As part of our work to explore how the NHS can help us all to live a healthier life, we are interested in the many ways that health care organisations can support prevention – from supporting people with long-term conditions to live well and prevent or slow their conditions’ progress, to addressing the circumstances that lead to illness.
Here are three very different projects the Health Foundation has funded that have supported people to live a healthier life. They provide lessons on how we can improve health for people with a long-term condition by reducing social isolation, prevent people with mental health conditions developing physical conditions, and use emergency admission as a ‘teachable moment’.
1. A social intervention to promote good health for people with COPD
Chronic obstructive pulmonary disease (COPD) is the second most common cause of emergency admission to hospital. People living with COPD can also often experience social isolation and anxiety. A British Lung Foundation survey found that 90% of those affected by COPD felt unable to participate in socially important activities. This can make it difficult for people to effectively self-manage or to meet their personal health goals, including smoking cessation. Social interventions for people with COPD have the potential to improve this.
The RIPPLE: Respiratory Innovation – Promoting a Positive Life Experience project provides a community-based clinic to reduce social isolation and anxiety for people with severe COPD. It runs social activities like bingo and yoga, and is attended by a COPD nurse or GP to give advice and answer questions. Participants are encouraged to learn effective self-management techniques and take part in rehabilitation activities.
A project evaluation showed the integration of health and social activities successfully reduced social isolation and improved mental wellbeing. Patients also reported increased ability to self-manage, and preliminary evidence indicated a reduction in unplanned hospital admissions.
The RIPPLE model is now being spread to six communities in the east and west Midlands. The team have engaged wide groups of practitioners and patients with the aim of reconfiguring physician and nursing support for people with COPD.
2. An early physical health intervention for young people with psychosis
Sedentary lifestyles, smoking, drug misuse, and the side effects of antipsychotic medication contribute to high rates of physical health problems in people with psychosis. Adults with psychosis are expected to die 15–20 years earlier than the population average due to preventable conditions such as metabolic disorders and cardiovascular disease.
A team in Worcestershire developed a 12-week physical health and wellbeing programme – SHAPE (supporting health and promoting exercise) – for young people experiencing their first psychotic episode. By intervening early, SHAPE empowers people with mental health conditions to live longer, healthier lives. It helps participants to make informed treatment and lifestyle choices with support from nutritionists, exercise physiologists and health trainers. The programme includes group activities and peer support, encouraging young people to develop friendships and motivate each other.
27 participants completed the SHAPE programme during the initial pilot. Young people who completed the programme maintained good physical health, with most showing a stable body mass index a year on. This is an excellent outcome as people experiencing their first episode of psychosis are likely to gain weight, especially in the first six months of antipsychotic treatment.
With further funding, the team developed www.mySHAPE.org.uk to share learning and maximise the impact of the approach across the health service. The site provides free, accessible resources to support good physical health for people with mental health problems. Five national and two international organisations have now started similar SHAPE schemes. The project has also received support from Worcestershire Health and Care Trust to extend their prevention strategy to community mental health teams across North and South Worcestershire.
3. A hospital-based intervention to help young people escape violence
Every year, thousands of young people find themselves in emergency departments as the victim of serious youth violence. This time of crisis can provide a valuable opportunity to help young people break away from devastating cycles of violence they may be caught in. At this ‘teachable moment’, Redthread Youth Limited takes a holistic approach to understanding each young person’s needs and aims, helping to prevent further hospital attendances.
In partnership with the major trauma networks, Redthread runs a Youth Violence Intervention Programme in emergency departments in London. Redthread’s youth workers are embedded alongside clinical staff. The youth workers use their unique position to engage and support young people who have experienced violence when they arrive at the hospital. By empowering young people to lead healthy, productive lives, the intervention aims to promote a route out of violence and criminality.
With support from the Health Foundation, Redthread’s approach is now being extended to Nottingham and Birmingham, cities with high rates of violent crime. In partnership with local NHS organisations, Redthread hope to scale their work further and bring positive change to the lives of vulnerable young people across the Midlands.