Winner Bradford and Airedale teaching PCT

Self injury Service

Despite the fact that a recent study has shown that as many as 11 per cent of 16 year old girls self-injure, the lack of compassion that they and others like them frequently experience in A&E, along with an overall dissatisfaction with the service, sees the majority choose not to attend hospital.

As a response to this, NICE guidelines and other indicators and managed by a clinical psychologist a pilot self-injury service was set up in October 2006. The intention was to provide 24 hours, 7 days a week primary care medical treatment to people over 16 years of age who self-injure.

Further to improving attending rates for medical treatment, the pilot also sought to assess the support and service needs of clients, to give information about other services and to equip practitioners with information about safe self-injury.

Service users call a central number from where the clinical response is coordinated. Appointments at a GP practice or community hospital are made within three hours of the call. Treatment is accompanied by a psychosocial assessment, which is passed to the GP for follow up as appropriate.

While the numbers during the initial six-month of the pilot were small, interim evaluation results show that money was saved through a reduction in A&E visits, that clients would use the service again and that it was perceived as better than going to casualty.

The opinion of the judges, in choosing Bradford and Airedale as their winner, was that it provides an important means to reducing the stigma and addressing the prevalence of self-injury through a more supportive and understanding service.

In meeting an unmet need and challenging underlying misconceptions the scheme has allowed for improved care in a priority area. The judges further took the view that the service should prove to be a trailblazer, both domestically and internationally.

Contact - Gillian Proctor, Clinical Psychologist,Gillian.Proctor@bradford.nhs.uk

Highly Commended South Birmingham PCT, Heart of Birmingham tPCT, Birmingham East and North PCT and Lloyds Pharmacy

'Heart MOT' Community pharmacy cardiovascular screening pilot

Identifying patients at risk of cardiovascular disease (CVD) is an integral part of the Birmingham Health and Wellbeing Partnership’s bid to improve male life expectancy.

Under the umbrella of this wider strategy South Birmingham PCT and Lloyds pharmacy developed a community pharmacy based CVD pilot screening and advice service to operate throughout the city.

Among its aims the pilot plans to screen a minimum of 1,600 patients by March 2008, develop pathways that will integrate the service with the NHS, and, by identifying risk, ultimately improve the patient's quality of life and reduce the economic burden.

Measurements taken include total cholesterol, blood pressure, blood glucose, body mass index and waist circumference. The service also obtains family, medical and lifestyle histories. Results are given in a summary that includes a CVD risk score, a GP referral where this is high, and lifestyle advice.

A service brand - 'Heart MOT' - with recognisable materials and logos has been a key part of the marketing strategy to attract patients to the service.

Pilot results to date confirm that 32 per cent of people screened are found to be at high risk of CVD. A big majority (81 per cent) of these are male. Almost half of all individuals offered a Heart MOT were referred to their GP.

The judges commended the Birmingham PCTs and Lloyds pharmacy for the innovative way in which they had effectively combined an understanding of public health need with a pharmacy led system of recruiting and screening people in areas of CVD risk prevalence.

Contact - Jonathan Horgan, Head of Medicines Management,South BirminghamPCT Jonathan.horgan@sbpct.nhs.uk

Newham Primary Care Trust, Serco Health

Community Matrons - empowering those with long term conditions

Newham is a challenging environment in which to provide healthcare. It is one of the most deprived areas inEnglandand has the highest incidence of diabetes in theUKand the highest rate of deaths from strokes inLondon.

Newham PCT has introduced community matron led case management to tackle some of the problems experienced by patients with long-term conditions. In turn and as the result of a partnership with Serco Health, the matrons are supported by improved information management systems that target vulnerable patients for self-care education and mobile technology that encourages on-the-move working.

Contact - Imran Devji, Group Manager - Primary Care Services

Imran.Devji@newhampct.nhs.uk

NorthEast LincolnshirePCT

HOPE ST Service

The aim of the HOPE (Health Optimisation, Prevention & Education) ST Service is to provide a patient centred one stop shop for people with COPD and older people at risk of falls. The service combines resources for people with similar issues. Local people play a central role in its design, development and delivery.

HOPE STinitiatives include Pulmonary Rehab Plus, an ongoing exercise programme that runs once Pulmonary Rehabilitation has finished and makes a real difference to greater functional independence. Quality of life indicators show improvements since its inception and Accident & Emergency attendances from falls in people over 65 have reduced by 7 per cent.

Kylie Farbrace, Falls Co-ordinator, Kylie.Farbrace@nelpct.nhs.uk

BoltonSalford& Trafford Mental Health Trust; Salford Royal Hospitals Trust;SalfordSureStart

TheSalfordPerinatal Mental Health Project

At around 29 per cent, rates of postpartum depression in SureStart areas ofSalfordwere much higher than the national average. The Salford Perinatal Mental Health Project was developed to tackle this high prevalence and its associated negative effects on child development.

Following a psychosocial assessment, women can be offered a range of integrated support and psychological therapies from a rapid access multi-professional, multi-agency service. Rates of clinical depression haves fallen from 89% at time of referral to 44% at point of discharge or referral. The NIMHE North West Development Centre website recognises the service as an example of positive practice in working with families.

Dr Suzanne Glendenning, Clinical Psychologist, suzanne.glendenning@bstmht.nhs.uk