Wellbeing and Prevention

Contents

• Safe Discharge and self-management
• Preventing illness for our staff
• Our Wellbeing and Prevention schemes will focus on
• Transformation Plan Headlines
• Measures for success

The wellbeing and prevention agenda has never been more important. Following the COVID-19 pandemic the waiting lists across the NHS are larger than ever before, and the scale of the challenge to support our growing population has not diminished.

Over the coming years, the demand is projected to increase still further, with an increase in people with Long Term Conditions (LTCs) and a further increased percentage of the population aged 65 years and older.

Digital has a significant role to play in supporting the health and social care to review health inequalities, to educate our service users and carers, and to prevent lifestyle choices potentially becoming significant health conditions and unsupported mental health concerns becoming significant mental health problems in the coming years.

“We are striving to improve self-care within sexual health services, to improve our digital front door offer. If we can do more through digital, we can take pressure off that front door and improve flexibility.”
Kim Knight, Sexual Health Services Lead, Leicester

Where remote monitoring and care is useful for those with an already identified health or care need and are actively referred into one of our care pathways, the theme of wellbeing and prevention will be fundamental to managing the ongoing demand on our services in the very near future. This will reduce admissions and support service user independence and timely discharge from our services.

The NHS Long Term Plan highlighted the need for digital tools as an enabler for more people to access NHS services and support self-management for such areas as smoking cessation, diabetes control and prevention, weight management services and drug and alcohol advice and guidance.

In the coming years, we want the ability to tailor health education, support materials and self-management apps through having a greater awareness of our service users’ living circumstances, habits, diets, wellbeing, mood and exercise routines.

For those that opt-in to proactive sharing of health and care data with the NHS App through integrated wearable technology or accessible care plans and mood diaries, there will be a significant change to how we can resource, tailor, and target care.

Through digital enablement, we can truly support prevention through to intervention and anticipatory care.

The technology is available now to fulfil the potential to move to fully event-driven models across certain pathways, yet the consent, information governance and processes are not.

In the coming years the NHS as a whole is tackling these issues, with the NHS App being pushed as the main means to connecting a single individual care record to wider information sources and locally collected health data from wearable technology.

Through our ongoing digital transformation, MPFT aims to ensure our systems are supported by the NHS App for the benefit of our people that opt-in to using the NHS App in the management of their own healthcare.

Our ambition is to introduce more digitally enabled models where service users can monitor their own health and make informed decisions based upon their own results, learned guidance and facilitated apps that will improve self-care and ultimately reduce burden on NHS services.

Throughout our engagement sessions, many wellbeing and prevention opportunities were discussed with our service users, carers and staff, with processes currently in place that could be improved and enhanced through new digitally supported approaches.

Many services are sharing information repeatedly through manual processes such as paper handouts and email attachments. Having this information available within a web page or app would likely increase exposure to a wider user group, improve access, ongoing adoption and reduce administrative overhead, and supports meeting our Green Plan.

An example of this digitally enabled self-management approach was a request from our chronic pain management service for an application to be created that would offer centralised advice, guidance and videos on how to manage pain that would offer interim support between appointments and treatments.

Other examples include:

• guidance and support on physiotherapy exercises to strengthen muscle groups to slow the onset of frailty.
• an app that could support constipation in young children for our Community Children’s Nurses and Hospital at Home team. 
• our Looked After Children services who wanted to improve collaboration through digital means with our local nurseries for integrated education and wellbeing reviews. 

All are valid examples of where we can innovate, improve and enhance our wellbeing offers through digital approaches and all feature in our transformation plan pipeline of priorities to deliver in the coming years.

“There is significant digital potential to the problems being defined through our Integrated Care Systems approach on frailty. We need to look to the future on workforce, treatments, remote monitoring, diagnostics to not just make people live longer, but live a healthy life.”
Professor Zafar Iqbal, Public Health Consultant

Nearly every service we spoke to has an idea of a digital app that could provide services and access above and beyond what was on offer right now.

If our health and care guidance materials are created, maintained and searchable to the general public and not just available to those on our current caseloads, we are truly assisting the wellbeing and prevention agenda for the communities we serve.

In terms of self-managed wellbeing, it was surprising that 88% of our service user digital survey respondents did not currently use wearable technologies such as Apple Watch and Fitbits.

Given a recent push of very popular health apps such as “NHS Couch to 5k”, and an increased trend globally of wearable technology users, more still needs to be done in this space if we are to reduce service admissions for cardiovascular, diabetes and obesity in the coming years.

Our Integrated Care Services (ICS) and Primary Care Networks (PCNs) joint service offers will offer more opportunities to promote healthy living devices and applications in the ongoing delivery of routine care, and our work on population health data will help target where to prioritise first based on knowledge on health inequalities across our communities.

Further to apps for health monitoring, there are a significant number of opportunities around health and care education too:

• MPFT’s Intensive life skills services offer support for those with personality disorders and they provide a substantial amount of training through worksheets that could be digitised as an online course. 
• Our Child & Adolescent Mental Health Services (CAMHS) Teams would benefit from sharing mental health support videos with parents and students. 
• Our Step On Team support service users with mental health needs to get back into employment and could benefit from digital materials. 
• Our Forensic inpatients receive basic training on use of digital technology such as accessing internet banking and applying for jobs online in the form of Power Point presentations that would benefit from a clear app-based course structure. 
• Our Sexual Health services provide advice and guidance for accessing free condoms via a paper “C-Card” approach that would benefit from an app that has searchable digital waypoints to find the nearest condom kiosks and dispensaries.
• Our Families’ Health and Wellbeing Service (0-19) provide universal offers to offer physical activity and balanced diet guides to parents and children which could be digitalised and therefore shared more widely than the paper-based processes in place at present, all would aid our wellbeing and prevention goals.

Our Health Service Journal (HSJ) Award winning partnership for Driving Efficiency through Technology for Tele-monitoring of patients recovering from heart failure was, in part, through the improved advice and guidance accessible within digital library services that could track service user progress through agreed information to manage recovery and aid ongoing management of the condition.

A key element of this award-winning scheme was the social prescribing features, and the linking of information sharing between services with sign-posting to locally available community and charity groups to support the whole citizen circumstances and not just the condition.

Our Substance Misuse Services offer several digital therapeutic apps such as Breaking Free Online which is an evidence-based recovery support programme from substance use, these approaches have also been met with positive outcomes and service user feedback in the management of their own wellbeing.

We will take learning from these approaches in our wellbeing and prevention aims and look to digitise our other pathways with digitally enabled advice, guidance, social prescribing and community services sign-posting built in to any website or application.

Whilst the areas listed are just a summary, it is clear from our initial digital engagement conversations that there is a lot more that can be done over the course of this strategy to strengthen our approach to wellbeing and prevention.

If we are providing advice and guidance at the point of care, in some respects we are too late.

We will find means to make our health and care education and support materials more accessible and searchable to all, and in so doing we can help those who may never end up entering our services.

For those that read our guidance and require further assistance, our self-referral options will be available and made clear through our digital sign-posting solutions and referral services.

Safe Discharge and self-management

There are many occasions where a discharge from our services may be delayed on the grounds of a lack of assurance that a service user will be capable of independent living.

If our wellbeing and prevention activities can increase the uptake of simple devices such as smartphones, tablets and voice activated digital assistants, we would have the facility and confidence to collaborate on setting up device aids. This will include features such as video calling for support and contact from family members and carers, and medicines reminders configuration to reduce the likelihood of missed medication.

More pro-active remote care and monitoring approaches are described within that digital strategy theme.

In the coming years whilst the demand on our services is known to increase, we are also hopeful that the digital competency and confidence of our service users will also equally increase. This will improve the amount of options our staff can take for delivering tailored care and pro-active ongoing self-management options through digital means.

Preventing illness for our staff

Our staff’s wellbeing is extremely important to us because if our staff are not happy or unwell, our culture is affected, our outcomes impacted and our care services suffer.

We want to ensure that our staff are happy, healthy and have access to all the support and guidance needed for their own wellbeing and healthy living for themselves, their friends and families.

Our Trust Board offered all workers wellbeing days for 2021/2022, acknowledging the efforts that many undertook through the pandemic above and beyond the core working hours and with lost annual leave at the end of the year too.

It also hosted a 14-hour award winning digital staff celebration event on the 27th April that engaged in a number of entertainment, social networking and wellbeing activities, accessible for all staff across the organisation.

“There is such an appetite and enthusiasm for digital working and a willingness across the Trust of staff that want to help the digital journey”
Danni Cook, Trust Recovery Lead Partner, Wellbeing and Recovery College Service Manager

Working with our People directorate and our Wellbeing and Recovery College, we will ensure our staff continue to have digitally enabled wellbeing offers and mechanisms to look after each other in digital safe spaces.

These offers were rapidly expanded upon and widely adopted through the pandemic and multiple lockdowns, and we want to continue supporting our staff in this way.

We will support access to local and national networks such as the Supporting Our NHS People wellbeing, mentoring and coaching offers and online learning materials.

We will continue to support and expand our online SOOTHE resources for Self-help, Open Up, Others, Teamwork, Help and Enjoyment for our workforce.

• Self-help: Practice self-care by being kind to yourself, take a break, stay healthy and stay safe
• Open up: Talk, remember we are all human
• Others: Others are here for you, you are not alone, we have supplied information where you can find support if you need it
• Teamwork: Stay connected, share the work, value everybody’s contribution - we are in this together
• Help: Look out for each other, keep huddling and talk about what’s helping and how you could help others
• Enjoy: Don’t forget to continue, when possible and maybe in a different way, the things that make you happy

All of our wellbeing resources are supported and improved through greater use of digital technologies and play a vital role within our strategy.

Some other examples of our wellbeing resources include:

• Our social media groups
• In Our Gift Ideas platform
• Celebration events (The Big Shout Out/The Big Welcome) 
• Staff clubs (“guilds”) for baking, doodling, gardening and book reading to name a few
• Our pulse checks to check on staff wellbeing through anonymised surveys
• Our support for physical health related schemes such as online tai chi, yoga and meditation classes
• Our cycle to work offer for tax free bikes to staff

We will continue to work with our colleagues across the Trust and the ICS and PCNs to improve our workforce wellbeing resources. We will make sure our digital systems increase uptake through greater visibility and use of the improved search features of the MPFT Wiki knowledge base and chat bot functionality.

Measures for success