The Integrated Care team work to develop and deliver person centred, multi-disciplinary approaches to support in the community. Working alongside health, social care and other voluntary sector organisations to empower people to access information and support to maintain and improve their health and wellbeing and self care.
Personal Support Navigators
Personal Support Navigators (PSN’s) seek to reduce the need to access health and social care and support people to live their best life. They work with GP practice based teams in Airedale and Wharfedale to develop an integrated approach to care and support.
The team supports people with multiple health conditions who are struggling to maintain their physical, mental and social wellbeing, to improve their self-care and resilience using an asset based, person centred approach.
To achieve this the PSN's use guided conversations and motivational interviewing techniques to work with an individual to develop personal goals. The approach is facilitative and works to support an individual to achieve their goals and ultimately sustainable results. We have found that many people will talk to and work with a PSN who have previously refused to work with statutory services. Through their work the team have found that sometimes obvious changes, such as giving up smoking, which would have huge health benefits are secondary to what is important to the individual. Ensuring a person has a pair of much needed glasses, contact with friends and family or that their hot water is working in their home can be of more importance to wellbeing.
The PSN team have been able to achieve some fantastic outcomes for their clients such as, reducing medication and hospital admissions, increased engagement with health services, improved and sustained self care and working in partnership with other services to help resolve issues around housing and domestic violence amongst others, advocating for the individual where appropriate.
Which organisations work within the PSN’s?
Our Age UK Bradford PSN’s works in partnership with a number of other organisations including, Airedale NHS Foundation Trust, Carers' Resource, City of Bradford Metropolitan District Council, Modality, WACA and Bradford District Care NHS Foundation Trust.
How is this service funded?
This service is funded by NHS Airedale, Wharfedale and Craven Clinical Commissioning Group (CCG) and the City of Bradford Metropolitan District Council.
''I thought I would need help for longer, but they have helped me get back to work. I can see this would help a lot of people.''
''It reminded me what I could be like, I am so much more positive now than I was.''
“The support was so comprehensive and practical”
Age UK Bradford District are pleased to be working on this five year National Institute for Health Research funded project with Bradford Teaching Hospitals NHS Trust, The University of Leeds, Age UK National and Age UK Leeds, to develop and test a new approach to care which aims to improve quality of life for older people with frailty, by giving then choice and control over decisions about their health and wellbeing.
Frailty is a condition of increased vulnerability to major changes in health as a result of seemingly small problems, such as infection or new medication. It is common in older age, affecting about 10% of people over the age of 65. It develops as we age because our bodies change and can lose their inbuilt reserves, for example muscle strength and can leave us with an increased risk of falls and disability.
Prosper is designed to improve self-management skills and help older people with frailty to improve their wellbeing and thrive with the support of their community. Based around the principles of personalised care planning and targeting a well-defined population, Prosper aims to improve coordination of GP, voluntary sector and social care services and increase the social networks of older people with frailty.
The lead researcher, Dr Andrew Clegg, Senior Lecturer and Honorary Consultant Geriatrician at the Academic Unit of Elderly Care and Rehabilitation (AUECR), University of Leeds and Bradford Teaching Hospitals said: "We are very excited about this major project to improve the lives of older people. Our close partnership with Age UK has ensured a truly person-centred approach that will focus on the individual priorities of older people living with frailty, including measuring quality of life as our main outcome of importance. We will also collect detailed information on use of health and social services, so the work is of considerable importance for older people, their families, the NHS, and social care."