Bristol Health Intergration Teams

Addictions HIT - (ADDHIT)

http://www.bristolhealthpartners.org.uk/health-integration-teams/addictions-hit/

Barbara Coleman, Barbara.coleman@bristol.gov.uk or 0117 922 2935

• Investigate drug treatment & risk of mortality

• Improve HCV testing and management

• Test the use of alcohol screening and brief interventions in custody suites

• Assess existing alcohol screening and brief interventions for young people

• Look at the cost-effectiveness of alternative models of community alcohol detoxification.

• Powers available to Bristol City Council to decrease access to low cost alcohol

• Powers available to Bristol City Council to decrease access to low cost alcohol

• Contingency management in ROADS

• Evaluate the delivery of recovery support to reduce risk of relapse

Sexual Health Improvement HIT (SHIPP)

http://www.bristolhealthpartners.org.uk/health-integration-teams/sexual-health-improvement-hit/

(collect data to evidence)??

• Effectiveness of key pathways evaluated in terms of patient outcomes captured automatically in routine electronic data

Is this data available to us?

analysed centrally

• Over 80% of staff trained in electronic record keeping

Chlamydia control:

• Evidence of change in prescribing practice

• Evidence of reduced prevalence of Chlamydia

• Evidence of reduced prevalence of azithromycin resistance in Chlamydia and other STIs

• Evidence of re-infection rates <20% at 1 year amongst treated patients

• Reduced incidence of PID, ectopic pregnancy and tubal factor infertility

• Evidence of all ascertained in routine electronic data

HIV Diagnosis and Treatment:

• Evidence of increased testing in line with guidelines in primary care

• Evidence of education in late diagnosis

• Evidence of reduced incidence

• Evidence of reduced morbidity and mortality amongst HIV positive patients

• Evidence of all ascertained in routine electronic data (Data)

Unwanted Conception:

• Evidence of reduced unwanted conception and reduced disparity in incidence of unwanted conception between more and less

Intimate Partner Violence:

• Reduced recurrence of IPV, improved mental health outcomes, reduced STI prevalence

Supporting Healthy Inclusive Neighbourhoods Environments HIT (SHINE)

http://www.bristolhealthpartners.org.uk/health-integration-teams/supporting-healthy-inclusive-neighbourhood-environments-hit/

Suzanne Audrey, Research Fellow: suzanne.audrey@bristol.ac.uk or 0117 928 7273

• A systematic review and evidence syntheses with a focus on health and the environment

Marcus Grant, Associate Professor of Healthy Urban Environments: marcus.grant@uwe.ac.ukor 0117 328 3363

• An annual seminar for stakeholders, professionals and policy makers in the fields of public health, planning and transport as

well as organisations with specific areas of interest e.g. mental health, the elderly, children and young people, minority ethnic

groups, young families.

• A database of organisations and individuals with expertise relevant to healthy neighbourhoods.

• Improved data collection methods to measure the ‘quality’ of the public realm and health and well-being in relation to it.

• At least 2 PhD studentships relating to public health and neighbourhood environments.

• At least 3 rigorously evaluated interventions relating to the priorities of the HIT partners.

• Changes to professional practice to incorporate evidence in relation to healthy neighbourhoods.

• Beneficial physical changes in previously poor quality environments.

• Improvements to the physical and mental wellbeing of ‘marginal’ patients: e.g. a reduction in medical consultations, hospital

admissions or prescribed medicines and improvements in measures of well-being and social inclusion.

Improving care pathways for self harm (STITCH)

http://www.bristolhealthpartners.org.uk/health-integration-teams/improving-care-in-self-harm-hit/

Salena Williams, Liaison Psychiatry, UHBristol on salena.williams@uhbristol.nhs.uk or 0117 342 2777

• Over 80% of staff in EDs trained in the use of self harm identification and risk assessment

• All Great Weston Ambulance Service clinical staff (100%) staff are trained in self harm identification and risk assessment

• All GP’s (100%) have access to training modules of suicide, self harm and risk assessment, and safe prescribing for self harm

• All patients (100%) who self harm and attend ED in Bristol are recorded on the Self-harm Surveillance Register, tracking trends

and demographics, incidence and outcomes. Regular reports of self harm characteristics and care in the Bristol area used to

inform commissioning and service developments.

• Most (>80%) patients receive a psychosocial assessment at ED following self-harm. Identification audited via the self-harm

surveillance register

• 10% reduction in the incidence of repeat self-harm in Bristol within 5 years

• Reduced prescriptions of drugs with high lethality when taken in overdose within 3 years

• 50% reduced admission to a hospital bed for self-harm within 5 years

• 20% reduced admission to intensive care of self-harm patients within 5 years

• 10% reduced length of stay in hospital if self harm patient admitted: Short-term meaningful admission with high patient

satisfaction within 5 years

• 20% reduced suicides of known identified self harmers in the 12 months following self-harm within 5 years.

• Research grant income of >£150,000 per year in relation to self-harm service research in Bristol

• 2-3 Publications in peer reviewed journals relating to research carried out within the HIT

• Improved patient satisfaction with service from EDs within 5 years

• Improved all levels of staff on the HIT pathway awareness of risk factors for repeat self-harm and suicide and of the services

available for self harm patients and appropriate referral to liaison psychiatry

• Improved carer satisfaction and increased awareness of self harm issues within 5 years.

Child injury prevention and injury care (CIPIC)

http://www.bristolhealthpartners.org.uk/health-integration-teams/child-injury-hit/

Julie Mytton, Associate Professor in Child Health: Julie.mytton@uwe.ac.uk

Integrated pathways of care from prevention, through urgent care to rehabilitation and reintegration

• Development of Patient Reported Outcome Measures for both parents and children following admission to hospital for injury

• Production and implementation of city-wide prevention strategy for hot drink scalds based on a review of current national best

• Establishment and audit of injury care pathways for burns and scalds

• Establishment and audit of injury care pathways for paediatric head injuries (mild, moderate and severe) and long bone

• Reduced duration of stay compared with baseline following admission for specific injuries (to be agreed following review of

current pathways and targeted to the injuries where discharge has been particularly challenging)

• Establish a major trauma integrated care exemplar (focus to be determined following consultation with stakeholders, but could

for example focus on multiple fractures, major head injury or severe burns etc)

• Reduced ED attendance and major trauma admissions through effective preventive interventions

• Patient Reported Outcome Measures indicate high levels of satisfaction with the integration of care

Enhanced collaboration between Health, Education and Social Care, between acute and community based agencies, and between

the voluntary, public and private sectors

• Bristol City Council to host a child injury prevention scrutiny day utilising the NICE tools provided with Public Health guidance on

Preventing Unintentional Injuries in the under 15s, to identify gaps in the wider collaboration of agencies and partners and to

generate an action plan..

• Identification and improved collaboration with voluntary sector organisations able to support the rehabilitation and

reintegration of children following injury

• Application of the action plan created following the Scrutiny day with demonstrable evidence of improved coordination of care

• Effective, routine sharing of data to plan for rehabilitation and reintegration between health, education and social care for