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Nursing Times Awards 2010

Innovation in Your Specialty Award

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WINNER: Promoting health and independence in older people, Diane Singleton, Liverpool Community Health. Award sponsored by the Royal College of Nursing

Background

Identifying potential risks and preventing ill health among older people are fundamental to reducing inequalities in health and improving health and wellbeing. They benefit patients by improving their health and quality of life, are cost effective to the NHS in the long term.

As a community nurse I was alarmed at how little awareness many older people had about their own health, how to stay healthy, and the services available to improve their quality of life. I decided to address this by promoting health and independence, enabling older people to live healthier, more active lives in their own homes for as long as possible. I developed a preventative screening tool to identify need and refer on to appropriate services such as routine health screening, medication review and falls assessment. This involves undertaking a holistic home assessment to determine health and reduce inequalities, then putting preventative measures in place.

I discovered that many older people who were inactive and isolated needed support and guidance to get involved in any form of activity. In partnership with a school and other organisations I set up a centre where they can participate in a wide range of activities, which improve health and wellbeing, and reduce social isolation and inequalities in health.

The process

I researched my area, talked with older people, met service providers from agencies/services working with older people and developed a screening tool to be used in the home environment to determine health status, concordance and potential risks such as falls. Working in partnership with other agencies such as the fire service, pension service, citizen’s advice etc, I raised awareness of the initiative and encouraged them to identify older people in need and to refer to us. This is a reciprocal approach in that any needs identified during my assessment, such as for smoke detectors, are referred to the appropriate service.

I then set up an active ageing programme of six weekly sessions offering older people advice and information from health professionals and colleagues from relevant agencies. I also established partnerships with local schools, which allowed me to establish a day centre on school grounds. This enables us to deliver not only gym and exercise sessions, but also computer, healthy cooking/eating, art, dance and drama sessions. We charge £2 per session, and pay half of all income to the school as rent.

The service is successful because I involved service users in developing it. I recruited approximately 30 older people to act as volunteers, supporting staff and motivating older service users. Our champion for the service is a young and active 100-year-old — a fantastic role model. We instil a message that “you’re never too old to try something new” .

Advice to other organisations

Individual nurses wanting to set up an innovative project that will improve care and their patients’ lives need persistence and determination to make themselves heard. Be prepared for criticism if your initiative is out of the norm, collate facts to back up your beliefs and use service users’ views to shape your initiative. Look for alternative sources of funding, and set up partnerships with other agencies or organisations to share costs.

Benefits of the initiative

This initiative demonstrates the benefits of taking a preventative, holistic approach to service delivery and of working in partnership to deliver best practice. Identifying potential risks and preventing ill health is fundamental to reducing inequalities in health and improving health and wellbeing.

The main benefits to service users are improved health and wellbeing, confidence and self-esteem, improved physical activity levels, increased ability to carry out daily activities, reduced health inequalities, and prolonged health and independence. This means older people remain healthy, active and independent for longer, resulting in less need for NHS services.

Financial implications

The team is small and funded by the PCT. I have secured additional funding each year, which has supported many of our activities. However, our fitness instructor is now a full-time employee and delivers the majority of exercise sessions, while volunteers with areas of expertise deliver other sessions such as computers and indoor bowls; other activities are now delivered in-house at no extra cost.

Contact

For more information on this initiative please contact Diane Singleton: diane.singleton@liverpoolpct.nhs.uk

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