Fair work

Community Care Collaborative: Transforming Primary Care in Wrexham

The Community Care Collaborative (CCC) is a Community Interest Company that provides an innovative and integrated approach to healthcare in Wales.

Founded by Dr. Karen Sankey in 2018, CCC developed a very clear vision for primary care after realising that the current model was failing at several levels.

Through research and testing, it found that patients often visit a doctor with an issue that has a social or mental health basis, which it believes GPs are not equipped to deal with in the best way.

Added to this, it’s thought that the volume of patients that a GP is expected to see in a day on top of other duties such as medicines, makes it impossible to provide an adequate service to every single person.

The solution is a model which delivers “an alternative model of health, social care and wellbeing in which GPs (doctors) are able to focus on providing medical care, and where, through working collaboratively at a community level with other agencies and patients themselves, the social and emotional needs of patients are given equal priority to their medical needs”, as its mission statement shares.

“The Challenge Fund seemed to me to be very much about trying to do things differently and about taking a chance to really give something a go to find out whether it works or not.”

Before receiving a Challenge Fund grant, CCC had already secured contracts to trial this model at three GP practices in Wrexham and had been granted permission to take over its first practice in September 2019 with the second and third following in January and April 2020.

However, the Challenge Fund grant has been essential in enabling CCC to develop its ideas further and successfully set up and recruit in a vast number of different areas of health and social care over the last 12 months.

Alison Hill of Capacity Lab, who assisted in bringing the model to life said that, “The Challenge Fund seemed to me to be very much about trying to do things differently and about taking a chance to really give something a go to find out whether it works or not.”

Firstly, CCC recruited a permanent emotional wellbeing team which is present at all three practices and aims to provide a first point of contact for patients that are in need of wellbeing support directly after booking an appointment.

What commonly happens in these cases is patients are referred on to other mental health organisations and can bounce back, so a key focus of this team is to reduce onward referrals by providing services in-house such as support groups, medication reviews, memory assessments and psychotherapy.

The organisation has seen that utilising this model alone has seen onward referrals reduce by over 57% compared with the previous evaluation period (Apr-Sept 2019).

Not only does this mean that patients are being provided a more appropriate and immediate response, but the cost savings to other health and social care services are likely to be significant. A social impact evaluation of CCC’s Emotional Well-Being Team found that it had delivered social value worth more than £1million in its first 12 months to November 2020, representing a social return on investment of 6.42:1.

More important to those involved is that 33% of people supported within this model (who were asked for feedback), said that without support they may have taken their own lives, further demonstrating the positive impact that the model is having.

To support the referral process, CCC recognise that as first responders to calls, front desk staff play a vital role in the patient process so it invested in training to develop them into ‘Care Navigators’. People within this role now have the knowledge to respond to individual patient needs and signpost them towards the relevant team, rather than automatically referring them to a GP.

Due to the high level of demand during Covid-19 and the huge upheaval of a system that has been in place for years, the booking system is an area that CCC is still working to make as effective as possible through continuous testing and experimentation.

Alison says, “We tried eConsult (Lite), which didn’t work out so we changed it and adapted it…it’s improving, but that is something that we haven’t got right yet and we still need to work very much on.”

Despite the obstacles faced by the pandemic, CCC is really proud of its progress this year, although there are some areas where work still need to be done, especially in recruiting full time salaried GPs.

Although CCC has been able to employ some part time doctors, Alison explains that a huge obstacle primary care is currently facing is that many GPs are working as temporary doctors known as locums, which she says, “In terms of finances, it’s going to destroy primary care.”

As they move towards the goal of recruiting more full time GPs in 2021, the team is confident that this integrated model will prove attractive to GPs, as it gives them more opportunity to concentrate solely on medical needs and to patients as they will be able to access a much wider range of inhouse support.

As CCC looks towards the future, it will be concentrating its efforts on recruiting full time salaried GPs, and building partnerships from within the Welsh Government’s FECF Community of Practice, as well as other organisations that can help to replicate this model across Wales.

Welsh Government, Living Wage Foundation and TISCreport forge alliance to tackle In-Work Poverty in Wales, and the UK

[:en]

Welsh Government, the Living Wage Foundation and TISCreport – the world’s only transparency in supply chains register already monitoring compliance with the Modern Slavery Act – have joined forces to publish which companies have been accredited as Living Wage Employers.

Says Stephen Chapman, Anti-Slavery Partnership Coordinator for Welsh Government: “The Wales Anti-Slavery Leadership Group is determined to tackle slavery and labour exploitation in Wales. We have established our ‘Ethical Employment in Supply Chains – Code of Practice’ for Welsh public supply chains and beyond. Our partnership with the Living Wage Foundation and TISCreport enables us to make the data on Living Wage Employer Accreditation available for all who wish to use it to promote better social outcomes.”

Mari Arthur, Director of Cynnal Cymru, says:

“Cynnal Cymru – Sustain Wales is the national sustainable development charity in Wales, with over 16 years’ experience of supporting change for a sustainable future. We became the Living Wage Accrediting Body for Wales in 2016 in order to work towards getting people in work out of poverty”. She continues “We support ethical employment practices generally and through the Living wage can help deliver real benefits to the people living and working in the most deprived areas of Wales; there are huge inequalities that urgently need redressing. With over 4,000 Living Wage accredited employers across the UK, 150,000 people are now receiving an increased salary (with £613 million extra in low paid workers pockets since the start of the campaign). However, there are currently just 144 accredited employers in Wales. Through working in partnership with the Living Wage Foundation, Welsh Government and the TISCreport we hope to strengthen this work in the UK as well as improving local economies in Wales and making sure everyone has the opportunity of fair wages.”

Jaya Chakrabarti MBE, CEO, TISCreport, adds

“We’re really proud to be able to announce the addition of data showing if an organisation is an accredited Living Wage Employer (or not) to the TISCreport transparency in supply chains register as part of our partnership with Welsh Government to encourage ethical employment in supply chains”. She adds “Further, our partnership with the Living Wage Foundation will enable us to raise awareness with our public, private and voluntary members about which of their suppliers are accredited Living Wage Employers across the whole of the UK. Members of the public will also be able to see this publicly on our site. We will update this monthly and look forward to celebrating more workers in public supply chains paid at or above the Living Wage.”

TISCreport has built its platform to enable buyers to quickly check their supply chains for available corporate transparency data. Just by uploading their suppliers from their systems, public sector buyers can keep their supply chains transparent, and they can check modern slavery act compliance for free.”

In accordance with section 54 of the UK Modern Slavery Act TISCreport tracks websites of all those companies and groups known by the system to be over £36M in turnover as well as recording voluntary compliance from organisations below the threshold. More critically, the system automatically alerts companies that are overdue that they need to take action as long as social media or email contact details are available.

The TISCreport dynamic dataset is continually being updated, and there are now 917 UK public bodies within the system. It is a certified open data provider, free to join, enabling an in-depth drill down of data against shared supply chains via a private, secure dashboard. Uniquely, beyond the UK, TISCreport interlocks intelligently with related global legislations focussing on supply chain transparency and tackling modern slavery/ human trafficking.

Says Stuart Gallemore, CTO of TISCreport,

“We’re worked hard to create a platform to help organisations fight modern slavery collaboratively, compatible with global technology systems and that is GDS compliant. With critical mass reached on the compliance data side we are now looking to join things up quickly with intelligence on the ground that can help real victims of exploitation. We’re integrating rapidly now with numerous related data sets that provide even deeper insights for all our members. The Anti-Slavery Helpline team are on the front foot with their approach to data sharing. These are exciting times!”

As a B-Corp social enterprise, TISCreport funds itself through subscription fees and data services from organisations able to afford the £200 annual fee. 50% of the subscription fee goes directly to anti-slavery charity Unseen, which runs the UK Anti-Slavery Helpline.[:]

Scroll to Top