Active and Independent Living Programme

Tuesday 26th September 2017

Susan Kelso, AHP Lead Early Intervention

National Lifecurve Survey Some Initial Analysis

AHPs working in partnership to enable healthy,

active and independent lives by supporting personal outcomes for health

and wellbeing

Health and wellbeing

Awareness

Access

Partnership

Research and

innovation

Workforce

Allied Health Professions Co-creating Wellbeing with the people of Scotland

The Lifecurve is rooted in….

Partnership

People Performance Prevention

Prevention, anticipation, early intervention, self management – where? What does it look like?

Time since starting on

‘curve’

Run half a mile

Hike several miles

Walk on a slippery surface

Walk a brisk mile

Run to catch a bus

Carry and climb stairs

3 flights inside

I flight outside

Get up from the floor

Walk several blocks

Get up from low couch

Cognitive

Risk

Health

Connections

Care

Rehab/reablement

Reactivation

Compensation

Care and support

Prevention: preventing what?

Prevention

Anticipation

Early Intervention

Primary

Secondary Tertiary

ACP

Intergenerational disruption

Falls Manage

ment

Move and

Improve Communication

http://www.evaluationsupportscotland.org.uk/

The first 100

Age by Gender at 2016

0

10

20

30

40

50

60

18-44 45-64 65+ All

Male

Female

Urban/rural classification

1

2

3

4

5

6

not known

Living where? - Urban/rural Classification

Scottish Indicator of Multiple Deprivation

0

2

4

6

8

10

12

14

16

Mostdeprived

Leastdeprived

SIMD classification

33% in 1-3

What Services?

0

5

10

15

20

25

30

Series1

Which Allied Health Professions?

0

5

10

15

20

25

30

35

40

45

50

Band/Grade/Designation of AHP staff

Band 2

Band 4

Band 5

Band 6

Band 7

Band 8

unknown

Reason for AHP visit?

first appointments

return appointments

Unknown

Intervention type

0

5

10

15

20

25

30

35

40

45

Series1

Intervention type Scottish Population (5.29M) • 61% adults and 73% children meeting moderate physical activity guidelines • People with MH difficulties more likely to die 15/20 years early • 50% have at least 1 LTC • 29% in most deprived areas with both physical and mental health difficulties • 21% of adults and 12% children meeting 5 a day guidelines • 65% adults overweight with 29% obese/70% children at a healthy weight Ref: The Scottish Health Survey (2015)

Additional Questions: responses for the 100

AHP setting: 68% community/32% inpatient Referral source: 80% NHS Living with?: 54% with others/36% alone Carers: 90% report they are not Work/regular activity: 75% no regular activity/20% work, volunteer, provide family support Home suitable?: 50% yes/46% struggling or needing help Emotional Wellbeing 64% good/very good 35% ok/not good/very bad Communication needs: 68% report having none

Additional Questions AHP setting: 68% community/32% inpatient

Living with?: 54% with others/36% alone

Communication needs: 68% report having none

Work/regular activity:

75% no regular activity/20% work, volunteer, provide family support

Carers: 90% report they are not

Home suitable?: 50% yes/46% struggling or needing help

Emotional Wellbeing

64% good/very good

35% ok/not good/very bad

Referral source: 80% NHS

Long Term Conditions by Gender

0

1

2

3

4

5

6

7

8

9

10

All

Male

Female

Unknown = 43

100 People service use profile

No records for 6 people

No. Gen Admission

No. people LTCs Male Female

Average Age

Age Range

SIMD 1-4

UR 1-3

1 19 0 or 1 4 15 66 18-101 8 15

2 3 0-4 1 2 45 25-63 2-9 2

3 1 1 1 0 82 82 6 2

5 1 1 1 0 27 27 3 5

non known 75 0-5 37 32 45 18-85 1-10 25

Using What Services in 2015/16?

Number General inpatient admissions

No. people

Length of stay

No. A+E

No. Outpatients

No. MH inpatient

Length of MH stay

Total prescriptions

1 19 220.66 15 14 2 8 1622

2 3 84.66 11 8 0 0 276

3 1 7 2 0 0 0 18

5 1 8.33 7 4 7 140 63

Unknown General

inpatient 75 0 20 40 19 2244 1708

Service use 2010 - 2015

Service Type 2010/11 2011/12 2012/13 2013/14 2014/15

in patient General admissions 27 23 18 16 27

Total LOS 78.6 333 83 133.6 191.6

maternity 2 0 0 0 n/a

in patient MH admission 6 8 25 31 36

Total MH LOS 538 918 1131.3 1220 1492

Total Outpatient 50 34 48 37 51

A+E episodes 47 25 33 43 34

Total BNF items 1789 3993 4136 4420 4884 Unknown General inpatient admission 81 82 84 85 84

National Lifecurve Survey 3 lines of enquiry

Potential areas for investigation • People with 5 or more A+E presentations – who saw them? Did they have care at

home services? No social care data.

• For those with high A+E attendances – is there potential to work with Alliance Scotland (3rd Sector) to change peoples’ trajectories? How do we ‘interrupt’ trajectories at an earlier stage? – ?via Community Led Support test sites?

• This sample has a significant number of MH inputs – so what does this mean for Primary Care and MH – potential for OT input? How do we to test across Scotland?

• Within the larger group – there appear to be 3 distinct cohorts – what does prevention/early intervention look like for each? Thinking about Primary/Secondary/Tertiary levels – eg How is ACP approached? How do we test?

• What are the implications for AHPs contribution to SDS – an approach to social work services? – eg working with independent providers? With care at home services?

• The Lifecurve is based on underlying physical functioning – what about groups who have particular patterns of ‘functioning’ – people with learning disability who experience aging earlier? – People with mental health difficulties – Disabled people who need social care support and the removal of broader

societal barriers to be able to fully participate

Contact Details Susan Kelso, AHP Lead Early Intervention

Scottish Government E: susan.kelso@nhs.net

Mob: 0794 308 3735 T: @susankelsoAHP

For More on the Lifecurve:

Go to https://ailip.lifecurve.uk

For more information on AILP programmes visit: http://www.knowledge.scot.nhs.uk/ahpcommunity.aspx