Together we can bridge the gap to recap the bottle
The aim of this project was to work in partnership with patients, healthcare professionals, Area Planning Boards and the third sector to develop a person-centred alcohol care approach across the Cwm Taf Morgannwg landscape.
The project focuses on enhancing, improving and expanding our alcohol care services from a 5 to 7 day provision, for which funding was provided by National Value Based Health Care Programme. The project is based on ValueBased Healthcare principles and focused on a life-course and whole system approach which starts from the user being able to share their experiences, their needs and aspirations in a way that meets their needs and informs the review, planning and implementation of new models of care and feedback.
Initially clinical teams and partners undertook a mapping exercise and research which highlighted that the service was provided in restricted hours i.e. 9 – 5 Monday-Friday, which meant we were not meeting needs in the hours most likely for alcohol related hospital admissions. Questions about alcohol were not routinely asked or onward referrals made in over 70% of emergency and planned admissions leading to unplanned detox, and missed opportunities to support, which led to continued re-admissions, known as frequent flyers and a system which was not providing the support required by our population.
There was also limited capacity within the service with the equivalent of one whole time equivalent Alcohol Liaision/Substance Misuse on each District General Hospital site. Evidence demonstrated that alcohol use patterns had changed and worsened through and post COVID for all ages therefore there was significant unmet need as well as increasing demand on the existing services.
From the outset the ambition was to ensure a patient-centred approach and service for patients with alcohol related problems, in ways and places which meet the needs of the patients and families accessing them, in partnership with patients, families and other partners. We initially mapped our presumed stakeholders first and then with the assistance of the third sector i.e. Barod, held sessions with service users to ask them, who to involve, how to involve and their honest feedback of their experiences, needs and aspirations.
We provided a safe, supported and non-judgemental space and a range of opportunities to provide their feedback, mindful of stigma and confidentially. We shared our ideas and they shared theirs. During these sessions we involved a creative song-writer to work with us all to capture their voices in a powerful way. A “spoken word” song has been produced which captures patient stories and their aspirations for the future. This song was played live to a varied audience of multi -agency service providers and service users at a celebration event, as part of a series of events we held for Alcohol Awareness Week in July 2023. Each service user was presented with a signed framed gift of the lyrics of their song along with other useful gifts which included a tote bag with the caption “you are valued”. This song is an innovative and heart-felt way of sharing and increasing awareness of the service user experience.
The service users have also undertaken specific pieces of work to assist us in shaping our service such as the development of a patient leaflet to use on an all Wales basis, a questionnaire to determine if support is needed for patients visiting emergency departments and a service user will be present at the interviews for the new staff to be employed within the 7 day service, and their involvement is represented on the patient leaflets.
Person Centred Care has to start with the person receiving it, with those delivering it in partnership. People’s voices must be gathered in whichever way suits them, but we must listen. This service is being built with them, to ensure we do have data for the future, but more than that, we know what works and what is valued by the people receiving the care. This has been a true collaboration with openness and involvement from a wide range of stakeholders. It is important to note not everything costs money, patients are keen to get involved and help if you ask and support them in the right way. This article is about them and is for them.
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