What we’ve learnt from the Compassionate Frome project
This week we managed to speak to Julian Abel, a consultant in palliative care who is heavily involved with the Compassionate Frome project.
I’d been looking forward to this chat for a while, as on the face of it there were certain elements of the project in Frome that could be very relevant to our work. In particular the role of a “health connector” in signposting people to relevant information.
Many thanks to Julian for sparing some time, he was on a work trip in Perth so we spoke over a video call (as an aside for anyone reading…if like me you hate Skype appear.in is much better).
So what did we learn…
To be quite honest, this interview didn’t go like our previous ones — a large part down to what Julian would call his awkward bone!
He challenged some of our assumptions and personal views around what is most important when someone faces the end of life — and all the better for it I think as this was a perfect segway into the work and background of the Frome project.
Essentially the key to the project is community itself, with all care being viewed through the lens of social relationships.
The very fact that this ‘solution’ is not a thing, a product or a service is in itself fascinating…the early results if validated are hugely encouraging:
What this provisional data appears to show is that when isolated people who have health problems are supported by community groups and volunteers, the number of emergency admissions to hospital falls spectacularly. While across the whole of Somerset emergency hospital admissions rose by 29% during the three years of the study, in Frome they fell by 17%.
Another interesting thing which came up on the call was the ‘Circles of Care’ model which I’d not come across before. This model identifies a person with an illness at the centre of a network which includes inner and outer networks, communities and service delivery organisations.
This was particularly relevant for our project as one of the findings from our research was that there seemed to be an unmet need, or a lack of understanding of the role of the extended carer network…i.e. friend of the carer.
I think we might all potentially have that experience of knowing someone with a family member going through an illness — have you ever wondered about how you can help?
On this point about carers, it’s great that organisations like Hospice UK are calling for proper assessment and support for family carers towards the end of life.
Role of the ‘Health / Community Connector’
The conversation got specific when we started to discuss how the project operated in Frome. For anyone interested in the detail of the model there is a good guide on the Health Connections Mendip website.
We were particularly interested in hearing about the following two roles:
Community Connectors are members of the community who know what’s out there and signpost friends, family, colleagues and neighbours to support in their own community. Community Connectors are very effective at integrating with their local communities — providing a bridge between local people and other services and building community knowledge.
Health Connectors work one-to-one with patients in Mendip General Practices and in patients’ homes. Health Connectors inform, empower and connect people with services in their community. The Health Connector and the patient work together, in partnership, to help build the knowledge, skills or confidence that the patient might want in order to help improve their health and wellbeing or manage their long term health condition.
Interestingly, it was mentioned that there were now 600 community connectors having roughly 20 signposting conversations a year. I think this figure highlights the ‘community’ nature of the project — clearly there is little role for lots of people to play…as long as the wider network is there to support them.
The problem with just signposting
A key part of the ‘connector’ role it seems is to signpost and it’s something that has come up time and again in our interviews, the need for someone to join up the dots for people going through the system…
I really just wish everything was better coordinated.
One thing which is interesting about the Frome model is that even the ‘Community Connectors’ get locally tailored training so it seems whoever the person/patient reaches out to needs to have knowledge of the system. In the case of Frome they signpost to the Mendip Directory which seem to address a lot of the low-level (but no less important) demands for information.
The website states role of ‘Community Connector’ exists because:
The more people there are that know about the support that is available in the community, the more we can all support each other. There are great services in our community but sometimes people don’t know about them.
This brings up a critical point about awareness, because it reminds me of the age old myth when it comes to digital services…
If you build it, they will come…
It’s something for us to think about when we start to think of solutions. In Frome, they’ve not just built the Mendip Resource Directory and expected it to be used by people — they have a support unit of ‘Community Connectors’ ready, willing (and trained) to signpost to it.
Takeaways for our project
The above insights into the Compassionate Frome project have perhaps thrown up more questions than answers, but this is no bad thing.
If there needs to be a ‘connector’ to help people find information — who might this be?
Does this ‘connector’ have to take the form of a living breathing human, or can it be a stand alone digital service?
Will the role of a ‘connector’ be consistent across regions?
How will people (including healthcare professionals) know this connector exists?
Clinical Nurse Specialists (CNS) to some extent already seem to be a ‘connector’ so how does this idea fit with existing roles?
Does this ‘connector’ need to be clinically trained?
At the very least, I think what the discussion with Julian has highlighted is the potential pitfalls of just viewing a person or patient in isolation. The need to consider a person with an illness in the context of their wider networks (of lack of in some instances) is critical — Frome is a good reminder of that.
We now have an example of how a ‘connector’ role within a community can impact the care a person gets — and that is hugely beneficial to our project.
Finally, our desk research has taken a little diversion to dig a bit deeper into what else is out there at the moment with respect to ‘connectors’ but also we’ve widened our definition of information.
We’ve since had an incredibly interesting chat with Garry Brough from Positively UK about the role ‘peer support’ can play as a source of information delivery for people.
Stay tuned for a separate blog on that!
As always if you’ve read this and are keen to find out more about the project — then tweetor email me.