Monthly Archives: February 2023

Supporting Anticipatory Care and Ageing Well: The Anchor Project

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“In the world of social innovation research it is more pertinent than ever to be attentive to change and adapt accordingly to emerging ideas and practices when presented. This has been the experience of the Social innovation Group and our current work on the ANCHOR project.” – Tom Bailey

The University of Exeter’s Social Innovation group (SIG) has now been working on place-based, person-centred issues within the health and social care sector to promote positive change for over 10 years. The primary focus of this multi-disciplinary research group in recent years has been the HAIRE project: Healthy Ageing through Innovation in Rural Europe, which is funded by the Interreg 2Seas European Regional Development Fund. Through the use of a co-designed Guided Conversation (GC) toolkit, HAIRE aimed to reduce loneliness, isolation and improve general wellbeing in the over 60 age group across rural communities in England, Belgium, France and The Netherlands. In terms of practical objectives, the project aimed to develop and test methods that empower and enable participants to:

  • Define what support is needed;
  • Participate in the design and delivery of services;
  • Develop solutions for the individual to reduce loneliness and improve quality of life, health and wellbeing, supported by the voluntary, private and public sectors.

HAIRE’s approach to achieving these objectives included the HAIRE toolkit, which was developed by the University of Exeter with support and consultation from the project partners in adapting the materials to cater to each location site. The toolkit is person-centred and allows for people to reflect on their own needs, interests, and aspirations in order for individualised care and support to be provided. The GC encourages a wide-ranging informal conversation that takes place between volunteers and participants. With the aid of visual and conversational prompts (see Figure 1), the GC fosters an honest and open dialogue between volunteer and participant to identify how the local area, community and the person themselves influence their wellbeing.

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Figure 1; A place-based visual prompt developed for Carnon Downs, Cornwall.

Due to the success of the HAIRE project across its eight pilot sites in Northern Europe, a new opportunity to use the same methodology in a wider area arose in Cornwall, England. This was named the ANCHOR project: Supporting Anticipatory Care and Ageing Well in Cornwall. This was funded by the NHS Cornwall Partnership Ageing Well/Urgent Care Response Programme Board as well as the Duchy Health Charity and a UKRI ESRC Impact Accelerator Award.

The aim of this project was to design and develop GCs to be implemented across the Coastal Primary Care Network (PCN) to support communities and anticipate undesired health outcomes. The ‘test and learn’ approach of the project was supported by the assumption that the toolkit would fit into existing work practices without adding to health practitioners’ workloads.

However, during the lifetime of the project there have been two significant innovations to service design and delivery in Cornwall which led the team to re-think how best the GC could fulfil the desired anticipatory care outcomes. These innovations were the emergence of the Community Hub model and a pilot scheme involving Community Health Workers (CHWs). These developments are part of the rapidly changing landscape of service design and delivery involving Cornwall’s voluntary sector (which we will deal with in another article). Understanding and adapting to these changes has been an important part of our work in ANCHOR.

While working in a practical capacity with both organisations and individuals to aid in the delivery of anticipatory care within the new innovation pathways we have also worked in a conceptual capacity to understand anticipatory care as both a philosophy and process of care. As a philosophy, anticipatory care speaks to the working assumption that care (provided by individuals, the community or health services) should enable people to maintain good health and wellbeing for longer. However, for those with chronic conditions, an Anticipatory Care Plan is necessary to precisely identify how an individual should be supported to prevent a deterioration in their condition and unwarranted health outcomes.

The ANCHOR project’s original aims – such as improving the management of long-term conditions, reducing loneliness and isolation, improving general wellbeing and reducing the demand on GP surgeries – are still important but can now be considered long term goals to be achieved while working in the emerging ecosystem of care including through Community Hubs and the CHW programme. Data will continue to be collected on these impacts, but the results will likely be published after the lifetime of the project.

The project is now essentially working to build capacity and skills in the sector that both supports the philosophy and process of anticipatory care. The ANCHOR project’s timeline serves to illustrate that flexibility, resilience and persistence required in the voluntary care sector and in research generally in order to succeed.

Article by Tom Bailey, Research Assistant on the Anchor Project

Feock Parish Looks to the Future: HAIRE ‘Thank You’ Day

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The following is a write up of Feock Parish’s ‘Thank You’ community event in February, 2023, held at Trelissick Gardens and organised by the Feock HAIRE team as the research project nears its end in March. Read on to find out what’s next for HAIRE in Feock.

A gentle thrum of chatter fills the Barn at Trelissick, which is twinkling with fairly lights and winter sun streaming through the windows. More than sixty people – including volunteers who have been involved with the HAIRE project in various ways – have gathered to hear what Feock Parish Council’s HAIRE team have to say about the project as it reaches its completion and to share in a discussion on its effect on the community and its legacy. They are also here for an almost-spring walk through the gardens with the National Trust team at this special estate on their doorstep.

The HAIRE team was led by Cllr Keith Hambly-Staite on behalf of Feock Parish Council and included Bex Rawbone, the Project Co-Ordinator and Cathy Whitmore, Project Administrator together with numerous volunteers who supported them. They all agree that HAIRE has impacted people’s lives by enabling older people to be listened to, and by supporting and developing a community directory of activities and services, improving connection and participation across the parish. Bex Rawbone created activities and events with very limited money and resources throughout a challenging time. These have had the effect of helping to empower people and improve their wellbeing. One new service put in place as a result of Covid restrictions has become an innovation the community cannot do without in the world after the pandemic: a telephone helpline.

A significant outcome of the project was the way Feock Parish Council re-examined its role regarding community support. It has determined to use the evidence of the project to continue with the services developed during the project. Cathy’s role as the helpful voice on the end of the telephone can’t be underestimated; throughout lockdown, it was Cathy who coordinated shopping and prescription collection for residents unable to leave their homes, and later, when supporting those living alone, she was not only coordinating services but forging connections with lonely residents. Feedback has been overwhelmingly positive from both service users as well as providers:

“HAIRE activity has helped people socially…and given them a new lease of life.”

“You have all done a wonderful job making things happen and providing a lot of help for a lot of people.”

“From an NHS point of view we appreciated everything that the team did for our patients – collecting scripts; helping wellbeing.”

Cathy’s role will be made permanent after the pilot stage of Project HAIRE ends, as it’s been recognised that people do so much better when they have a listening ear. Having time to talk and listen is one of the most important learning outcomes for Feock. When reflecting on the HAIRE outcomes, the team say it has engaged a whole new way of thinking about supporting the community – a two-way community engagement link whereby access to local information and resources is made easier. A community directory has been made available on a new community wellbeing website, MyFeock, and activities are advertised in numerous ways, using both traditional posters, word of mouth, and social media.

“It has connected people who would otherwise have stayed at home, often by themselves.”

“Sense of belonging and participation”

“Made life more interesting!”

The HAIRE approach means that throughout the pilot phase, the team were attentive to community-level interests, which can change over time. Some innovations have a life-cycle that is shaped by a community’s lived experiences: it’s useful for a time, then it can evolve into something new. What HAIRE provided – and will continue to provide – is dialogue with communities and understanding so that changes can be made as and when they are appropriate. The continued involvement of local volunteers and community members is vital as HAIRE moves beyond its pilot stage. As one of the local NHS service providers made clear to the volunteers: “We could not do it without you.”

If you would like to know further information about Feock’s wellbeing opportunities, help to support their services and to know what’s happening in Feock Parish, contact:

Telephone: 01872 863 333 (Monday – Friday, 9.30-12 noon)

Email:

Facebook: MyFeock Wellbeing

Website: www.myfeock.co.uk