Northern Excellence in Active and Healthy Ageing Symposium€¦ · Foreword: Dr Hakim Yadi, OBE,...

NorthernExcellenceinActiveandHealthyAgeingSymposium

June6th 2017,HorizonLeedsConferenceCentre

SymposiumReportPreparedBy:NicolaWilson,onbehalfofActiveandHealthyAgeingNorthOperationsExecutive

ContentsandAcknowledgements

1. Titles Page12. ContentsandAcknowledgements Page23. Foreword:ProfessorMartinVernon,NHSEngland Page34. Foreword:DrHakimYadi,OBE,TheNHSA Page55. Foreword:RichardStubbs,YorkshireandHumberAHSN Page66. SectionOne:SettingtheScene Page87. Photograph:AHANorthOperationsExecutive Page108. SectionTwo:WhoAttended Page119. Photograph:SymposiumChairandSelectionofSpeakers Page1210.Infographic:IdeasCloud Page1311.SectionThree:WhatTookPlace Page1412.SectionFour:ConclusionsandNextSteps Page2513.AppendixA:Dashboard:RoundtableFeedbackbyTheme Page27

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Acknowledgements:TheAuthorwishestoextendhergratefulthanksandappreciationtocolleaguesontheAHANorthOperationsExecutivefortheirinputtoandfeedbackthroughouttheprocessofwritingthisreport.Similarly,particularthankstoShirleyHannan(theNHSA)andTomLindley(TRLHealthcareInnovation)fortheirideasonhowtobringthereporttolife,visually,andtoherCEO,DrHakimYadi,fordedicatingNHSAresourcetosupportthiscrucialprogrammeofwork.Finally,veryspecialthankstoallthosewhogaveuptheirtimetoattendtheSymposiumandforyourenergyandideasthatyoubroughtwithyou.NicolaWilson,July2017

Foreword: ProfessorMartinVernon,NationalClinicalDirectorforOlderAdults,NHSEngland

We are indeed living in challenging times. Yet over the last year,working for NHS England as National Clinical Director for OlderPeople, I have been both privileged and impressed by theenthusiasm, ingenuity and commitment to hard work going onaround the country focused on improving care and outcomes forour ageing population. As a health and care system collectivelywe have much to be proud of.

Of course there is much more to do if we are to drive up carequality and outcomes both now and for future generations.People aged over 85 represent one of the fastest growingsegments of the population and soon in the UK a fifth of thepopulation will be over the aged of 65. As a result, the country’shealth and care systems are facing considerable challenges as westrive to meet the needs of the most vulnerable people in oursociety.

There is an urgent requirement to ensure that we support ourolder population to stay as healthy, active and independent aspossible through the effective management of the long-termconditions, which accompany us into later life.

Prevention of unwarranted variation and promotion of healthyageing are always going to be key to this. Through my role withNHS England, I’ve been delighted with the progress being madeacross the country, which addresses the Active Healthy Ageingagenda, particularly in relation to the innovations showcased bythe Northern Academic Health Science Networks and theNorthern Health Science Alliance.

In 2016 through their coordinated bids, the entire North ofEngland was awarded 3* Reference Site Status in Active Healthy

Ageing through theEuropean InnovationPartnership. A trulyremarkable achievementbased on our successfulinnovation in this area todate.

It was the work of theseinnovative organisationsalongside the NorthernHealth Science Alliance that

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pulled the symposium together to not only showcase what hasbeen achieved already but to set a direction for future andaccelerated progress in Active Healthy Ageing.

Whether it be through the adoption and spread of the awardwinning electronic Frailty Index (eFI), through Bone Healthprogrammes, the fantastic Steady On! Initiative, the work takingplace by The Greater Manchester Ageing Hub, or any of theother examples profiled on that day, we know that deliveringchange to improve people’s lives is what really makes thedifference. The innovative and creative work by theseorganisations over the last few years has enabled great strides tobe taken in addressing the real issues that challenge the NHS andthe populations we serve across the country. It is encouraging tosee that we have also worked actively and productively withpartners and other agencies across Europe. What comes nextthrough joint working across the North of England, under theumbrella of a combined AHA Strategy, has the potential toimprove the day- to-day lives of millions of people.

Foreword: ProfessorMartinVernon,NationalClinicalDirectorforOlderAdults,NHSEngland

Icannotthinkofagreaterambitioninthisfieldthantoimprovetheexperienceofageingforpopulationsthroughoutthecountry;theNorthisleadingthewayinthisforEngland.Thesymposiumrepresentedafantasticpositivestep- thisreportisanothersignificantstepforward.IcommendittoyouandhopethatthisimportantworkcontinuestoprogresswellsowecanbringaboutpositiveandenduringchangeinActiveHealthyAgeingforourfuturegenerations.

ProfessorMartinVernonNationalClinicalDirectorforOlderAdults,NHSEngland

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Foreword: DrHakimYadi,OBE,CEOoftheNorthernHealthScienceAlliance(NHSA)

TheNorth’sexpertiseinactiveandhealthyageingissecond tonone,withcentresofinternationalexcellencelocatedacrosstheregion.Lastyear,theoutputsfromarigourousassessmentprocessbyapanelofindependent expertsfromacrossEuropedemonstratedthatnotonlyistheNorthleadingthewayonhelpingpeoplelivefullerandmoreactivelivesbutisalsoleadingonhealthresearchandinnovationinageing.Thesetwoactivitiescombinedmeanwehavethepotentialtomakeaveryrealdifferencetomillionsofpeople’slives.

TheNorthernHealthScienceAlliance(NHSA)hassupported ourmemberorganisationsintheNorthEast,NorthWestCoast,Greater ManchesterandYorkshireandHumberareas throughouttheAHAReferenceSiteapplicationprocess lastyear,andmorerecentlytorealiseamuch-neededcoordinatedalignment, andisproudtobeanon-goingpartnerintheActiveandHealthyAgeing North (AHANorth)programmeofactivitythathasbeencreated.

DrHakimYadiOBECEOoftheNorthernHealthScienceAlliance(NHSA)

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Foreword: RichardStubbs,CEO,YorkshireandHumberAHSN

Many of us are familiar with the story of our growing ageingpopulation. People aged over 85 are the fastest growing part ofthe population. In the next fifteen years one fifth of thepopulation will be over 65.

However, we often miss the important nuances of our growingageing population. The World Health Organisation’s (WHO)Misconceptions on Ageing and Health highlights many of these.For instance, expenditure on older populations and onencouraging everyone to age well, the report argues, is not acost but a high-return investment. In the report’s words, “theseinvestments can yield significant dividends, both in the healthand well-being of older people and for society as a wholethrough increased participation, consumption and socialcohesion.”

It is clear that strong leadership is necessary to form acomprehensive, innovation-based approach to active andhealthy ageing across many sectors. In 2013, Yorkshire and theHumber became one of the first regions in England to beawarded three-star European Reference Site Status for Activeand Healthy Ageing. The European Reference Sites are coalitionsof regions, cities, integrated hospitals or care organisations,industry organisation, SMEs and research institutions that jointlyaim to provide concrete examples of innovative services withproven added value to citizens and care systems in EU regions.

All Reference Sites have committed to sharing theirachievements with others and transferring knowledge acrossEurope. The Yorkshire & Humber AHSN led the latest successfulbid on behalf of all stakeholders in the region to retain ourinternational recognition for the region’s active and healthy 6

Foreword: RichardStubbs,CEO,YorkshireandHumberAHSN

ageing initiatives.

Following this, I was delighted to chair the Active Healthy AgeingSymposium along with our colleagues from the other threeNorthern AHSNs and the Northern Health Science Alliance, whohosted the event. The symposium shared the bestpractice taking place across the North of England, the basis for allof the North of England being awarded Reference Site status. Wewere delighted that Professor Martin Vernon, National ClinicalDirector for NHS England for Older People and Person CentredIntegrated Care, could join us at the conference.

The symposium was a clear statement of our ambition as aregion to meet this challenge head on, and to capitalise on theincredible and impactful work that is being delivered across theNorth. The energy on the day was positive proof that we have ahuge opportunity to make a fundamental difference in thisextremely important agenda.

RichardStubbsCEO,YorkshireandHumberAHSN

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SectionOne: SettingtheScene,whatisanActiveandHealthyAgeingReferenceSite?

In January 2016, a valuable opportunity arose placing excellencein Active and Healthy Ageing (AHA), taking place across the Northof England, on a European platform. Additionally, thisopportunity afforded the creation of a structured collaborationand alignment in older adult health between the four North ofEngland Academic Health Science Networks (AHSNs) - GreaterManchester AHSN, The Innovation Agency (North West CoastAHSN), North East Coalition for Active and Healthy Ageing, andYorkshire & Humber AHSN.

This opportunity arose in the shape of the North of EnglandAHSNs being given strategic guidance from the Northern HealthScience Alliance (NHSA) to apply for ‘Reference Site’ status in the2nd Call from the European Innovation Partnership on Active andHealthy Ageing (EIP-AHA). This alignment ensured eachorganisation could contribute their individual expertise at local-level, whilst offering a ‘similar but different’ narrative in theirsuitability for trans-Northern joined up capabilities, in addition tothe trans-European collaboration expected of AHA ReferenceSites.

A Reference Site is defined by the European Commission as:

1https://ec.europa.eu/eip/ageing/reference-sites_en

All four applications were successful, and in December 2016 thefour organisations received international recognition for theirexcellence in active and healthy ageing, at a ceremony within theEuropean Summit on Digital Innovation for Active and HealthyAgeing in Brussels. In total, 74 regional and local organisationsacross Europe were awarded "Reference Site" status at theceremony.

Whilst in Brussels, the NHSA and the four Northern AHSNs metto scope a new programme of collaboration in older people’shealth, ultimately joining forces in their wealth of expertiseparticularly regarding frailty and falls prevention. The NHSAcommitted to support and offer strategic alignment to the fourAHA ‘Reference Site’ organisations and an Active and HealthyAgeing North (AHA North) Operations Executive was created,chaired by Richard Stubbs (CEO of the Yorkshire & HumberAHSN), to guide the collaborative programme, which whilst stillin its infancy provides valuable and much needed support to:

“Ecosystems which comprise different players (including regionaland/or local government authorities, cities, hospitals/careorganisations, industry, SMEs and/or start-ups, research andinnovation organisations and civil society), that jointly implementa comprehensive, innovation-based approach to active andhealthy ageing, and can give evidence and concrete illustrationsof the impact of such approaches on the ground”. 1

“Their collaborative approach in engaging health and careproviders, government, industry and researchers in thedevelopment and adoption of innovative solutions havehelped to improve health and care outcomes for patients, andoffered new models and approaches that will help transformthe way services are delivered. This recognition along with thetechnological and innovative solutions being developed willhelp to open new commercial markets across Europe andbeyond.”

(JohnFarrell,StrategicAdvisertoTheReferenceSiteCollaborativeNetwork,July2016)

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SectionOne: SettingtheScene,whatisanActiveandHealthyAgeingReferenceSite?

• NHS England’s ‘5 Year Forward View’ national strategy,• and with additional alignment, to parts of HM Government’s

‘Life Sciences Strategy’ due for publication during the summerof 2017.

One of the first objectives the AHA North Operation Executiveset itself was to deliver a showcase of what is already happeningin the field, whilst also drawing on how Northern expertise alignswith national, UK and European policy and strategy in ageinghealth and wellbeing. The ‘Northern Excellence in Active andHealthy Ageing Symposium’ took place on June 6th 2017 in Leeds,and this report has been created to provide the reader acomprehensive understanding of what took place on the dayfrom the AHA North Operations Executive perspective and willconclude with the tangible next steps we seek to take.

What is our ambition?1. Oursisahugechallengethatcanonlybemetthrough

collaborationandcreativity.2. TheNorthisleadingtheway(asourcollaborativeand

creativeSymposiumdemonstrated).3. We’reonlyjustgettingstarted.So,pleasewatchthisspace

formoretocome.

Inthemeantime,wehavetwoquestionsfortheattendeereader:• Asasensecheck,havewegotthiswrite-uprightanddoesour

accountandexperiencemirroryours?• Areweontherighttracktorealiseouraspirations?

AnyfeedbackwouldbegratefullyreceivedbyNicola.Wilson@thenhsa.co.uk 9

OpsExecplaceholder

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AHANorthOperationsExecutive

LefttoRight:AmandaRisino(GM),DaiRoberts(GM),AndyShakeshaft(NWC),RichardStubbs(Chair,Y&H),GrahamArmitage(NE),SteveStericker (Y&H&),KirstieClegg(GM),NickiWilson(theNHSA)

SectionTwo: WhoAttended?

RichardStubbs,CEOofYorkshire&HumberAHSNandChairoftheAHANorthOperationsExecutivechairedtheSymposium,andinvitedattendeeswerestrategicallytargetedfortheirstakeholderopinion.

SignificantdiscussionandattendeemappingwasundertakenbytheAHANorthOperationsExecutivetoensurethattherightpeoplewouldbe‘intheroom’tosensechecktheideasandaspirationsofatrans-Northernprogrammeofdelivery.

Thesectorsrepresentedonthedayincluded• NHSEngland• GPsandCCGCommissioners• ProviderTrusts• LocalAuthorityCommissionersandPublicHealthLeads• UniversityandResearchInstitutions• ThirdSectorandCharitableOrganisations• IndustryandSME

Afulllistofregistrantsandattendeescanbeviewedhere.

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Speakerspictureplaceholder

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NorthernExcellenceinAHASymposiumChairandaSelectionofSpeakers

LefttoRight:RichardStubbs(Chair),ElaineColgan(NI),AbiPhillips(Wales),DonnaHenderson(Scotland),ProfessorOliver James(NE),DrSarahDeBiase(Y&H),ProfessorMartinVernon(NHSEngland),ProfessorMaddalenaIllario(Campania,Italy)andDrHakimYadi,OBE,(TheNHSA)

TheSmallestIdeasCanTakeUsaLongWay……

Ideas CloudIncrease use of community assets such as 'men in sheds'

Age as a 'meaningless' characteristic.

Ageing is flexible and malleable

We need a two-way dialogue between the practitioner and the

service user, and there is an opportunity to use tech/digital for this to support people to change

behaviours.

It isn't about ageing but how we lead our lives, there is a real

need for conversations in their own environment.

Ideas Cloud

SectionThree: Whattookplace?

Thissectionofthereportprovidesthereaderwithanoverviewoftheday’sagendaandactivity.Thespeakers’slidescanbeviewedhere,andtheirbiographiescanbeviewedhere.

WelcomeAddressRichardStubbs,CEO,Yorkshire&HumberAcademicHealthScienceNetwork

Richard is the Chief Executive Officer of the Yorkshire & HumberAcademic Health Science Network (AHSN), an organisation thatconnects NHS, academia and industry to facilitate change acrosswhole health and social care economies, with a focus onincreasing economic growth and improving outcomes forpatients. Previously, Richard was a core member of the NHSNational Leadership Council, and has acute and commissioningsenior management experience. He joined the NHS from the BBCas a graduate trainee, and is also an alumnus of the NHS ‘TopLeaders’ and NHS ‘Breaking Through’ programmes.

Keynote1:Campania’sExperienceintheEuropeanInnovationPartnershiponActiveandHealthAgeing(EIP-AHA)ProfessorMaddalenaIllario

Since December 2016, Maddalena has coordinated the CampaniaRegion Division on Health Innovation. Maddalena previouslycoordinated the Research and Development Unit of Federico IIUniversity Hospital as well as managing the Italian team of the‘PERRSILAA’ and ‘Sympathy’ projects, and Campania’sparticipation in the ‘Sunfrail’ Project. Since May 2015, she hasbeen a ‘Promoter’’ (expert) for the A3 Action Group on

Prevention of Frailty and Functional Decline of the EuropeanPartnership on Active and Healthy Ageing, and additionally sitson the coordination team of A3 Action Group’s Area of Food andNutrition. Since 2013, she has coordinated Campania ReferenceSite activity within the European Partnership on Active andHealthy Ageing.

Keynote 2: Aligning Northern Collaboration in AHA withNHS England Priorities in eFrailty and Frailty IndexingProfessor Martin Vernon

Martin qualified in 1988 in Manchester. Following training in theNorth West, he moved to East London to train in GeriatricMedicine where he also acquired an MA in Medical Ethics andLaw from King’s College. He returned to Manchester in 1999 totake up post as Consultant Geriatrician, building communitygeriatrics services in South Manchester. In 2015, Martin movedto Central Manchester where he is Consultant Geriatrician andAssociate Head of Division for Medicine and Community Services.He also holds Honorary Academic Posts at Manchester andSalford Universities and was appointed as Visiting Professor atthe University of Chester in 2016. In 2016, Martin was appointedNational Clinical Director for Older People and Person CentredIntegrated Care at NHS England.

Northern AHA Exemplar Practice, Yorkshire & HumberDr Sarah De Biase

Sarah is the Programme Manager for the Healthy AgeingCollaborative, a network established to support the developmentand evaluation of new evidence-based models of care for peoplewith frailty. Cross cutting the Yorkshire & Humber AHSN’s 14


Healthy Ageing and Connected Bradford (part of ConnectedHealth Cities) programmes, Sarah leads a portfolio of projectsdesigned to test the clinical utility of the electronic Frailty Index(eFI) and engage primary care clinicians to use the eFI toproactively identify, diagnose and manage frailty.

Northern AHA Exemplar Practice, North EastProfessor Oliver James

Professor James, FMedSci, was a Consultant Physician inNewcastle for 30 years, Professor of Medicine from 1985, Headof Newcastle University School of Clinical Medical Sciences from1995, Pro Vice Chancellor Medical Faculty 2004- 2008. He wasSenior Vice President Royal College of Physicians 1997-1999 andhas authored over 300 papers on aspects of liver disease andageing.Professor James presented the AHSN NENC Bone Health

Programme. The programme uses a population-based approachto assess routine GP practice data to identify patients at risk offracture across the North East and North Cumbria. The BoneHealth initiative looks at identifying 'at risk' patients at GPpractice level and starts them on the correct patient pathway inline with local and national guidance. Interventions includeeducation/information for patients on a healthier lifestyle,medication compliance, medication initiation or change.

Raising the Bar: How a ‘Good’ Reference Site in AHAbecomes ‘Better’Donna Henderson, Elaine Colgan and Abigail Phillips

OurvaluedcolleaguesfromtheAHAReferenceSitesofScotland,NorthernIrelandandWalesrespectivelygaveusaninsightintotheirlocallevelexemplarandawardwinningexpertiseinolderpeople’shealthcare,andhelpedusunderstandhowgoodcanbecomebetter. 15

“Supporting increased implementation of the eFI throughoutthe region has the potential to make significantimprovements to the health of local people living with frailty.The index is recommended in the national GMS GP frailtycontract which will support primary care across England toidentify the estimated 3% of patients at risk of severe frailtyregistered with every GP practice across the country toreceive individually tailored assessment, support and casemanagement. Better targeted and proactive care for peopleliving with frailty has the potential to reduce demand on non-elective care services and produce savings across local healtheconomies.”

DrSarahDeBiase,ProgrammeManager,Yorkshire&HumberHealthyAgeingCollaborative

"The Bone Health Programme in collaboration with ClinicalCommissioning Groups and General Practices, supported bythe AHSN-NENC, and in partnership with Interface ClinicalServices and pharmaceutical companies, provides awonderful example of a collaborative way of working inwhich patients benefit enormously by reducing their risk ofhip and fragility fractures, while there is a likely largefinancial saving to the NHS. We are extending this to benefitpatients as widely as possible throughout the North East andNorth Cumbria and beyond!

"ProfessorOliverJames,MedicalDirector,AcademicHealthScienceNetworkfortheNorthEastandNorthCumbria.


As Head of European Engagement at the Scottish Centre forTelehealth and Telecare (SCTT), Donna Henderson leads NHS24’s European Engagement Team, which aims to enhanceScotland's reputation as a leader in digital health and care andpromote economic opportunities for Scotland, on behalf of theScottish Government. Donna has been a lead Co-ordinator of theEuropean Innovation Partnership on Active and Health Ageing B3Action Group on Integrated Care - the largest of the 6 EIP on AHAAction Groups – since 2012.

Elaine Colgan has recently taken on the role of Head of eHealthand European Branch in the Department for Health in NorthernIreland. This includes the further development of the Northern

Ireland 4* Reference Site, European engagement, Ireland. Thisincludes the further development of the Northern Ireland 4*Reference Site, European engagement, and management ofstructural funding on behalf of the Department. Elaine istreasurer of the Reference Site Collaboration Network.

Abigail Phillips currently heads up the healthcare technologyprogramme overseeing multiple key work streams including theEfficiency through Technology Fund, SBRI Healthcare and theestablishment of the technology assessment and adoptionfunction, Health Technology Wales. Prior to working in theWelsh Government Health and Social Services Group, Abigailheld positions in Finance and Economy Departments as well as aboard position at a local charity supporting vulnerable individualsand their families.

Morning Speakers Panel Q&AChaired by Dr Hakim Yadi, OBE

Hakim is CEO of the Northern Health Science Alliance Ltd (NHSA).He led the formation of the NHSA, bringing together 20 NHSAmembers across the North of England securing over £60m incontracts and raising the profile of the North’s health research.

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"For Northern Ireland, one of the important factors as we lookto the future is being able to test our innovations and scale upsuccessful improvements. This is made easier by our joined upapproach to active and healthy ageing, involving partners inacademia, business, our Department for Economy, andinvolving user co-design when we consider our futureservices. This collaboration was key to achieving 4* statusand demonstrating the quadruple helix approach. Our uniquesystem of integrated health and social care facilitates ajoined-up, person-centred approach to care and assists withtrialling and scaling up of innovative solutions, which coupledwith our NI Electronic Care Record – a single secure web-based regional clinical portal – creates a flow of patientinformation across health and social care leading toenhanced quality, safety and efficiency of care and practice."

ElaineColgan,HeadofehealthandEuropeanBranch,DepartmentofHealth,NorthernIreland.

"Wales is continuing to build on the activity which got us to4* recognition of the value of partnerships in the UK beyond,using alternative funding models for innovation – grants,industry partnerships, procurement mechanisms andincreasing the use of outcome data to drive systemimprovements."

AbigailPhillips,HeadofHealthcareTechnologyProgramme,WelshGovernment.


Previously, Hakim co-managed the translational medicine teamat PA Consulting Group and was seconded to the UK Governmentas Chief Operations Officer and was a founding member of theDepartment of International Trade Life Sciences Organisation. Heis co-founder of two women’s healthcare companies and is co-founder of the Global Heart Network.

Hakim acted as the Q&A Chair and invited all speakers from themorning sessions back to the stage. Most questions were takenfrom the audience. Answers below are summarised and notverbatim.

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Professor Maddalena Illario (MI): University hospitals areproven in their expertise and add value to partnerships.Support must also include local stakeholders. We have foundsome non-profit organisations difficult to engage but theyultimately can translate approaches in a swifter and easier toadopt way.

Donna Henderson (DH): We look to provide funding toScottish voluntary and community services to encouragecross-sectoral relationship building.

Elaine Colgan (EC): It is vital to have Clinicians on board;however, the challenge is that they all work in their ownindividual ways.

Question from the Chair, Dr Hakim Yadi (HY):“Ageing and staying well are not solely dependent onhealth system function but also a societal civic challenge.Do you consider that you have the right partners in place?If not, how best do you build relationships?”

Professor Oliver James (OJ): Start with the GP federations.Find the lead clinicians and enthusiasts to champion. Nowthat our objectives are known, we are talking to CCGs more. Itis down to talks with individual practices. Use local media toencourage patients to ask GP what they’re entitled to.

Professor Martin Vernon (MV): It is a case of needs versuswants. Address needs of individuals within communitiesversus wants of population. Agree on the need for a narrativeto align two things. The narrative should incentivise people tolive well and engage in what’s happening around them. Thereshould be a successful health and social care system plusinterventions based on need. Give people back ownership oftheir own care when able.

MI: The social isolation aspect is an important driver.Involving older adults in any decision-making process helpsadoption. Follow where they go rather than inviting themsomewhere else.

HY:“Regardingindividualinterventionsversuspopulationhealthchallenge,howdowearticulate?Howdowedevelopstrongnarrativetoconvey?”

OJ: I agree on the importance of evaluation (e.g., models usedin Ireland). Try to do more health economics. Increase thesense of empowerment to all staff in practices/preventionservices.

QuestionfromtheFloor: “Whataretheholisticbenefits?”


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Abigail Phillips (AP): Wales has Housing Associationinvolvement, but there is more work to do. The Welshgovernment is very interested in remote monitoring tosupport independence at home.

DH: Tech enabled care is key, with some of most innovativesolutions led by our Housing Associations. The D4 actiongroup of the European Innovation Partnership on Active andHealthy Ageing has an Age Friendly Environment focus tofeed in broader environmental impacts, also feeding intodigital cities work.

QuestionfromtheFloor:“Towhatextentarehousingproviders,planningdepartments,environment,cultureetc.includedinthisthinking?”

cancer/dementia narratives. It’s important to improvecommunication skills – what benefits and why, and how canwe organise your care around you?

MI: We use self-assessment tools around adherence to diet,which in turn empowers the person.

Dr Sarah De Biase (SDB): Using health-checks for over 75year olds. Frailty nurses are using PRISMA7 for self-reporting.Resources such as these are used alongside discussions withclinicians to measure resilience and ability to cope.

MV: There is a blog on the NHS England website. We workwith Age UK for a sounding board approach with older peopleregarding what frailty means. We are starting to embed thisinto the NHS England narrative regarding routinely identifyingfrailty. The purpose is to create opportunities for people. Weneed to sell the benefits of using the tool, similar to the

QuestionfromtheFloor:“Howtoselltoendusers?Languagesuchas#frailty#fallsisnotpopular.Isthereauser-friendlychart/pathwayforusersandfamilies?”

MV: No, of course it hasn’t. There is a need to take differentapproaches, think about what we are commissioning andwhy. There is a civic duty re value for money in health andsocial care commissioning and delivery. New models, likeRightCare, iron out variation across the country, which isimportant. We need to maintain an agile, flexible and astuteapproach to commissioning. Prevention question – partly recommissioning but also responsibilities for providerorganisations to engage with the commissioning processes.Creating headroom for large provider organisation placesduty on them to reinvest. We need productive dialoguebetween commissioners and providers: with falls being agood example. It needs to be assertive, evidence based,diligent.

QuestionfromthefloortoProfessorMartinVernon:“Demandreductionbyincreasingprevention.PBR/tariffresultsinchallengesgettingintoprevention.Hascommissioningrunitscourse?”

“..hascommissioningrunit’scourse?”


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QuestionfromtheFloor:“Towhatextentarehousingproviders,planningdepartments,environment,cultureetc.includedinthisthinking?”

EC: Northern Ireland has a legal requirement / top downapproach with Age friendly subgroups for our preventionagenda.

MV: Community is the answer. Public messaging at a locallevel. Understanding inter-generational relationships. Showpotential gains, e.g., Wigan’s clear offer from Public Health tolocal community, positive engagement.

QuestionfromtheFloor:“Wecouldbebetteratlisteningtoolderpeople.Weneedtoempowerandskillupvolunteers.GPsneedmoreinfooncommunityassets.Howcanwelisten,influenceandgetolderresidentsmoreinvolved?”

AP: Even with funding, it is difficult to change practice.Therefore, there is a need for engagement, negotiating andinfluencing. Command and control is a last resort. We usededicated networks to share best practice. However, itdepends on the aspirations and motivations of anorganisation.

DH: Agree. E.g., the ‘mastermind’ project, online CBT. GPs arekeen to access projects such as these due to KPIs. Attendanywhere model – e.g., Australian virtual clinic for GPs whichis a low-cost solution and easy to integrate. GPs can seewhere patients are requesting to be seen virtually. There is acompelling need for GPs to adopt this. Any low tech, easy touse option should support rather than give more work.

QuestionfromtheFloor:“Processforsharingatpaceandscale- Isthereanidealmodel?”


Northern AHA Exemplar Practice, North West CoastSumaiya Sufi and Yvonne Skellern-Foster

Sumaiya is a quality improvement and safety specialist forresidential settings. She manages a team of contract monitoringofficers and quality improvement coordinators who work withproviders to ensure they meet contractual obligations andprovide safe, quality care. As well as working individually withproviders, Sumaiya is responsible for developing good practiceguidance, tools and processes that support quality improvementin residential settings. Falls are a consistent concern forresidential providers and STEADY On! Provides an opportunityfor staff, residents, family and friends to address the issue in asimple and practical way.

As FALLS Team Partnership Lead at East Lancashire TeachingHospitals NHS Trust, Yvonne is an accident preventionpractitioner both in Children’s’ and Older Peoples’ Fallsprevention. For the last 17 years, she has been a key member oftwo multi-award winning innovative prevention services. Shecurrently leads the East Lancashire STEADY Team.

NorthernAHAExemplarPractice,GreaterManchesterPaulMcGarryandProfessorChrisTodd

Paul has led Manchester’s multi-agency urban ageingpartnership, now known as Age-Friendly Manchester, since 2003.The partnership works across public, private and communitysectors, and with residents, to improve the quality of life ofMancunians in mid and later life. In 2017, Paul was appointed asthe Head of the Greater Manchester Ageing Hub, which heworked with partners to set up over the previous twelve months.

The Greater Manchester Ageing Hub has an ambition for GreaterManchester to be the first age-friendly city region in the UK, tobe a global centre of excellence for ageing, and to increaseeconomic participation among the over-50s. Strong partnershipsin Greater Manchester will be pivotal to realising theseambitions, including close working with the Mayoral team andnationally with the Centre for Ageing Better (CfAB).

Chris is Professor of Primary Care and Community Health, Schoolof Health Sciences, University of Manchester. He leads theHealthy Ageing Research Group with a major theme of fallsprevention and activity promotion amongst older people,including the use of technologies in support of interventions. Heleads the pan-European ProFouND falls prevention network andis a member of the leadership group of the EIP-AHA ActionGroup 2 on falls prevention. He works with the GreaterManchester Ageing Hub providing expertise on evidence basedinterventions to achieve the Hub’s strategic goals in the areas ofactivity promotion and falls prevention.

North West Coast and Greater Manchester Exemplar PracticeQ&A: Chaired by Nicki Wilson

Nicki is the Operations Manager at the NHSA and served as theQ&A Chair. She invited all speakers from the previous twosessions back to the stage, and questions were taken from theaudience. Answers below are summarised and not verbatim.

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CommentfromtheFloor:“CommentfromtheFloor:“STEADYOnprojectcanbeusedinnon-clinicalsettingse.g.,FireandRescueService,butneedsclinicalbackingandnetworks.”


Action Planning for a Trans-Regional Programme ofCollaboration in AHA

IntroducedbyRichardStubbs,attendeeswereinvitedtoparticipateinroundtablediscussions,ledbyspeakersactingasfacilitators.Discussionfocusedonfourtopics,withspecificquestionsbeingasked.Thefindingsweregatheredinrealtimeandbuiltuponwithinthenextsession.Thetopicswereasfollows;FallsPrevention,eFrailty,Musculoskeletal(MSK)andCross-Sectoral,Trans-RegionalCollaboration.

EachTopicwassupportedbystats,challengesandopportunities,whichtheTopicFacilitatorssharedwiththeirgroups.EachWorkingGroupconsideredthefollowingthreesub-domains,inrelationtotheirtopic,withintheirdiscussion;bestpractice,barriersandopportunitiesavailableforimmediate‘join-up’inothersub-regionsoftheNorth.Throughoutthesession,‘runners’gatheredideasfromtablesandtookthemtoDrHakimYadi,inpreparationforthenextPlenarysession.

Inadditiontothesettopicsunderdiscussion,an‘IdeasCloud’areawasavailablefordropin,tocapturevaluablecontributionsout-withtheformalarenaofdiscussion. 21

Paul McGarry: A few things helped us build the Manchesterprogramme including our ongoing relationship with theUniversity, and working with the World Health Organisation.When you have the WHO seal of approval, it opens doorsoutside of the political arena and helps create a differentstory from the generic ageing one. Governmentalprogrammes ended in 2011 and we looked to the OECDreport about the changing world demographics, sub-regions,and cities at the centre of developing their own policies,strategies and leadership. A national network of 20cities/local authorities was created making it easier to dowithout support from the national government. Wedeveloped a Memorandum of Understanding with the Centrefor Ageing Better who also support work toward age friendlyenvironments and communities. Our older peoples groupmeets regularly, holding Manchester City Council to account.The programme helps develop capacities in the city to createbetter places for older people; and moves us away from ahealth service focus.

Professor Chris Todd:We need to think about how to upscalein the future. A good example would be primary prevention offalls rather than focussing on those at high risk and/or whohave already fallen. A Public Health approach and the GreaterManchester devolution agenda can help achieve thispopulation shift which is the future to active and HealthyAgeing.

QuestionfromtheChairtoGreaterManchester:“AsidefromtheMayoralagenda,whataretheotherkeyenablerstoyoursuccess?”

Yvonne Skellern-Foster:Working into our 60s is becomingcommonplace. Older people need to be in charge of owndestinies. Make it ‘fun.’


Plenary Session: Building Viable Propositions and Next StepsDr Hakim Yadi

Followingonfromtheround-tableworkshopsession,Hakimpresentedasummaryofkeypoints,ideasandmini-propositionsarisingfromthediscussionthattookplace.

HakimopenedtheplenarybyinformingattendeesthattheSymposiumwastrendingonTwitter,secondonlytotheweather.Anoverviewoftheplenarycontentcanbeviewedhere,andHakim’sslidesareavailabletoviewwithinthemasterslidepresentationoftheafternoonsessionbyclickinghere.

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FallsPreventionDiscussionSynopsis

• Whendoes‘oldage’start?- BiologicalAgeversusActualAge?

• De-medicaliseageing

• Focusonyoungeraudienceaswell– e.g.,grandchildtograndparents

• Simplemessagesintherightlocations– e.g.,supermarkets

• Ensureyoureachisolatedpopulations

• Digitalliteracymustbeconsidered

• Bringtechnologyearlyintopeople’slivesandmakeitperson-centric

• Exemplars!Exemplars!

• Shareexperienceandbestpracticeofcommunityassets

• Educationalandfuntechnology,e.g.,gaming,exercisetomusic,tea-towels– “Itworkswewantmoreofit”

eFrailtyDiscussionSynopsis

• Pan– Northerncollaborationneeded(recognisethecomplexity)

• Fundingforimplementation

• Newrolesinhealthcareforfrailty

• Evidencedbasedbriefingsforcommissioners

• Moresupportforprimarycarebutrequiresawholesystemapproach

• Earlierintervention

• Shareexemplars(supportinglocallytotestandimplementfromexamples,butensuringtheyhavehadtheappropriateevaluation)

• Fundingforimplementation

• Newrolesinhealthcareforfrailtyandsharereal-lifestoriesofpatients


Plenary Session: Building Viable Propositions and Next Steps (cont)

23

MSKDiscussionSynopsis

• MSKQOF– Exerciseandmovement

• Simplifypathwaysandmakeitfun

• Earlierinterventionandstratification,life-courseapproachmakingitahabit

• Raiseawarenessthroughbetterhealthliterature

• Needsdonotchangeovernightwhenyouareolder– lifecoursemanagement

• Focusonreducingsarcopenia&roleofexercise

• Motivationandcommunity– healthilylifeyearsnotexpectancy

FallsPreventionDiscussionSynopsis

• Multi-disciplinaryapproachcrucial,notjustGPs

• Prioritynextstep:toengagepatientsandthepublicandfosterinvolvementinaPan-NorthernAHAprogramme

• AHSNsandNHSA– Needbuy-inbeyondhealth

• Callforan‘AtlasfortheNorth’onAHAbestpractice

• Trans– Regionalprojectideasforimmediatescaleup,e.g.,the‘ProteinPill’beingdevelopedatLeedsBeckettUniversityand‘StandingTall’projectfortheNorth

• CHCModelasanexemplarmodelofsuccessfulpan-regionalcollaboration


Plenary Session: Building Viable Propositions and Next Steps (cont)

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MSKDiscussionSynopsis

• Newwaysonengaging?

• Agefriendlycities

• Prepareforprevention

• Createvisionforlaterlifeearlieroninlifecourse

• Newroutesfortechnologyaccessfortheelderly

• Howweleadourlives=howweage

• Betteraccessanduseofco-producedtechnology

• Needabroaderapproachtoevaluation,e.g.,socialimpactandthirdsector

SectionFour: ConclusionandNextSteps

In bringing this write up to a close, it is worth revisiting observations made in the Introductory section, namely that the objectives oforganising and delivering the Symposium were to test the appetite and energy across the North of England for a trans-regionalprogramme of work in ageing health.

Thanks to the time given by the attendees on the day, and the numerous positive and supportive messages and communication that theauthor and the AHA North Operations Executive have received, our hypothesis for hearts and minds being ready to collaborate andalign our thinking has been tentatively proven.

However, this is an ambitious programme of work - in itself innovative - and as an immediate next step we shall build on feedback fromthe round tables by conducting an inventory of skills and expertise already established, plus a gap analysis within each of the four AHSNsub-regions geographies of the North within four condition themed areas, namely:

• Atrial Fibrillation,• Musculoskeletal Disorders,• Falls and Fractures, and• eFrailty,

enablingustosharpenourfocusontoopportunitiesfornaturalscaleup,plusstarttheprocessofcreatingthemuch-mentioned 'AtlasfortheNorth'.

Welookforwardtoprovidingyouwithregular,timelyupdatesandsharingopportunitiesforyourinvolvementastheAHANorthprogrammeofactivitydevelops.

For further information regarding the content of this report, please contact Nicola Wilson, Operations Manager, NHSA:[email protected]

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Appendices

26

AppendixA: RoundTableDiscussionsScribeNotes

27

Theroundtablediscussioncoveredavarietyoftopicsthroughoutthecourseoftheday.Pleaseclickonasubjectareabelow toaccessthescribenotestakenduringeachsession.

MSKFallsPrevention MSKMSK

MSKeFrailty MSKIdeasCloudMSKCross-Sectoral,Trans-RegionalCollaboration

FallsPrevention eFrailty MSK Cross-Sectoral,Trans-RegionalCollaboration IdeasCloud


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FacilitatorQuestion:Whatisthechallengeofpan-regionalspread/adoption,whatdoweneedtotakeonboard?

● Manchester:Itisverydifficult– theNorthEastoptedoutofthecityregionandweneedleadershipatthatcityregionleveltomobilisealltheplayersatthatlevel.Itsmoredifficultandyou’vegottoworkwithinGM10localauthorities,hospitals,CCCGs.It’sanunusuallycomplexsetofrelationshipsandyou’vegottohaveanideaofwhatyouwanttoachieve.

● InGM,wehavetosave£2bnandnotsurehowmanypeoplethinkit’sachievable.● Withleadershippeopletakeownership.Partofthenegativeofthatisthatpeoplethink‘notinventedhere’– iftheyfeelpart of

theinventionthey’remorelikelytotakeitforward.● AspartofanAHSNwestillhavethatissue– notinventedhere– butthisagendaiseveryone’sagenda.Ifyouwereontheoutside

listeninginyou’dbeaghastthattherewouldn’tbeatrans-regionalconsensus.Thereisnopartofthecountrythatisn’tsufferingfromthesechallenges.There’sawidespreadofpartnershipwork.Isthereapartofwhereithasworkedwellwherewehaveagoodpartnershipacrossregionsandwhy?

● It’saboutsizeinWalesandNorthernIreland.There’sanestablishedcommunitywithdevolvedpowersetc.;theyknowhowtogetthingsdone.InLondonit’salmostimpossibletogetthingsdoneatthatscale.There’salsosomethingaboutpeoplewholeadlocalgovernment,healthandsocialcare.Youneedtoadoptacityviewandgetcitypride.Whichissomethingthat’sdevelopedinManchesteroverthepast20years.

● Nationalagendashavehelpedwiththat,aspeoplecan’taffordtohavethatagainsttheadvancingpopulationage.● So,identityisreallyimportant.It’snotallharmoniouswithintheboundariesofManchesterbutevensothere’ssomethingyou

havewithinManchester– thereisaNorthernidentityandperhapsweneedtobemajoringonthatinourpitch.OneofthethingsI’vebeenthinkingaboutsinceReferenceSiteawardhappenedistheGoldenTriangleandI’dhaveheardaboutitbynowifthislevelofsuccesshadhappenedintheSouth.

● TheNorthernPowerhouseistheclosestwehavetothatandyoucouldarguethattryingtodevelopanapproacharoundageingandhealthandcareservicesmaybeonewayforward.Ifyoufindyourselfoutofdecisionmakingitsverydifficulttogeton theagenda.

● IsawapresentationlastweekfromBrussels.Oneoftheslideswasalightbulbmomentwheretheysaid,‘Allthebigsocialservicesparticipateinanearlyandkeyway.’Weneedtogettherightbalance.Shiftingthebigagendahasmoreofanimpactthanstandingoutside.

● CanwebehelpedbyUniversities?Wedon’thavethatconnectiononthetrustside– we’relackingconnectionsbetweencliniciansandacademics.

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● WhenImetacolleague fiveyearsagoIsaid,‘Whereareyoudoingyourresearch?’Hesaid‘Bologna.’It’sanappealforlocaluniversitiestogetinvolved.

● TheUniversitiesseemtokeeptheimpactforthemselvesandnotsharebetweenuniversities.● IfwesaidtotheNorthernagenda,“There’ssixthingsweneedtodo,”thatwouldhaveahugeimpact.● Andthat’swhatpeoplewant.We’vegotnineSTPsintheNorth– we’vemovedpastpilotnow– it’s‘whatcanwedonow?Isit

scaleable,viaSTPs?’Thatcouldbethesixthings.Ifyouhaveevidencetosuggestthatsomethingworksyoucangetmorepeopleinterestedinit.

● Oneofourthingsis‘tellushowitgetsdone.’Youneedacommissioningtoolkittoo.● Youneedcohortpatientgroupsthatarelikelytoneedaninterventionandthendeliverholisticpatientcareandifthatdoeswork,

spreadacrossdifferentgroups.● Fallspreventionwe’veknownthatforalongtime– howmanyhealthandsocialcarecommissionthat?It’saboutsystem

leadershipandpeoplebeingontopofit.I’vesatandhadconversationswithpeoplewho’vespentsixfiguresumsbecausethey’veseenanarticleaboutsomething.Thesystemispepperedbypartiallyinformeddecisions.

● There’salsoanissueaboutkeepingitontheagenda– short-termfunding,fallsofftheradar– thensomeonewillsaythere’sanissuetheresoitislookedatagain.

● Thereisn’ttheleadershiparoundit.● Anexampleyougaveabouthavinganolderperson’sforum– quiteoftenthatgroupofpatientsdoesn’thaveavoice.Itdoesn’t

getthatsamepresscoverage.● Therearelotsofexamplesofforums.Upuntil2011therewasalotofthisactivity.Afterthecutsthisdisappeared,sogiving

peopleavoiceandanactiveroleisabsolutelyright.● Theinnovationnowisalltheretohelpbringeverythingupandtolinkitallintechnologyisanotheropportunity.

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• HealthyAgeingAHSNrole– thatrepositoryofinformation.Otherwiseyou’dgotopublichealthEngland.• So,usingassetsalreadyinplace?• Itdependsonthebuy-inofpeople– somaybethereneedstobemoreeducationaboutwhatwedo.• ComingfromLiverpoolUniversitysetting,wewerethinkingtherewasagapbetweenwhatwearedoingattheresearchleveland

what’sdoneinpractice– wethinktherewouldberoomforsomeonetalkingtogether.• JustoverlunchweweretalkingtosomeonefromLiverpoolUniandwe’refromLiverpoolHope– we’venothadtheseconversations

before.• Inourstudywearelookingatdifferentarmsofatrial– frailetc.Wedon’thaveGPreferralsorpeopletorecruitfrom– wehaveto

goacrossandfindpeopleourselves.We’dliketocross-researchthat.Wedon’tknowtheGPsorthelinks.Theimplicationswouldbebestgiveapproval.

• Asasocialworkertherewouldbepeopleincarepackages– becauseoftheirfrailty– includingscience.That’sgoodasapreventativemeasure.

• InLeeds,wehaveaLeedsAcademicHealthPartnershipnetwork.SoifthisquestionwasgoinginLeeds,there’saplatform.• Oneofourmaintenantsisdevelopingmulti-disciplinarygroupsofpeopleworkingtogetherandmeetingintheneighbourhood.That

wouldbeanidealforumtogetin.Myotherthoughtwasthedeanery– it’dbeidealforthem.• Asanexemplaryoucanseethatgapneedstobefilled.• Ifyou’vedonethelegwork,youcanseehowthingsmayneedtobefilled– thatknowledgeisshared.• Weneedtolearntobeclearandcommunicativeaboutcrossbenefit.Weneedtobesystematicallyincludingthisinwhatwe’re

doing.• WehaveaPIPmeetingwithTheInnovationAgency,Cheshire,etc.There’sthreemeetingsayear– that’salotofnetworking.• Sothat’sagoodideaofhowsomethingworks.• Threedifferentchannels– websitewhereyouputuptrialsyou’redoing– andGPsscreeningcanseewhattrialsarerunningon.• University‘communitiesofpractice’meet,talkaboutsomething,andthenuseaGoogledoceverybodycontributesto– isthere

anywhereonlinethatwhatwe’redoingtodaycanbebuiltonto?• Thereneedstobearepositoryofgoodideas.

FallsPrevention:


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• Thiswouldlookreallygoodbutwedon’tgivepeopleawayofdoingit.Youneedtogivepeopleareallygoodexampleofthingstotryandtheresourcestogoinanddothat.Youneedtojoinupthehooks.

• I’msittinginasilooverhere.Weneedtouseandshareresourcesandthenputconcretethingsyoucandointopractice.• Weneedanasset-basedapproach,workingtogether– youhavefantasticworkbutsometimesthingsaren’tputinplace.Weneed

theoldergenerationon-board.Youneedconsultations.Weneedtoputsomethingpositiveinplace.• You’rerightabouttakingarisk.Struggleswithmoneymeanwe’retryingtoholdontowhatwe’vegot.Sometimesyouneedtobea

bitradicalandsometimesCCGsaren’tabletodothat.• CouldSTPsbeavehicleforthis?Therearelotsofthingsoutthere– STPs,bythesoundofthem,couldbeaworkstream.• Wedon’tstartwithawhy– CaseforChangeisadifferentthingforme– sothereneedstobea‘what’sinitforme?’foreveryone,

asamotivatorforpeopletoworktogether,tojustifyeverything.• Articulatethehookeachtimetomotivatepeople.• Concreteexamplesoflocaldelivery.• ‘AmbitionforAgeing’– it’saboutusingwhatyouhaveandwhatwouldyouliketosee– ifyouengagemorewithyourcommunity.

Dementia-friendlycarehomes– viewingthemasanassetratherthanseeingthemassomethingoutsidesociety.• Thinkingintogenerationalstuff– gettingthemessageacrossinthecommunity.• Howdoyoubranditandsellittogether?–shiftingpositivemessages.• Arewegettingthemessageintobigbusiness?– we’remissingoutahuge,hugeworkforce.• Dementiafriendlyisusuallyjustpeoplefriendly– butithasn’tgotthesamebrandingorawarenessthat’sgrownwiththedementia

friendly.• Isthereanythingbuiltinforyoutoshare?• Wouldn’titbeniceifpeopledidaoneminutepresentation– onepersontalkingtooneperson.• Webinars– toshare.• TherearesomefantasticthingsI’vebeento– wantingtosharethat.• NorthernLightsqualityandimprovementawards– nowthewholeoftheNorthisinvolved– it’sahugeamountofworkinvolved.• Aroundthetablewe’vegotalotofdifferentorganisations– abankofinformation.• I’dliketobeabletoemailthepeopleattending.• There’sanationalfrailtynetwork.

FallsPrevention:



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• It’snicetohavethis[AHAmeeting]formattoshareinformation.IknowtheAHSNsaregoodaswell.Perhapstoshareexcellence,alandingpagetoshareinformationwouldbegood– sometimesyoujustdon’tknoweveryonesoitishardtoshare.

• There’sanagreementthatyouneedsomething– Iliketheideaoftherebeingaframeworkbutitbeinglooseandcreative.• Thereneedstobetrustwithpeopleforthat.• Ifyou’resomewheresharinggreatideas– that’sfantastic,alreadypeoplearesharingsomefantasticthings.• Sharingbusinesscasesaswellcanbereallyusefulandhelptoputbestpracticesintoplace.• Goodtohavetheevidencebehindit– acceptingthatyou’resharing.• Weneedtoworktogetherandnotbepreciousaboutthings.Ifyouworktogetheryougetbetteroutcomes.IntheNHS,weshould

besharingandnotfeelpressured.• STPsareincomegenerating,iftheNHSispreparedtosupportdevelopment.• Thenitshouldbeimportanttobeabletoshareitacrossandputitinplaceacross.• Thesuccessofsomethingseeingatoolbeingusedacrossthecountry.AHSNsgetincentivefromthingsbeingshared.

• Horizon2020projects– SMEs– sharingandcollaboratingwouldbegood.• It’sgoodtohaveanarenatosharethis– weshouldbemeetingquarterly.It’sgoodtohavethingsthemedsoyougettheright

peopleintheroom.• It’sdifficultbecausesomepolicyleadsarechampingatthebittospeaktoyou.• Thelevelofcollaboratingisstark– theconnectionsacrossGMaregreat– it’sfromdevolution.• Reallyspecificgroupsareimportanttoidentifydifferentissues.• We’vegotasector-basedapproachtobusinesssupport.They’retheretorepresentthelifesciencessector.• Ifthey’vegotaKPIlinkedtofundingthey’realloverit.That’showwegotprivatesectorinvolved.Withpublicsector,we don’thave

asmanypeopleinvolvedpartneringoutsideWales.We’veonlygottwohealthpodsthat’vebeeninvolvedinEUprojects.• Thereisnomechanismtocoachpeoplethrough.• Havingadedicatedresourceisimportant.Noonewillcreateheadroomtodobidwritingandcollaboration– that’ssomethingwe’ve

identifiedasbeingreallyimportant.

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• Universitiesareveryengaged.Thechallengeisidentifyingtherightpeopleacrossorganisations.Evenifyougettotherightpersontheyhavetimeissues– ‘Areyoutoobusytoimprove?’

• Headspaceisthechallenge.• Sustainableleadershiptraining– howdowecoachourleadersthroughtosustainableleadership– innovationscouting.• Fearofwhatyou’regoingtodo– procurementisamassivestumblingblockthatdoesn’tneedtobe.There’sadifferenceinappetite

inengagingwiththeprivatesector– thereisalotaroundsupporting,holdinghands.• Platformtoshareyourprofile,likespeeddating– wemanagedtoget1000meetingssorted.Thinkingaboutengagingwiththings

differently– peopleinthatspaceyoucantalkto.Ageingwellpolities,atpolicylevelseeingthatyouneedtodosomethingwilldriveyoudownaroute.InWales,youalsohaveanolderpeople’scommissionertoholdpeopletoaccount.

• Fromanolderperson’sperspectiveIwould.Peopledon’tknowaboutalotoforganisations,likeforexampleAgeUK.• Weneedactiveagersaswelltospeakwithpeople– andwhyaren’ttheywritingourpoliciesandtravellinganddoingwhatthey

wantustodo?• Iwenttothesciencegroupintheuniversityofthe3rd age.Theyweregreattoengagewith.• Agefriendlycitiesaredoingthatalready.• Oneofthetechnologieswehavearestep-trackers.Universityof3rd agerssaid,‘We’llbuythem.’Nowthelocalauthorityarebuying

them.Don’tunderestimatethepowerofthesilver.• AHSN– howdowelinkourReferenceSites,scopingworkforwhat’sontheradar– bringingustogether.• WealreadyhavearaftofmeetingsacrossGM– differentareashavedifferentlevels.• Knowingwhoisintherooms– whotogotoyougetpresentations,theytellushowgoodtheyare.• Hackathonsareagoodwayofdoingit.

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• Somethingaboutpeersupportandacommunityofpracticewhereyoucansupporteachother– youhavetheknowledgehowdoweworktogether.

• IthinkthatnotjusteLearningbutactuallybeingtogether.Youthinkabouthowstimulatingweallare– youdon’tgetthesame thingonacomputer.

• Itsalsobeingcommitted– isthisaboutspreadinggoodpracticeacrosstheNorth– ifwe’regoingtobevalueditneedstobeevaluated.

• Collaboratingneedstobevalued.• Arewesharingresearchorbestpractice?• Somuchenergygoesintooneplace– itmightbeaboutareasspecialisingmore– ifyouwanttotalkaboutmuscularskeletalyou

knowtheoneplacetogo.• It’salsoaboutenhancingtheidentity.Liverpooldidabrandcalled‘It’sLiverpool’andthatmoveduson.Comingupwithabrand

helps.• Wedotendtobepreciousaboutbrands.Weneedtolearnthelessontoshare– iftheNHSistobetheorganisationwewantitto

be,itneedstobetheplacewestopputtingthingsinsilosthatweneedtoshare– weneedtogetovertheculturalpiece.• AtrialFibrillation(AF)collaborativesaregoodtoscaleup.• LeedsCitycouncilworkinginpartnershipwithSamsung,3rdsector– thereareothersitesinEuropedoingthesamething.• Thinkingaboutfrailty– thatstartedoffinBradfordandthatreallyhasgoneoutandspread.Weuseourcohorttodoresearchand

wecanspreadtheword.Wejusthavetobecarefulwedon’ttaxthemtoomuch.IfyougetitintoNICEandGPpractices– itispossible.

• AsupportivenetworkacrosstheNorthtoputtingbestpracticecanhelptoshareitnationally.• Enablers–• Isitcollaborativeaswell?Involvingeverybodyfromalllevelstobecommittedtoit.Andbeingvalued– eachneedstobevalued.• WedoHackathons– ifyouwanttodosomethingyoutakeawayhierarchyandthatmakesitverypowerful.• Yes,becauseit’spowerful– eachsectorneedstoseevalueindoingit– inwhatyouaredoing.Foreachsectorthereneedstobea

differentmessage,it’salwayshowyougetthemessagetodifferentlevels.• I’vefoundexemplarsreallyusefulandI’dlovetohearthemagain– anditisalwaysbetterbeingsomewherehearingnewthings.• quickly.

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• Ashowcasewouldbegreat– goingaroundtheregionsandgettingthedecisionmakerstheresothatpeoplecanadopt.• Youneedtogettogetherforapracticalpurpose– what’sthebestthingtosayaboutwhatyou’vetakenfromtheday– ahalf-year

review.• Doaroadshowandgetthemanactionplantotakeawaywiththemtomakeachange/apledgetochange.• Canwestoptalkingaboutsavingmoneybecauseitreallyswitchespeopleoff?Ifwedosavemoney,canweputthatintoother

thingsweneedtodevelop.Reinvestthatmoneyintosomeoftheideas.• Organisationalaccountabilitytomovearoundthesystem.• Iliketheideaofpapers– A3typeofposterswithaspacesayingwhatyou’reinterestedinandpropagatingideasreally

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• Let'sgatherexemplarsofbestpractice,e.g.,the'STEADYOn!'Projectthatwasshowcasedtoday.Thisisthe'holygrail'forfallspreventionandprediction.

• Howwouldwegearupservicestohandleaninflux?• Thereismostdefinitelyaneedformorepreventativeservices.• Keyquestionis,"Howdowekeeppeopleengaged"?• Let's'de-medicalise'thesubjectandmoveawayfrommedicallanguageandterminology.• Thisterm'olderpeople'- whoisoldandwhendoesbeingoldstart?• Let'smakebetteruseofhomedevices,e.g.,Amazon's'Alexa'.Bringingthingsinearlierhelpstonormalisethings,butonly if the

technologyisperson-centred.• Let'sdesignthingsthataretruly'wearable',e.g.,alifelineintheshapeofabrooch.• Anotherusefulthinglikethatwouldbea'STEADYOn'screensaver- asanaidememoir.• Simplemessagesinusefulplaces- e.g.,messagesonbakedbeanstins,andsupermarkettrolleys.• Howdowe'sell'thismessage?Don'tput'ageing'inthemessage.• Whoareourtargetdemographic?Thebaby-boomersand'swingingsixties'era.• Howdowegetthemessageacrosstopeoplewhoareisolated?• Howdoweshiftpolicyfromacutesettingtopopulationbased?• Whatkeepspeopleactiveandfullyengaged?Isthereawayofmeasuringthis?• Weshouldmovethedebateontoexistingtechnologyandwhat'savailablenow.• WearebehindthetimeswithwhatisavailableacrossEuropenow.• Upscalingtheworkforce,howcanwedothis?• Multiplefactorsincludetraining& development,systemcompatibility,consumerchoosingtheirowntechnology&activatingpeople.• Fallsandfracturespreventionconsensus- weneed'falls'ontheQOF.• Lookatexistingcommunityassets,e.g.,trainthetrainer.• Toolslikethe'teatowel'areverysimpleandhighlyeffective.• 'PracticeChampions'inGPpractices.• Commissioningshouldbetranslatedintopractice.• Shiftthefocustoyoungerpeople,peerpressure,childrentograndparents.

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FallsPrevention


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• GPpractices&primarycareasastartingpointforanincreasedfocusuponprevention.Needtobemoreproactiveinengaging withGPpracticesandpresentunambiguousevidenceinrelationtoimpact.

• GPcorecontract=identifyingfrailty&providingnationaldatasetrefrailty.EngagementneedstofocusuponeasytoaccessinterventionsthatdonotincreaseGPworkloadandhaveanindicationofhealtheconomicsanalysis.

• AneedforapanNorthernAHSNcollaborationtothinkwholesystemandengagestakeholdersinthenon-healthcontributiontofallsprevention.

• Needthecompellingbusinesscasearoundinterventions,fallspreventionandfrailty.• Targetearlyadoptersinprimarycare– aNortherncollaborationcouldachievescaleinearlyadopters.• Medicationreviewsandensuringtheroleofpharmacyisdeveloped.• AHSNsNorthtoworkcollaborativelytoprovideevidencereuseofeFI,barriers,impact,identifying&linkingexistinggoodpracticeto

eFI,e.g.,theNorthEastAHSNbonedensityprogramme.

• InformationsharingresuccessfulandpreventativeinterventionsislimitedacrosstheNorth.ANorthernAHSNcollaborationtoenhancesharingofpilotinitiativesandpromotethequalityofevidenceofimpactandROI.

• ThereisaninconsistencyofcommissioningfrailtyservicesbyCCGs.TheSTPsidentifiedasavehicleforsharingsuccessfulapproachestocommissioningforfrailty,e.g.,placebased,singlebudget&integratedcommissioningwithoutcomes.TheNorthernAHSNcollaborationtoconnectandaligntoSTPplansacrosstheNorth.

• RoleofNorthernAlliancecouldbetodevelopaplatformtosharethelearningonNorthernfootprint- shiningalightonvariance,implementationbarriers,ROI,commissioningstrategies,etc.

eFrailty:

eFrailty MSK Cross-Sectoral,Trans-RegionalCollaboration IdeasCloud



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• Frailty&fallsoverlap- avoidseparationofassessmentandintervention.• Shareevidencethatinterventionsactuallyreducethenumberoffalls.• DoNorthernAHSNshaveacollaboratingandguidingroleinensuringrobustevaluationandevidence?• HowcanweeffectivelylearnfromeachotheracrosstheNorth- triangulatecomplimentarylearningacrosstheNorth?Measurethe

impactofsharingactivities,i.e.,doesitaccelerateadoptionandimplementation?• Positionandprofileearlypreventionbestpracticetocomplimentmoderateandmoreseverefrailtyinterventions.• NortherncollaborativeofAHSNstoattractfundingtotheNorth.AlignnationalcontextandstrategicprioritiestoaNorthern

narrativethatcapturesissuessuchaspoverty/demography/population/urban/ruralandstrengthssuchasacademic&researchexpertise.

• ‘DrFoster’dashboardsandfrailty- howtolearnfromdataextractsatscale?• HowtoeffectivelyuseGPsystems- ensuringconsistentcoding?• AnationalQOFrefrailty&dataquality.OrexplorepanNorthernlocalQOF.• LinkGPstopackagesofsupportorinterventionprogrammesthattakeawayfromthemtheburdenofrespondingandbeing

situationallyawareofthepolicycontextandalignmenttogoodevidence,goodevaluation,peerreview,andsharelearning.Learnfromothersforapurposethatcouldincludeadoption&implementationofEuropeaninitiativesformingconsortiumgrantfundingbids.UseNHSbrandasanattractivebrandtoinvestin- investintheNorthernNHS.

• AneedforaNortherncollaborationtoincreasethefocusuponprevention.Identifyevidencebasedpreventionprogrammes,e.g.,GMSMEDigitaldiscussedtheirdigitalplatformformovement&exerciseasapreventiveprogramme- Howtoscaleup?

• NorthernAllianceasalobbyingvehicle- forfundsatPanNorthernimplementationscale.• Anorthernalliancethatfocusesuponfrailtytoensureanynetworkactivitiesfocusupondeliveryofprojectsorinitiatives thathave

tangibleimpactandarealignedtothenationalstrategiccontext– standsgreaterchanceofattractingnationalfunding.

eFrailty:



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Facilitator:ChallengesfacingprimarycareinmeetingtheGMSGPFrailtyContract17/18withprioritiesaroundfragility.WhatsupportmightaNorthofEnglandActiveandHealthyAgeingAllianceofferinrespectof:• Populationwhowouldbenefitmostfromatailoredapproachtocare(i.e.,person-centred).• Meetingtheneedforareproducibleandeffectiveapproachtofallsriskinmoderate/severefrailpeople.• Meetingtheneedforareproducibleandeffectiveapproachtomedsopinmoderate/severefrailpeople.• Documentingandsharingwithkeyindividualsthepreferencesfortailoredcareofolderpeoplelivingwithfrailty.• MakingbestuseofdatageneratedbytheGPFrailtyContracttoreduceunwarrantedvariationinoutcomesamongolderpeople

livingwithfrailty.

Challenges• Workforcecapacity.• Simplifyaspartofroutineappointment.• Alreadyproblemswithgettingappointments.• Fearofadmittingfallingforfearofbeingsenttoacarehome.• Somedon’trememberfalling.• Needforapositivemessage.• 40%ofthepopulationdon’tgotothedoctoranyway.• Whataboutusingopticians,pharmacists?Needtobeopportunistic.• Howtotargethardtoreachpeople.• Liverpoolhas800healthvolunteerstopromotetechnologyandgivehealthclasses.• Howtospreadinnovativeideas,e.g.,fireservicecontract– digitisefireservicework.• Concernredataintegrationanddatalinkage.• Howwillitbemonitored?ReferencetoProfessorMartinVernon– variationpresentedindifferentlocalities– howtodealwiththis?• Preventiontechnology(fallsassessment)– howtotargetresources&mobilisethemtotheappropriatesystem.• Pushself-managementagenda.• Useofcommunityresponseteam?

eFrailty:



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• Differencesbetweenruralandurbanareas.• Importanceofcommunitysupport.• Importanceoftargetingactiveagegroups– getthemtousemedicalapps.Ratingsdoneondailybasis.Wellbeingtrackedovertime.

LINCUS(PaulHarding).• DutchGOCIETY– riskoffallingapp.• MedsOptimisation– dischargemedsreviewdonebypharmacist.Medsmanagementincarehomes– movingtowardselectronic

ratherthanpaper.Pharmacistsabletointervene.

Challenges• Toolcanpulloutolderpeopleonrecords.• UseofEMIStools.• SunderlandVanguard.• Skillsrequired,e.g.,useofresourceslikepharmacists,communitynurses.

‘Ask’ofaNorthernAlliance• Useofcasestudies.Mobilisationofknowledgeandgoodpractice.• Useofdatatoidentifyneedsandprevalence’s.Itispopulationbasedratherthanlocalitybasedatthemoment.• Hubsplacedwherehigherriskandincidenceis.• Whatotherdataislinked?– i.e.,useasmuchdataaspossible.

eFrailty: TrackTwo



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TailoredApproach• Heartdiseaseandhowitismonitored(i.e.,samedespiteseverity).eFIredevelopmentneeded.• RiskstratificationanduseofeFI?Shouldbothbeusedtogether,multi-disciplinaryteammeetingstodiscusspatientswhoscore

highly.• Comorbidities– Northumberlandpathway– difficulttomeasureinanoutcomedrivensociety.• Problemswithdatasharingevenwithsocialcare.• Whatkeyoutcomesshouldbemeasured?• Financialissue– bestvalueforsystem?Forpatient?• Howtomeasure?• Resilienceissue:Whataboutresilientpeoplewhoaresuddenlyhitwithsomething?Whatarethesetriggers?Whatmechanisms

couldbeusedformonitoring,e.g.,followupphonecall,communitynurse,andcarenavigator?• Shouldthosewhoareclassifiedasfrailhavebetter/speedieraccesstoGPs?• The2%dead.

MedsOp&NorthernAlliance• Polypharmacyandfallsrisk.Awarenessofgoodpracticesharingandimplementation.Powerofsharingstories(evidenceofgood

practice).Needtoprovideanenvironmenttodothis.• Testing- goodevaluation.• Butincompatibilityofsystem.• CCGslackmoneyandshorttermfunding.Newideas– buy-inthenfundingwithdrawn.• Changeapathy.• eFIismakingiteasier.• PoolingofresourcesofAHSNs

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Challenges• Whatdoyoudowithyourresults?• Needforsocialinfrastructure.• Whataboutearlyadoptersvlaggards?Initiallymorevariation.•‘Ask’ofaNorthernAlliance• Mightreducevariabilityduetouseoffulltemplate.• Moreaboutlearningaboutgoodpractice.• Identifytoolsthatwouldsupportthecontract.• Whatwouldhelpfacilitate?• Currentfocusonmedsreview– dossieroflocalresourcestogivetopatient.• Casestudieswithpracticaladvicereimplementation.• Workstreamofpeopletodoassessmentson.• TemplatethatcouldbeusedbyGPor/andotherhealthpractitioners.Buttheywouldneedspacemakingforthis.• Screeninguncoverslotsofpeoplewhoneedlotsofsupportwhodon’tgetit.Whatdowedo?Nocapacitypluscutsinservices.• Howdoyounarrowthecohortdown?• InvestmentinLeedsCommunityNetwork– exemplaryorganisation.• Communitycapacityneedslookingatandsupporting.• Focusonwiderdeterminants.• LeedsOlderPeopleForumleadsonlookingatotherfactorsinvolved(e.g.,socioeconomic).• Risk– hardtoreachgroups.• Problemreconsistencyofdata.Subjectiveratherthanobjective?• Shouldn’ttherebeonevalidatedtoolratherthanseveral?NHSdoesn’tmandateaparticularoneandtheyareverydifferent.• Useofdifferentdiagnostictools.Needtoincludesocialdimensions.• “Frailelderly”notagoodlabel.Needtochangelanguage.

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Challenges:• Time,workforce,skills,rememberingtodoit,innovationknowledge/shortageofpracticenursesandGPs/lotsofGPsretiring.• ShouldbeacollaborativeapproachwithDeaneriesandUniversitiesrepromotinggeneralpracticeasacareerandcollaborationof

resources.• Communitypharmacistsareidealforapproachtofallspreventionandmedsreview.• Firstyearshouldgiveunderstandingofprevalencerate.• Needtolookatlongtermreview

’Ask’ofaNorthernAlliance• Toprovideexemplarsthathavebeenevaluatedandtoolkits.• Newrole– e.g.,carenavigators.• Lookatbeforepeoplegetolderandfrail– whatwouldhelppreventithappening(i.e.,primaryvsecondary)?• UseofVitaminD/aminoacids.Bonehealth.Proteininthediet.Takeevidencebase.Currentlyout-datedinformationfromPHE.• Cohortidentificationformoretailoredapproach– partnershipandcollaborationsesp.withprivatesector.• Useofsoftintelfromvoluntarysector.

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• Frailtycontractshouldbepartofphasedapproach.• Timedependsonthesystem.• Supportingpeopleinhowtotalktothepatients.Positivelanguageratherthannegative.Needsreframing.Goodpositivebranding

ratherthantheamountofnegativityinvolved.• Seeingmoreunmetneeds.• Useofotherpeopleinthesystem,e.g.,anappointmentwithaGPseemsmoreseriousthannurseswhomightalwaysusetheirfirst

names.• Usedatatoreducevariationinunmetneeds.Bringservicesintothecommunity,e.g.,fallsassessmentbychiropodists–

opportunism.• Peoplewhousemultipleservices– targetthemforserviceredesign?• SupportfromNorthernAllianceforrollingoutgoodpractice?Co-designrequired.• MedsOptimisation– needforwardfacingGeneralPractices.Betterutilisationofstaff.• UseofITsolutions.• Peerledisbestinfluence(e.g.,GPFederations)– clinicalchampions&advocates.NetworksliketheCahootsSocialNetwork.

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MSK: TrackOne

Question Table8 Table10 Table6

1)UsedatatoidentifythepopulationwithMSKconditionsandwherethereisunwarrantedvariationintheprovisionandoutcomesofcaretohighlightwheretherearethegreatestopportunitiesforimprovement.

OftenMSKconversationscanbefocussedonmedicalisedsideofthings.Costsandissuesinsystemsandpathways,ratherthanlookingatpreventionandsupportmethodologies.

2)Supporttheshiftinemphasisfromthecurrentmedicalmodeltowardsperson-centredcareandsupportedself-management.

Activemindsleadtoactivebodies. Isthereenoughsupportinhelpingpeoplemoveintoactivelygettinginvolvedinexercise?Alotofsupportisavailable,butpeopleoftenfinditdifficulttomoveintoanexerciseframeofmind.Behaviourchangecanbetrickyandperhapsmorecanbedonetoencouragepeopletotakeownershipoftheirowncare.

Needtoshifttoapsychosocialapproachratherthanmedicalisedresponse.

Gettingpeopletoparticipateinprogrammesofexercisecanbereallydifficult.

GPsoftendon’thavemuchofanoptionbuttorefertophysiowhenapatientcomestotalktothemaboutMSKissues.Butoftentherecouldbelessmedicallyfocussedsolutions.


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MSK: TrackOne

Question Table8 Table9 Table10

3)EngagewithlocalhealtheconomiestodevelopapublichealthapproachtoMSKconditions,includingareproducibleandeffectiveapproachtocommissioningMSKphysicalactivityacrossthe4Tiersofpyramid.

PhysicalactivityapproachinLeedsisfocussedaroundfallsandfrailty,butnotspecificallyaroundMSK.

GreaterManchester:MSKandMHarethebiggestdriversaroundabsencefromwork.CouncilstaffcangetdirectaccesstophysioratherthangoingthroughNHS,toreduceimpactofabsencesandshortenthem.

NotintheLeedsJSNA.However,intheLeedsSTPplanMSKisincludedasaspecificarea.

4)SupporttheworkofthenationalArthritisandMusculoskeletalAlliance(ARMA)todevelopregionalnetworksandupskillfrontlinestaffworkingwithpeoplewithMSKconditions.

Activemindsleadtoactivebodies. Aproperplatformtodisseminateevidencewouldbehelpfulinsharingoutcomes.Patientslocallyarehearingabouttheprogrammeviawordofmouth.Buttherearen’tanyspecificservicesthattheycanbereferredintoinadditiontothestudyworkinitself.

Therehaven’tbeenmanyhigh-profilemessagesaroundMSK.

PHEhasn’ttakenitupasanissue.

Bestpracticehasn’tbeensharedparticularlyaroundMSK.



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MSK: TrackOne(additionalnotes)

Table8 Table9 Table10 Table6 Table7GPsdon’tgetQFpointsforosteoarthritis.SuchpainscanbelowerdowntheprioritylistinconversationswithGPs.

Isthereamissinglinkbetweenfallspreventionetc.,andworkaroundpromotingactiveMSKselfcare?

Exercisereadiness:areenoughpeoplefeelingconfidentandcapableingoingoutandexercisingorinattendingclassesetc.?

It’shardsometimes.Alotofolderpeoplewillassumethat‘ageingpains’arefineratherthanbeingathingthatneedstackling.

SalfordRoyal,usinganXboxcameratomapbodymovementsovertimebetweenvisits.

Needstobeamoreeffectivepatientcentredcareapproach.

LiverpoolHope(DrOmidAlizadehkhaiyat)doingstudyintoMSK.

Bigemployersneedtotakeupthemanteltoagreaterdegree.

Peoplewillbringforwardcomplaintsaroundachesandpains,butnotactuponadviceofexercisingandlookingafterthemselves.Theywillpreferamoreactiveintervention.

Selfreportedwellbeingscoreapp:LincusdownloadforfreeRescontechnologies(biometricschap).

Getactive(Scotland)app.

Thereisstillagenerationofolderpeoplewhohaven’tworked,andthereforemaynotknowwhattododuringthedaytokeepactive.

Keepingmindsactiveisakeypartofhelpingtokeepthebodyactive.

Reducingimpactofsarcopenia(themusclewastagecondition)–doingsomeresearchastowhatexercisesbetterhelpreducethis.

Isthereenoughonusonthepsychologicalsideofthings?

PeopleareofamindframethatexercisewillmakeMSKissuesworse,ratherthanbeingpartofasolution.

Transportisakeyissue,andespeciallycouldbeamongstolderwomen,whereahusbandmayhavebeenthedriver.Peoplemayfindmobilityanissue.Public/socialtransportisakeypartofbuildingparticipationandconfidence.

Isthiswhymessagesdon’tgetthroughenoughtoinfluencebehaviourchange?

Peersupportisatopicthatolderpeopleraisethroughfocusgroups.



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MSK:

● Earlypreventionacrossalife-courseapproach.● Keepingactive,butwhat's'fun'foryou?● Whoarethe'drivers'ofprogrammes?Serviceusers?Keepthemmotivatedtostayengagedandinthecommunity.● Seekbehaviouralchangeacrossthepopulations.● Wearenotgoodatsharingbestpractice.● Majoremployersneedtotakeupthemantlealittlemore.● TheCharteredSocietyofPhysiotherapyhasadvancedinfobutisnotnecessarilyfiltereddown.● Weshouldembraceinnovationsfaster.● Digitaltechnologyneedstobeless'medical'.● Urgentsolutionsareneededtoempowerpatientself-management.● Needforpublichealthawarenesscampaigns,e.g.,ontheimportanceofexerciseandkeepingactive.● Makebetteruseofcommunityassetstospreadtheword,e.g.,fireandrescueservices,police,localauthoritysportscentres.● Ourapproachtohealthliteracyneedstobeaddressedtogetitright.DoserviceusersknowaboutMSK?● ChangingthenarrativeonMSK- lookmoreathealthylifeexpectancynotjustoveralllifeexpectancy.● MSKQOF- exerciseandmovement,butneedsresearch,andneedstobefun.● Simplifypathwaysandmakethemfuntoo.● Weplaceourfocusontheproblem,i.e.,thosethathavefallen,butweneedtotakeamorepreventativeandproactiveapproach

withmoreawarenessraisingprogrammes.● People'sneedsdon'tchangeovernight,backtothequestionofwhoisan'olderperson'?



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Cross-Sectoral,Trans-RegionalCollaboration:

• ConnectedHealthyCities(CHC)projectasanexemplarmodeloftrans-regionalcollaboration.• Multi-disciplinaryapproachiscrucialandshouldn'tjustbeaboutaroomfullofGPs,butopportunityforcross-fertilisationoflearning.• Prioritymustbegiventopatientandpublicinvolvementasthenextstep.• LeedsBeckettUniversityhavedevelopedaproteinpilltoboostthedietaryneedsofolderpeople.Thisoffersanopportunity for

trans-regionalcollaborationbetweenLeedsBeckettandasimilarsizedinstitution.• Thekeytosuccessofatrans-regionalprogrammeofcollaborationinAHAwillbetostartsmallandgrow.• TheAHANorthOperationsExecutiveshouldcreatethematicprogrammesofwork,e.g.,AtrialFibrillation,fallsandfractures, themes

thatallfourAHSNsarecurrentlystrongin.• Whatweshouldstopdoingisasimportantasaskingwhatweshouldbedoing.Let'sdowhatworks,buttodothatweneedtoknow

whatdoesn'twork,andweneedrobustevaluationtohavebeenundertakenbeforeimplementationhappens.• An'AtlasfortheNorth'onAHAbestpracticeswouldbeagreatstart,asoneeasyportalviatheNHSAwebsite,whichincludes

fundingopportunities.• AstrongernarrativeisneededfortheAHANorthprogrammetoenablepatientandpublicengagement- "I'mnotold!"• Preventionoffallsvs.preventionofinjury(materialscienceandspecialistfurniture).• Gettingtechnologytotheconsumer- companiescanaccessCCGsorAHSNstosupportthis,butwherearetheaccesspoints?• Bringwiderstakeholderstogether,workwiththethirdsectororganisationslikeAgeUKandsimilarorganisationstosupport

communityservices.• EducationandAHA:atwhatpointdoesaneducativemessagestart?Shouldwebeaimingatthe40-50agegroupinsteadofthe60-

70andweshouldbetakingthemessageintoschools?• TheCHCmodelisfundedbyHMGovernment,sohowdopeoplesharegoodpracticeifitisnotfunded?• ThereisaveryrealneedtosharegoodpracticeandnewideashappeningintheNHSataregionallevel.Isthereasystemleadership

roleatregionallevel?• AHSNsarestartingtoworktogetheronsimilarpiecesofwork,andtheNHSAisbestsuitedtoprovidethesupporttothisprogramme.• Weneedtofocusonthetopthreeprioritiesfortheregion.• Howdocommissionershearaboutinitiatives?• Thereneedstobetheattitudetosharethingsthathaven'tworkedaswell,namelybegivenpermissiontofailandfailfast.• AcademicInstitutionsneedtoproduceanevidencebaseandgetitfromvarioussources.• TheNHSispronetoreinventingwheelsasitisnotquicktosharegoodpractice.



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• Peoplehavelimitedcapacitylocallytolookoutsideoftheirboundary,soweneedtohelppeoplenavigatearoundthegoodideasthatareoutthere,andalsomakeitlanguageappropriateforthelocallevelcontext('notinventedhere'syndrome).Oneleverforactionisseeingwhatneighbouringareasaredoing.

• 'Anonymous'ideasmightbemoreappealingtoanotherarea.• Peoplerespecta'trusted'brand- e.g.,University,RoyalCollege- becausetheybelievethequalityassuranceworkhasbeendone.• DeliveryvehiclecouldbebySTPfootprint.• Weneedthetimetoevaluateandembednewideasandinnovations,andmakeevaluationframeworksavailableandsimple.• TheNHSAisideallyplacedasanhonestbrokertomakethisprogrammeatruetrans-Northernsuccessstory.



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• UseAcademicHealthPartnershipstoassistscaleup.• Itwouldbeusefultonarrowthegapbetweenresearchersandpeopleinclinicalpractice.• Timeisakeyissueinjoiningup.• Today'sSymposiumhasbeenveryhelpfultobringourideastogether.• Helpsustoadopta'communityofpractice'model,tobringtogetherlearningreadytoshare.• Considerintroducingnewrolesdedicatedtoidentifyingandsupportingfrailty.• Callformorejoinedupworkingbetweenpublicandprivatesector.• SharedagreementacrossregionsandsimilarorganisationsviaanMoU.• Itiscrucialtolearnlessonsandscaleupinnovationsbyunderstandingpriorities.• Sharedworkingenablesustolearnvaluablelessonsandscaleupinnovationsandhelpdriveprojectsforward.• Trulyintegratedhealthandsocialcarefacilitatesperson-centredjoinedupcare.• Clearachievementsforscalableandaffordableopportunitiestoidentifygoodstuff.• Communication- whyarewedoingthis?Whoarewedoingitfor?Weneedtocreateapositivenarrative.• Communityaction- weneedtoknowwhatpeopleneed.Isolationincreasesillnessandcanhastendeath.Weneedtocreate

communitynetworksthatsupportandencourageconnectionsbetweenyoungandold.


AppendixA: IdeasCloud

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IdeasCloud

• FitBitforeveryone!• Gymmembershipsonprescription.• Increaseuseofcommunityassetssuchas'meninsheds'.• Agefriendlycitiesandcommunities,broaderapproachtoevaluation,particularlythesocialaspects.• Ageasa'meaningless'characteristic.Ageingisflexibleandmalleable.• Encouragepeopletoplanforlaterliferatherthanhavelife'stop'.• Itisn'taboutageingbuthowweleadourlives,thereisarealneedforconversationsintheirownenvironment.• Weneedatwo-waydialoguebetweenthepractitionerandtheserviceuser,andthereisanopportunitytousetech/digitalforthisto

supportpeopletochangebehaviours.• Furthercross-regionalcollaborationtosupportthis.


Northern Excellence in Active and Healthy Ageing Symposium€¦ · Foreword: Dr Hakim Yadi, OBE,...

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Transcript of Northern Excellence in Active and Healthy Ageing Symposium€¦ · Foreword: Dr Hakim Yadi, OBE,...