presented by robbie preece & lesley sherwood · • 4 x datax data-zones possil are 2 3 26 and...
TRANSCRIPT
Presented by Robbie Preece & Lesley Sherwood
POSSILIt’s difficult but not imPOSSILble
ki ti i Gl ’– smoking cessation success in Glasgow’s most deprived neighbourhoods.
OutlineOutline • Background – before 2014 – new service model
through 14-15-16through 14 15 16• What does the service look like now• Reflection on past 32 monthsReflection on past 32 months• Service improvement challenges in large Health
Boards• Engagement with GP Practices – longer term
behaviour change and sustainable services• Points for discussion
The work of this presentation started here
BackgroundBackground
Why Possil? Numbers very poor was it usWhy Possil? – Numbers very poor – was it us who had Quit?
• Inequalities “Focus” – 40%MDD – does it un-focus?focus?
• 6505 data-zones in Scotland4 x data zones Possil are 2 3 26 and 29• 4 x data-zones Possil are 2, 3, 26 and 29
• Most deprived 0.5% of the country• SIMD maps
Why joint working with Pharmacy RWhy joint working with Pharmacy- R• National Strategy & Cessation Review 2014• Very few examples of joint working across GG&C
– despite contract……Section 2.2.9despite contract……Section 2.2.9
“…community pharmacy…..integral part of NHS…community pharmacy…..integral part of NHS Boards’ wider smoking cessation services
….signposting and cross-referrals….must be….signposting and cross referrals….must be actively undertaken”
What was developed?What was developed? • 4x local pharmacy cluster - referral pathway to new
serviceservice• Using cluster = big sample size = 450 quit attempts
T t t t t 10% i fi t 6 th t ft• Target to extract 10% in first 6 months – to soften concerns around impact on business model
h h h t f• pharmacy chooses who to refer• At the same time- a big effort around GP
engagement – lots of charts• Cessation Conference 2014 - QUIT Possil
Cessation Conference 2014 – working with GP Practicesg
What does the Possil service look like now?What does the Possil service look like now?• All day drop-in every Tuesday, highly visible and well-known.
Very busy: up to 26 clients weekly (2 staff)• Very busy: up to 26 clients weekly (2 staff)• Weekly visits to local pharmacies – relationship and constant reminder.• Signposting by pharmacies rather than referringg p g y p g• Embedded - ongoing contact with GPs via Practice meetings and
membership of local COPC (Community Orientated Primary Care)• Mostly self-referral but hear about it
through a health professional • Word of mouth - reach into our targetWord of mouth reach into our target
communities• HSCP Volunteer provides support
Ongoing developmentOngoing development…In addition to a strong focus on GP engagement
meetings and regular pharmacy contact we domeetings and regular pharmacy contact, we do targeted activities e.g.:
• Closed groups (e g women's recovery group)Closed groups (e.g. women s recovery group)• Info sessions• Community breakfastsCommunity breakfasts• Gala days• Housing Associations• Housing Associations • Employability & Wellbeing Programmes (‘Pitstops’)• Flu clinics• Flu clinics
Promoting Patient Stories….• “The stop smoking group was nice and relaxed andThe stop smoking group was nice and relaxed and
there was no one pointing the finger, saying you will stop smoking!”
(June, 60, quit smoking 40/day)
• Some evidence that feedback to GPs works!
Rebranding sing marketing theor from Desire CodeRebranding using marketing theory from Desire Code
From….
To…..
RebrandingRebranding…
RebrandingRebranding…
Reflection - LReflection… LIn 2016 still sustained and growing service:• up to 26 clients each weekup to 26 clients each week
Possilpark activity – NW bucking the trendPossilpark activity – NW bucking the trend
Reflection….-Reflection….-• Pharmacy now only part of the input, GPs a strong focus too• Possil pharmacy quit rates (4 weeks) improved from 23% - 37%
• Money generated: additional £120,000 floating about Possil somewhere!!!
p y q ( ) p- are we extracting the right people?
floating about Possil….somewhere!!! (2015/16, 12 week quit, 20/day)
• Holistic approach – complex lives soi i d f l h isignposting and referral to other services
(Lifelink; Money Advice etc) - 12 weeks??• Have we created a multi-disciplinary p y
culture – staff feel part of the Health Centre
Possil Celebrates Cessation Success, Feb 2016
Roll-out challenges in massive HealthRoll out challenges in massive Health Boards with multiple planning units
• You’ve shown how to work with pharmacy to help generate activity p g y
• How to work with Primary Care to generate activity to sustain a service?activity to sustain a service?
• What is a critical mass of population needed to sustain a service? Create a new indicator!to sustain a service? Create a new indicator!
SIMD1Community attempts
Community quit attempts - rateOld indicator
Cluster PracticesSIMD1 Population
attempts 40%MDD
attempts rate per '000
Possil 4 9796 92 9.4Phead/Crail/Westm 4 12749 76 6.0
Old indicator was GP Referrals
easterhouse 4 14437 66 4.6Maryhill 3 15735 64 4.1Woodside&NH 7 15605 44 2.8Drumchapel/Hosp 6 14538 39 2 7
New indicator to enable l l t t Drumchapel/Hosp 6 14538 39 2.7
Springburn 5 12324 33 2.7Shettleston 2 8012 21 2.6CastleM/Croft/CarM 4 18032 38 2.1
local teams to reinvigorate development
Admiral St 3 7387 14 1.9Yoker 2 5479 10 1.8Pollok & PollokN 3 12263 21 1.7Thornlibank 2 5348 9 1 7
of sustainable services
Thornlibank 2 5348 9 1.7Govanhill/Egg 5 14423 23 1.6Carntyne 3 7776 12 1.5Ibrox 3 7571 10 1.3
Cluster reminder –these are
Govan 4 12080 13 1.1Bridgeton 11 22948 21 0.9Townhead 2 7976 4 0.5
these are walkable!
Cluster HSCP/SecPracticesSIMD1 Population
Community attempts 40%MDD
Community quit attempts - rate per '000
Possil NW 4 9796 92 9.4Phead/Crail/Westm NE 4 12749 76 6.0easterhouse NE 4 14437 66 4.6Vale WD 3 5793 25 4.3Maryhill NW 3 15735 64 4.1
Board wide Paisley Renfrew 6 14755 48 3.3Dumbarton WD 6 6270 18 2.9Woodside&NH NW 7 15605 44 2.8Drumchapel/Hosp NW 6 14538 39 2.7S i b NE 5 12324 33 2 7
Board wide clusters
Springburn NE 5 12324 33 2.7Shettleston NE 2 8012 21 2.6Clydebank WD 6 20040 50 2.5Greenock Inver 8 24054 58 2.4paisley W Renfrew 2 7014 15 2 1
If we were a Board wide paisley W Renfrew 2 7014 15 2.1
CastleM/Croft/CarM South 4 18032 38 2.1Johnstone Renfrew 6 11912 24 2.0Port Glasgow Inver 5 10933 21 1.9Admiral St South 3 7387 14 1 9
Board wide service
then where Admiral St South 3 7387 14 1.9Yoker NW 2 5479 10 1.8Barrhead ER 3 6761 12 1.8Pollok & PollokN South 3 12263 21 1.7Thornlibank South 2 5348 9 1 7
then where would we
realign our Thornlibank South 2 5348 9 1.7Govanhill/Egg South 5 14423 23 1.6Carntyne NE 3 7776 12 1.5paisley S Renfrew 5 11347 16 1.4Ibrox South 3 7571 10 1 3
realign our efforts?
Ibrox South 3 7571 10 1.3Govan South 4 12080 13 1.1Bridgeton NE 11 22948 21 0.9Townhead NE 2 7976 4 0.5
We will be impressed if you can read this
It’s on the wall or the desk or weIt s on the wall or the desk or we are holding it up
E t ith GP P ti l tEngagement with GP Practices – longer term behaviour change and sustaining services
• We think this tells us the local team has won over the Possil cluster of GP Practices
• We suspect that using other Health professionals to raise awareness for you is a magnitude better than dressing p as an anthropomorphic cigarettethan dressing up as an anthropomorphic cigarette• GPs have a great status in society – use the
b d GPSmoking Toolkit evidence to embed GP behaviour changeg
