Darnall Well Being in partnership with Clover Group Practice has piloted a community based integrated approach to support hard to engage clients around self management of Long Term Conditions.
After a successful start further funding was secured from SHSC to develop this approach as an integrated model called Enhancing Primary and Community Care (EPCC). The project’s key partners were Clover Group, Darnall Well Being and Sheffield Health & Social Care trust. Clover Group employed two Health Trainers, one Community Support Worker and a Community Development Worker/ Project Administrator with generic and Serious Mental Illness (SMI) skills to work on this pilot. District Nurses, GPs and other services were also part of a Multi Disciplinary Team (MDT) which had regular meetings to discuss patients’ engagement and support needs.
Enhancing Primary and Community Care (EPCC) has provided a comprehensive and intense support for hard to reach and hard to engage clients. People are supported to manage their own health and wellbeing through patient-centred care planning which has the benefit of local insight and community health interventions complementing Primary Care.