Spice and the Young Foundation: partnership innovation award runner-up

The Uplift scheme 'helps you anchor yourself, to anchor your place in society and your sense of identity', says one service user. Photograph: Spice

A time-bank project designed for health and social care service users is helping them feel less isolated and has the potential to transform their lives.

Under the Uplift scheme service users spend time volunteering for local organisations in return for time credits. They receive a credit for every hour given; in return the earned credits can be spent at local leisure or cultural venues which have signed up to the scheme.

Uplift has been established by the social enterprises Spice and the Young Foundation. It involves four local authorities in England, more than 200 local organisations and 1,000 service users who have notched up 20,000 credits.

As part of Uplift, each local authority hosts a Spice facilitator whose job it is to create a local time credit network made up of service users, community organisations, public services and private businesses. Each network offers a mix of earn or spend opportunities.

David Russell, head of health and social care at Spice, says: "Uplift is a large and ambitious project across four geographical areas, involving a wide range of service types and communities.

"On average we find that 40-60% of participants have never given time before ... this is having a wide range of positive outcomes particularly around culture change, increased physical activity, mental wellbeing, confidence and community pride."

One service user from Norfolk who has signed up to Upflit says it has made him more "anchored". He says: "It's opened up social avenues – I've now got a group of nodding acquaintances at the gym, which helps you anchor yourself, to anchor your place in society, and your sense of identity."

Spice and the Young Foundation are also working with commissioners, service heads, support workers and service users to see how the idea of time credits can be adopted more widely into their own systems and approaches to work. Russell says: "This can range from large scale service asset mapping to redesigning support working systems, to building co-production into the commissioning process."

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NHS South Worcestershire CCG: hospital admissions award runner-up

Dr Nikki Burger says the target is for GPs to deal with an average of five ambulance cases a day. Photograph: South Worcestershire CCG

GPs have been dealing with 999 calls during the day, which were traditionally handled by ambulance crews – reducing the number of patients admitted to hospital and saving £1.1m

The scheme was set up by South Worcestershire clinical commissioning group (CCG) and the West Midlands ambulance service last October in an attempt to cut the number of avoidable hospital admissions and free up paramedics to take on more life-threatening calls.

GPs are available from 12pm until 8pm – when 999 calls are often at their highest – every day of the week.

An ambulance is always dispatched to the scene in case an emergency admission is needed. But the crew or the ambulance control room can call out the GP if it is felt that the patient could be treated at home by the family doctor rather than being taken to hospital.

Since the scheme was launched last October 50 GPs have taken 1,221 calls with only 20% of patients being taken on to hospital. The project, which costs £21,000 a month to run, has prevented 970 A&E attendances and 500 hospital admissions, saving £1.1m. The scheme has been so successful that GP urgent support is also being made available to care homes, minor injury units and community care teams.

GP Dr Nikki Burger, the CCG's urgent care lead, says: "We recognised the potential to expand the role. Our target is that the GP deals with 35 ambulance cases a week – an average of five a day – and the rest of the time they are available to provide the extended support role."

The initiative was originally run as a pilot scheme by the CCG's predecessor Worcestershire primary care trust as a solution to tackling increased demand on NHS services during the winter.

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United Response: workforce innovation award runner-up

United Response Stamp of Support programme encourages carers to allow people with disabilities to take sensible risks.

A disabled woman made herself a cup of tea for the first time after her support workers realised providing her with a surface-mounted cup and a hot water dispenser meant she was no longer in danger of scalding herself.

Staff at the charity United Response came up with the solution because they realised that the benefit of making a cup of tea far outweighed the possibility of her being scalded. The support workers felt confident that it was a risk worth taking.

A young adult with a learning disability now travels to work by bus on his own, rather than taking expensive taxis. The staff knew there was a possibility that he could get lost on the way, so they gave him a mobile phone to ring them if needed. Staff realised that the financial and personal benefits were greater than the chances of him getting off the bus at the wrong stop.

Both cases illustrate the success of the charity's Stamp of Support initiative – which is encouraging "positive risk-taking" by staff in the organisation, which supports 1,300 adults with learning disabilities, physical disabilities or mental ill-health.

The charity wanted its 3,500 support staff to have the confidence to take a calculated risk when making decisions which would help service users achieve their "hopes and dreams".

"We didn't want them to risk their safety, but we wanted them to know that so long as they have acted reasonably then we will support them all the way," says Shonagh Methven, the charity's senior business partner for risk management.

The Stamp of Support slogan now appears on all its health and safety material and on a staff keyring.

Staff guidance and advice to support them to make a positive risk decision – even if it ends in failure – has been written into the charity's risk management strategy.

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Rivington and Blackrod and Ladybridge high schools: winner, partnership innovation award

Pupils have also been trained as 'health ambassadors' and hold theme-led assemblies on a range of health issues. Photograph: Rivington and Blackrod high school

It could easily have been a bureaucratic nightmare that failed at the first hurdle. The dilemma was how do you bring together the NHS, local government, education and sports centres to deliver a school-based health project that the students would be happy to use?

The answer, according to Michelle Howard, director of business development at Rivington and Blackrod high school in Lancashire, was to be committed to the vision and have the confidence and trust in each other to share information and best practice.

"We worked with all our partners to ensure that all our procedures and practices worked well together," she says. "We learned so much more about each other and how we could best use our skills, resources and specialisms to deliver the best outcomes for us all. It was also about sharing that responsibility."

The teenage health project at Rivington and Blackrod high school and the Active Health scheme at its linked federated school, Ladybridge high school, has gone from strength to strength since it was first established in 2007.

The intention, following wide consultation with parents, young people, the local community and public services, was to create a student-friendly accessible health and wellbeing service offering advice, guidance and information on the school site. "It started out when we were looking at Every Child Matters, which was on everybody's minds at the time," says Howard. "It was about looking at what we could do to help young people stay healthy and safe."

A steering party was set up, which included representatives from parents, pupils, schools, the local authority and leisure providers to design and develop the project, which had £450,000 of Big Lottery Fund money.

Today more than 3,000 young people have made use of the project, which offers them a range of advice and information including healthy eating, sexual health and contraception and drug and alcohol awareness.

Support for emotional wellbeing and advice about how to cope with stress is also offered by the project, which is run by school nurses alongside a project co-ordinator who can refer students to different services as required. "There isn't one aspect of health that we shy away from," says Howard.

School students have also been trained as "health ambassadors" – taking the healthy message to their classmates by holding theme-led assemblies and teaching them how to carry out CPR and other lifesaving first aid skills.

At the same time, 13 members of staff have learned about healthy eating and nutrition and are now passing on their knowledge to students across the school.

The project, says Howard, has generally improved the students' physical and emotional health. But there have been more tangible results: the behaviour of 81% of children who attended its anger management programme has improved; the local teenage pregnancy rate has started to fall and 87% of children who received counselling said they were feeling better.

Howard attributes the success of the project to the depth of the relationships between the different partners. She says: "It's about trust and acknowledging that 'I am really good at this' and saying 'how can we work together to get the best outcomes?'. We also had a very strong vision, which we all focused on and never lost sight of."

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Intelesant: winner, technology innovation award

With the End of Life Monitoring and Assessment tool, GPs can be notified of care home residents' end of life wishes.

An app-like tool that has the potential to change the culture around advanced plans for frail and older people in care homes has been developed in Trafford, Greater Manchester.

The End of Life Monitoring and Assessment (Elma) tool allows care homes to electronically send a resident's advanced plan – a statement of their end of life wishes – via a handheld device direct to the individual's GP computer system. The plan, which is Read-coded and compatible with the practice system, can then be accessed around the clock by other NHS staff from ambulance teams to A&E doctors and community nurses.

It means that for the first time care home staff can directly share their knowledge about a resident with the wider NHS. Crucially, Elma also allows GPs and other NHS staff to be kept up-to-date with the advanced plan of an older person living in the residential care system whom they may rarely see and may be little known to them.

With the resident's consent, Elma can also be accessed by their family or friends using a secure two-factor authentication. Uniquely, Elma has also been designed to be used as an experiential training tool by care home staff to teach them how to create and develop an advanced plan with a resident.

Before Elma was introduced, care homes that did promote advanced plans for residents used paper versions, which then had to be faxed to the GP surgery. The time-consuming process was open to error and the information the plans held was often inconsistent, says physiotherapist Louise Rogerson, director of service development at Intelesant – the company behind Elma.

Because of Elma, it is hoped that eventually all people living in Trafford – not just care home residents – will have an advanced plan, which can be securely accessed by healthcare professionals and the individual's family. Rogerson said: "Any of us who have an advanced plan can use this system; it's not just for people in the last years of their life, it's for anybody who wants an advanced plan."

Additional coded data about the resident, which has been added by the care home staff can also be accessed via Elma by healthcare professionals, if necessary. That data includes latest information about a resident's usual level of consciousness; their mobility; their diet and their weight.

Rogerson says: "These are key indicators about how well a patient is, about how frail they are, and was something which the doctors in A&E said would be useful. It's the kind of information which the care home staff would have."

The electronic tool, developed by Intelesant, Trafford clinical commissioning group and the local hospice, has already been used by one local care home and is in the process of being rolled out to another nine.

The data Elma captures also reflects that required by the electronic palliative care co-ordination system, which is part of the national end of life care programme in England.

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Michael Yoakley's Charity: partnership innovation award runner-up

Manager Julie Wickenden shows off one of the hospital avoidance beds, which helps prevent inappropriate hospital admissions. Photograph: Michael Yoakley's Charity

A care home in Kent is helping to free up hospital beds and preventing older people being inappropriately admitted to hospital, following a partnership with a local GP surgery.

The Michael Yoakley's Charity in Margate provides the North Down surgery with two short-term hospital avoidance beds, which are offered to older patients who are unable to be cared for at home and need support.

The patients spend a maximum of seven days in the home at a charge of £500 a week, which is significantly cheaper than the £500-a-day it would cost to pay for a high-dependency NHS hospital bed. So far this year the home has looked after 24 older people who have been recovering from common infections and viruses, including chicken pox.

The charity's executive manager Julie Wickenden says the scheme turns on its head the traditional relationship between the home and GPs, where family doctors have traditionally served the needs of the home.

"We have a large local hospital where we have many elderly people clogging the system when they don't need to be there," she says. "Our seaside area also has a high proportion of elderly residents many of whom are geographically distanced from their family members who might otherwise care for them, so the default when they are unwell, or even just vulnerable, is a hospital admission.

"A lot of care homes are looking to develop different kinds of initiatives because they are not having so much success with social services funding as the councils are really holding back putting people into residential care, so we have had to look for other ways of making up the finances."

The initiative, which allows continuity of care by the patient's own GP, has been so successful that the home is now in the process of building an extension, so that it can provide more hospital-avoidance beds.

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Applying sunscreen? Don't be stingy

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Most people use sunscreen too sparingly. If you're wearing swim gear, it takes about 1 ounce (28 grams) of sunscreen to cover all exposed parts of your body. That's the amount in a standard shot glass. If you're only using a dime-sized drop of sunscreen, you're not using nearly enough.

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