The objectives of the S&W Herts Living Longer Better Programme

• Allowing clinicians, and those non clinicians working in our community to enhance peoples health, to have full access to all wrap around services available locally and nationally, to improve peoples health and wellbeing.
• The trigger is the persons individual health data, recorded as a Snomed code and their postcode.
• It will be fully automated to save clinicians substantial time.

 
The Lab
South-West Hertfordshire represents a population of 607,200 people and represents our Place. We have 4 Intergrated Neighbourhood Teams. Dacorum with 155,100 people, Watford and Three Rivers with 196,100 people, St Albans and Harpenden with 148,200 people and Hertsmere with 107,800 people.
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We are focusing on people within a Primary Care Network from each Neighbourhood Team.

• Alpha PCN from Dacorum
• Attenborough PCN from Watford and Three Rivers
• Alban Heath PCN from St Albans and Harpenden
• Herts Five PCN from Hertsmere

The total population that the 4 representative PCNs serve is 200,000
The PCNs will use the W:ISH platform to offer people within their PCN additional support  and non-drug therapy both local and digital beyond drug therapies.
Supports include activities, voluntary organisations, educational links to support networks.
They can be locally or nationally available
It will use the person’s medical codes and their postcode as a unique identifier and wrap all services available for their care
The information can be ‘pushed’ to the clinician or searched by the clinician using cohorts of people aligning to disease Snomed codes

 
​ Examples of initiatives 

• Type 2 Diabetes can have access to health walks, join Diabetes UK, find more vigorous activities using a link to www.movingmore.co.uk platform or understand their medication better with links to information.
• Person with Parkinson’s can have access to a local neurological support centre such as www.chilternsneurocentre.org or www.lets-dance.org.uk or information from Parkinson’s UK
• People with Heart Disease can link up with healthy living groups linked locally including weight loss, exercise classes, health walks
• People with Depression and anxiety can have all access to a range of talking therapies offered by the local system such as within https://www.hpft-talkingtherapies.nhs.uk/ . Also, vigorous activities available locally to improve any benefit from medication or stand-alone therapy for milder depression or anxiety
• Repeat drug prescriptions can be accompanied by booster messages
• Birthday Boosters can be produced for healthier living

Input to the NHS plan 
This aligns with all 3 of main NHS objectives set out in Darzi report, the 2025-26 Operating Model and the Neighbourhood Health Guidelines.

• Shift from Analogue to Digital
• Shift from disease treatment to disease prevention
• Shift from hospital to community