We understand the value of having specialist wellbeing support to help promote and maintain good physical and mental health, reduce health inequalities, and empower patients to address their wider holistic needs, all of which are key to good population health.
At Corby Urgent Care Centre (CUCC), we have had a Wellness Hub since we began delivering the service in 2019 and adapted one of the consulting rooms into a dedicated space for wellbeing:
“The Wellness Hub is here to support and empower our community to address life’s challenges and meet their own wellbeing goals. The Wellbeing Advisors work collaboratively with our patients and clinical staff to ensure person-centred, compassionate care is provided to all patients”
Understanding and supporting our community has also been an area of great focus. The Local Authority Health Profile for 2018 showed that the general health of people living in Corby was poorer compared with the England average. The rate of alcohol and self-harm related hospital stays, rate of STIs, and the average BMI of people in Corby are all higher than the national average, with 17% of children living in low income families.
We identified early on that there was a significant amount of patients attending CUCC who wider needs. Whilst most patients had an urgent medical need as their primary reason for attending, for some patients, their attendance was due to a non-medical need. In addition, we saw some patients were frequently re-attending CUCC. This told us that some patients’ needs were being unmet within the wider health system and we recognised that we could play a key role in bridging this gap in our offer to patients, to provide support to address patients’ wider wellbeing needs.
We needed to understand more clearly what issues patients were experiencing and wanting support with, to help us design pathways and ensure the provision of wellbeing support was appropriate, with enough resource to meet demand.
Population health management
Using a population health management approach, we analysed the presentations most commonly seen in patients attending with wellbeing needs, which are anxiety/ worry, low mood and stress. We then built pathways for the Wellness Hub to respond to this population need, with interventions designed to help address various wellbeing areas.
Patients are always assessed initially by a triage nurse during streaming to ensure they are medically fit and any clinical need is dealt with before accessing the Wellness Hub.
The Wellness Hub operates 8am to 8pm daily, with two Wellbeing Advisors who have extensive experience in mental health, and varied qualifications and training in fields such as smoking cessation, stress, pain management, substance misuse, domestic abuse, and self-harm. As a tailored service, Wellbeing Advisors work with patients to assess individual triggers, needs and wellbeing goals, using a social prescribing informed method of “wellbeing plans” – a tool that helps service users set SMART goals, and access wider health and social services as required. These are documented in clinical notes and updated after each follow up session so other health professionals involved in the patient’s care can support these goals and enable a cohesive approach.
As well as providing direct support and advice within the Wellness Hub itself, a key part of this service is to connect patients with other services that can offer additional or specialist support in the community. We liaised with other local providers across Corby including community health services and third sector organisations to establish signposting pathways so patients could be offered enhanced support and greater choice. We use a database of local and national services to signpost service users to other providers, including bereavement support, relationship support, peer support and activity groups, support for homelessness and financial issues. Where safeguarding issues present, the Wellness Hub can support referrals to Adult Social Care, Children’s Services and MARAC.
The Wellness Hub has been an especially valuable service throughout the COVID-19 pandemic, which impacted individuals, staff and communities enormously, with loneliness, isolation, stress and anxiety caused by uncertainties and social distancing, as well as those experiencing bereavement. Given that many services in the community had to effectively close due to numerous restrictions and lockdowns, the Wellness Hub served as a vital place of support for people struggling with these challenges.
Staff have also benefitted from confidential “Reach Out” drop-in sessions for support within the Wellness Hub.
Since April 2020 there has been an increase in the number of patients accessing the Wellness Hub, with consistently over 100 patient consultations each month. Twice as many females access the service compared with males, and it is mostly accessed by patients aged 22 and older. We are therefore considering how to target some populations to raise awareness of the Wellness Hub and provide this service in community outreach approaches. Video and telephone access to the Wellness Hub has been made available to support access during COVID-19, however many patients prefer face to face, so the majority of consultations have been in person.
Patient feedback shows the Wellness Hub has a positive impact on people, with themes highlighting personalised support, feeling empowered, practical coping strategies, increased self-esteem and quality of life:
“It was good to hear and find different ways to help cope. It was explained well and helped make me feel more at ease.”
“A lot more practical than other treatments I’ve had. Gives a sense of responsibility”
Mood scores also show that patients’ moods improved significantly from initial contact to leaving the Wellness Hub.
The mental health support offered at the Wellness Hub has helped reduce the impact on crisis services, and helped reduced deterioration in patients on the waiting list for specialist support, by providing ongoing support, liaising with specialist treatment teams to ensure they have a current overview of the patient’s situation, and helping patients feel more “primed and ready” to commit to engaging with specialist support.
For frequent attenders to CUCC who have no medical need, we have developed a specialist pathway whereby the Wellness Hub liaises with other professionals involved in the patient’s care to formulate a comprehensive person-centred approach to supporting the patient to access the most appropriate service at the time of need. This minimises impact on the wider health system and ensures the person’s needs are met in the right setting, and that core issues are tackled.