all passionate growers! Come and join us to hear about some of the exciting growing projects happening in the borough and find out how you can be involved in a new urban growing project at DY1! Tuesday 3 May between 10-12pm at DY1, Stafford Street, Dudley.

To get you excited let me tell you about some of the amazing things that people have started growing across communities in Dudley.

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