Preventative action and activities
Menu of Interventions (MoI)
The Office for Health Improvement and Disparities (formerly part of Public Health England) has produced a menu of preventative interventions to contribute to its ongoing efforts to support local leaders to work together across integrated care systems such as the one here in Gloucestershire.
The MoI, which is under constant review, outlines evidence-based, preventative public health interventions that can help improve the health of the population and reduce health and care service demand in the short to medium term. It supports local decision makers to consider evidence-based public health and preventative interventions as they seek options to address local challenges through the health and care planning processes.
For the MoI to be useful in supporting local decisions, it will need to be complemented by local expertise.
View the Menu of Interventions.
Health in all Policies (HiAP)
HiAP is an approach that seeks to identify and influence the health and equity impacts of policy decisions, to maximise its health benefits and minimise its health dis-benefits and avoid harm.
This approach recognises the importance of action needed at every stage of life (throughout the life course) including at working and older ages, to improve equity within and between generations. It is considered one of the key ways in which we can influence the wider determinants of health experienced by different people and address health inequalities.
Find out more about the Health in all Policies approach.
Place-based approaches
Place-based approaches recognise the importance of addressing the wider determinants of health (the conditions into which people are born, live and work) across the life course.
Joined up, place-based approaches utilise the leadership, expertise and levers that are available in local areas to affect their local environments and tackle the complex causal pathway of health inequalities.
The Population Intervention Triangle (PIT)
The PIT is a national framework which was developed through practical experience working to achieve measurable population level change in health and wellbeing outcomes - including addressing health inequalities between and within local geographies. In Gloucestershire, we have been using this model to understand where we can have the greatest impact and how to focus system leadership and planning.
The model addresses the need for action on civic, service and community segments. Joint working across the interfaces between these three segments is also needed to enable the whole to become more than the sum of its parts. This model offers a framework to enable the system to work across all segments, and to also step outside of traditional roles and boundaries. This combination of approaches is essential for developing and building complex, adaptive approaches to effect change at population level, achieve equity and reduce inequalities.
“Strengthen community action”
Within this ‘seam’, the role of civic authorities is to support local communities (of neighbourhood, culture, interest) to become empowered, resilient and independent, enabling them to support individuals and families to take more control of their health and wellbeing. An example of our work within this seam is ‘Levelling Up’ in Gloucestershire. Levelling Up has specific missions around decreasing gaps in life expectancy and wellbeing. To facilitate this, a Levelling Up Together grant scheme has been developed which will be focussed on the twelve most deprived LSOAs (equating to ten Wards) in the county.
“Service engagement with communities”
Although systems have been working to integrate their structures and processes, with focus on care closer to home, there are persistent barriers between systems and more disadvantaged people in their communities. People working in our system have said that ‘action on’ health inequalities is an important part of their role, but many have asked for better information, support, tools, models and learning mechanisms to assist them in this. Examples of action to date include the development of a health inequalities digital hub providing information, practical support and signposting for those wanting to consider their work area through a health inequalities lens.
“Civic service Integration”
Civic authorities, such as local councils and the NHS, work closely with a range of service providers. Examples of action to date include working with public sector organisations in Gloucestershire to prioritise health inequalities in their strategies and organisational ambitions; challenging them to think differently about their role in ‘action on’ health inequalities and reviewing and developing Gloucestershire County Council’s Equality Impact Assessment (EIA) process from a health inequalities perspective.
Here are some examples of place-based working in Gloucestershire:
Know Your Patch builds networks for those working with individuals and groups to help people stay independent for longer and to lead full and happier lives. Know Your Patch has a network of organisations in each district in Gloucestershire. These networks meet regularly for networking and discussion and communicate through email bulletins and updates. These networks help connect VSCE and statutory organisations together for effective partnership working.
The Know Your Patch (KYP) Networks were created in 2018. There is one network based in each of the six district of Gloucestershire and they are hosted by local voluntary and community sector organisations. They were established with the belief that thriving communities are key to good lives. Connecting with local people, places and things that can help will in turn help people live well and worry less. KYP believes that people prefer to find their own solutions. When we get better at helping those people, we reduce pressure on services.
KYP networks meet at least quarterly for networking and discussion and communicate through email bulletins and updates. Public sector colleagues including the adult social care locality teams are part of the KYP networks and have built strong and trusted relationships with the KYP host agencies.
During the COVID-19 pandemic the KYP networks swiftly switched to meeting virtually and membership had grown by 1,800 by September 2021.
Find out more at www.knowyourpatch.co.uk.
Know Your Patch builds networks for those working with individuals and groups to help people stay independent for longer and to lead full and happier lives. Know Your Patch has a network of organisations in each district in Gloucestershire. These networks meet regularly for networking and discussion and communicate through email bulletins and updates. These networks help connect VSCE and statutory organisations together for effective partnership working.
The Know Your Patch (KYP) Networks were created in 2018. There is one network based in each of the six district of Gloucestershire and they are hosted by local voluntary and community sector organisations. They were established with the belief that thriving communities are key to good lives. Connecting with local people, places and things that can help will in turn help people live well and worry less. KYP believes that people prefer to find their own solutions. When we get better at helping those people, we reduce pressure on services.
KYP networks meet at least quarterly for networking and discussion and communicate through email bulletins and updates. Public sector colleagues including the adult social care locality teams are part of the KYP networks and have built strong and trusted relationships with the KYP host agencies.
During the COVID-19 pandemic the KYP networks swiftly switched to meeting virtually and membership had grown by 1,800 by September 2021.
Find out more at www.knowyourpatch.co.uk.
Social prescribing is an approach that connects people to activities, groups, and services in their local communities to meet the practical, social, and emotional needs that affect their health and wellbeing. Social prescribing teams support individuals and community groups, to facilitate local, appropriate and sustainable social connection, and to achieve this, work collaboratively with all local partners.
Social prescribing is a key component of Universal Personalised Care. Find out more about social prescribing.
NHS Gloucestershire Integrated Care Board (formerly known as Gloucestershire Clinical Commissioning Group) and Gloucestershire County Council have co-commissioned a service called the Community Wellbeing Service (CWS), which offers social prescribing. There are 5 providers covering the county and these are:
- Gloucester = Home Group
- Cheltenham and Tewkesbury = Caring for Communities and People (CCP)
- Stroud = Independence Trust
- Forest of Dean = Forest of Dean District Council
- Cotswolds = Gloucestershire Rural Community Council (GRCC)
The CWS commenced in October 2017, replacing, and bringing together the functions of the previously separate Village and Community Agents and Social Prescribing Hub services. The CWS was commissioned for an initial period of 5 years plus a 2-year extension.
The CWS takes referrals from health and social care staff, voluntary and community groups, as well as self-referrals and citizen referrals (i.e., someone’s friend or neighbour). It offers social prescribing to anyone over the age of 16 who either has a Gloucestershire GP or a Gloucestershire postcode.
Social prescribing supports people to develop relationships to connect people to relevant activities for their health and wellbeing. It is a way for local agencies to refer people to a link worker. Link workers give people time, focusing on ‘what matters to me’ and taking a holistic approach to people’s health and wellbeing. They connect people to community groups and statutory services for practical and emotional support.
Link workers also support existing community groups to be accessible and sustainable, and help people to start new groups, working collaboratively with all local partners.
Social prescribing works for a wide range of people, including people:
- with one or more long-term conditions
- who need support with their mental health and wellbeing
- who are lonely or isolated
- who have complex social needs which affect their wellbeing
In addition to the CWS described above, most of Gloucestershire’s Primary Care Networks (PCNs) have their own Social Prescribing Link Workers (SPLWs), who will usually only take referrals from staff at one of the GP practices within the PCN. Some are specialist Children and Young People’s Social Prescribing Link Workers who take referrals from wider sources, such as schools.
The SPLWs came into being in 2019 when NHS England offered all GP Practices in England funding for Additional Roles which included social prescribers, amongst 16 other roles (such as pharmacists). The Primary Care Networks and Community Wellbeing Service works closely with one another to ensure a place-based approach.
Social prescribing is an approach that connects people to activities, groups, and services in their local communities to meet the practical, social, and emotional needs that affect their health and wellbeing. Social prescribing teams support individuals and community groups, to facilitate local, appropriate and sustainable social connection, and to achieve this, work collaboratively with all local partners.
Social prescribing is a key component of Universal Personalised Care. Find out more about social prescribing.
NHS Gloucestershire Integrated Care Board (formerly known as Gloucestershire Clinical Commissioning Group) and Gloucestershire County Council have co-commissioned a service called the Community Wellbeing Service (CWS), which offers social prescribing. There are 5 providers covering the county and these are:
- Gloucester = Home Group
- Cheltenham and Tewkesbury = Caring for Communities and People (CCP)
- Stroud = Independence Trust
- Forest of Dean = Forest of Dean District Council
- Cotswolds = Gloucestershire Rural Community Council (GRCC)
The CWS commenced in October 2017, replacing, and bringing together the functions of the previously separate Village and Community Agents and Social Prescribing Hub services. The CWS was commissioned for an initial period of 5 years plus a 2-year extension.
The CWS takes referrals from health and social care staff, voluntary and community groups, as well as self-referrals and citizen referrals (i.e., someone’s friend or neighbour). It offers social prescribing to anyone over the age of 16 who either has a Gloucestershire GP or a Gloucestershire postcode.
Social prescribing supports people to develop relationships to connect people to relevant activities for their health and wellbeing. It is a way for local agencies to refer people to a link worker. Link workers give people time, focusing on ‘what matters to me’ and taking a holistic approach to people’s health and wellbeing. They connect people to community groups and statutory services for practical and emotional support.
Link workers also support existing community groups to be accessible and sustainable, and help people to start new groups, working collaboratively with all local partners.
Social prescribing works for a wide range of people, including people:
- with one or more long-term conditions
- who need support with their mental health and wellbeing
- who are lonely or isolated
- who have complex social needs which affect their wellbeing
In addition to the CWS described above, most of Gloucestershire’s Primary Care Networks (PCNs) have their own Social Prescribing Link Workers (SPLWs), who will usually only take referrals from staff at one of the GP practices within the PCN. Some are specialist Children and Young People’s Social Prescribing Link Workers who take referrals from wider sources, such as schools.
The SPLWs came into being in 2019 when NHS England offered all GP Practices in England funding for Additional Roles which included social prescribers, amongst 16 other roles (such as pharmacists). The Primary Care Networks and Community Wellbeing Service works closely with one another to ensure a place-based approach.
Your Circle is an online directory resourced by Gloucestershire County Council Adult Social Care. Anyone working or living in Gloucestershire can use the Your Circle website to identify local activities and support that may be of interest. It ensures that people have the information, advice, and guidance they need at their fingertips.
Timely, up-to-date, and reliable information is essential in enabling people to make good choices about care and support, and to find the community support they need when they need it, whether it’s a practitioner, a carer, an individual or a family member.
Your Circle is intended to be a dynamic portal that can be updated by the Your Circle team or by organisations themselves. Know Your Patch Members are encouraged to update their entries and the team regularly attend the network meetings.
Your Circle is an online directory resourced by Gloucestershire County Council Adult Social Care. Anyone working or living in Gloucestershire can use the Your Circle website to identify local activities and support that may be of interest. It ensures that people have the information, advice, and guidance they need at their fingertips.
Timely, up-to-date, and reliable information is essential in enabling people to make good choices about care and support, and to find the community support they need when they need it, whether it’s a practitioner, a carer, an individual or a family member.
Your Circle is intended to be a dynamic portal that can be updated by the Your Circle team or by organisations themselves. Know Your Patch Members are encouraged to update their entries and the team regularly attend the network meetings.
During a consultation in 2018 it was acknowledged that as well as increasing demands on ASC there were increasing demands on the voluntary sector and community groups to provide more activities and support for people. The Thriving Communities Grant Programme is designed to invest in these organisations and their activities which promote social connections and maintaining independence at home. The Thriving Communities Grants are promoted through the Know Your Patch networks, the Gloucestershire VCS Alliance Bulletin and on Your Circle.
Applications to the grant scheme are scored by local grant panels which comprise of individuals with insight and expertise in the communities of interest. In 2018/19, 30 Thriving Community grant applications were awarded. Since 2018, the Adult Single Programme has awarded £1,075,189 in grants to 145 community or voluntary sector organisations, which has meant an additional 3,214 people have been supported.
During a consultation in 2018 it was acknowledged that as well as increasing demands on ASC there were increasing demands on the voluntary sector and community groups to provide more activities and support for people. The Thriving Communities Grant Programme is designed to invest in these organisations and their activities which promote social connections and maintaining independence at home. The Thriving Communities Grants are promoted through the Know Your Patch networks, the Gloucestershire VCS Alliance Bulletin and on Your Circle.
Applications to the grant scheme are scored by local grant panels which comprise of individuals with insight and expertise in the communities of interest. In 2018/19, 30 Thriving Community grant applications were awarded. Since 2018, the Adult Single Programme has awarded £1,075,189 in grants to 145 community or voluntary sector organisations, which has meant an additional 3,214 people have been supported.
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