Health Integration Teams (HITs) - COVID-19 response


Our Health Integration Teams (HITs) are responding to COVID-19 in the following main ways:

  • Developing new services
  • Evaluating service changes and investigating behaviour change
  • Co-ordinating and improving communications

The HITs can also act as networks for contacting clinicians, public health professionals, patients and academics to gather feedback on issues relevant to the COVID-19 response.For example, the Bristol Health Partners core team is sharing research requests with appropriate contacts.

To find out more, please contact Oliver Watson, Joint Chief Operating Officer (interim), Bristol Health Partners - oliver.watson@bristol.ac.uk.


Developing new services

Our Active Older People (APPHLE) HIT and Active Ageing Bristol are working with a local consortium to support the mental and physical health of older people during lockdown. This includes: Age UK Bristol newly-launched helpline; OASIS Talk telephone befriending and counselling service; support to access food and medications; development of virtual physical activities. Organisations involved include: Greenway Centre, LinkAge, Alive, Bristol After Stroke, Bristol Ageing Better, Active Ageing Bristol.

Our Movement Disorders (MOVE) HIT is developing a new pathway which will include access to a specialist neurology advice line for healthcare professionals working in the community. It will link to co-ordinated work on end of life care that is being led by Dr Kate Rush (Medical Director, Sirona care & health).

Our Stroke HIT is investigating using AI to support image interpretation and diagnosis, and also increasing telecare.

Members of our Bristol Bones and Joints HIT are working with other researchers on a project to investigate the best strategies for self-management of COVID symptoms post-hospitalisation.

Our Kidney Disease HIT is accelerating plans to establish a virtual chronic kidney disease service. This was planned prior to COVID-19 and has taken on increased importance. The project is supported by Research Capability Funding.

Our Dementia HIT has mapped service changes during COVID-19 and is supporting partners in their transition to online provision of information and support sessions. This includes the 'Dementia Friends' programme, alternative formats for social groups and establishing a new 'companion calls' service, whereby volunteers phone people affected by dementia.

Our Chronic Pain (formerly known as Integrated Pain Management) HIT has worked with Silvercloud, Vita Minds and other partners to develop electronic CBT for people with chronic pain. This HIT has also been working with colleagues in Wellspring Settlement to develop “The Virtual Hub”, funded by St Monica Trust. This brings together different organisations across Bristol to run virtual activities during the current situation caused by Covid19.Lead by Alive! activities in partnership with Active Ageing Bristol, the “Virtual Hub” will support activity classes to happen on- line or on the phone, enabling people aged 65+ in particular to still take part in their previous activities- or try new ones- whilst continuing to stay safe. This complements previous shifts in services which have included telephone befriending and arranging prescription delivery.

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Evaluating service changes

Several of our HITs are interested in evaluating the service changes being made in response to COVID-19. We are in contact with the CCG’s Research and Evidence Team and ARC West to get a better understanding of similar evaluations and generic tools that HITs can use in evaluating their virtual consultations.

HITs are involved in mapping changes and adaptations to services in response to COVID-19 across their clinical/social care areas. This includes information on the various types of remote support and virtual healthcare being offered to patients and service users. This information is being collated and shared with others for evaluation purposes. Detailed information is available on request.

Our Bladder and Bowel Confidence HIT has surveyed health professionals from primary, secondary and pharmacy settings to investigate the service changes being made and perceived issues and opportunities (initial findings available on request). Issues identified include: A) lack of access to patients in care homes; B) concerns that interactions have become more transactional to access continence aids only, missing wider preventative opportunities and C) that a blended approach of initial face-to-face with remote follow-up appears most successful.

Our Perinatal Mental Health HIT is evaluating online, evidence-based tools for managing wellbeing during pregnancy – this is a part of a national evaluation.

Our Stroke HIT will investigate: the impact of COVID-19 lockdown on stroke survivors’ mental and emotional wellbeing and the long-term impact of the current drop in number of patients presenting with TIAs. They are also planning to explore impact of earlier hospital discharge following a stroke, (resulting from shorter length of stay) than was usual practice pre-COVID.

Our Suicide and Self-Harm (STITCH) HIT is determining the change in A&E presentation for self-harm during COVID-19 and the long-term impact of these changes. An immediate priority is to investigate a sudden recent increase in suicides and in people presenting at emergency departments with severe mental illnesses because they can’t (or perceive that they can’t) access community services and crisis teams.

--

Investigating behaviour change

Our Active Older People (APPHLE) and Healthy Neighbourhood Environment (SHINE) HITs are investigating the impact of reduced traffic and air pollution on people's willingness to walk and cycle on local roads. This includes analysing data regarding physical activity among different population groups in response to Government exercise guidelines during lockdown. It will also include review of air quality data from a soon to be installed sensor outside the Bristol Royal Infirmary.

Our Sexual Health (SHIP) HIT are keen to analyse the effect of COVID-19 on STI rates in Bristol using routine data (both GUM, online testing and CSP). They are currently seeking capacity to do this analysis.

Our Suicide and Self-Harm (STITCH) HIT is reviewing studies into levels of self-harm and suicidal thoughts amongst population groups during COVID lockdown.

Members of our Psychosis HIT are involved in an application to collect information about mental health and COVID-19 in 40 countries using an online survey tool.

--

Co-ordinating and improving communications

Our HITs are sharing best practice in patient communications during the pandemic. This is both within HITs (using the network to develop and disseminate core communications), and between them (for example, sharing communications from different specialties and adapting).

HITs are also using their networks to disseminate new clinical guidance to relevant practitioners.

Our Perinatal Mental Health HIT is creating a new website, funded by the CCG, which will bring together all of the perinatal mental health services available across BNSSG, including Voluntary and Community Sector and NHS. It will act as a one stop shop where parents or professionals can go to access the latest information on services, easily.

Individuals for the Eating Disorders HIT have been part of working on a COVID-19 health information patient app which includes advice on symptoms, mental health and wellbeing support and signposts to validated resources. The app covers all aspects of physical and mental health.The HIT has also written a section on Eating Disorders that has been reviewed by a PPI group as part of this app (a separate Eating Disorders app will also be developed shortly).


Health Integration Teams (HITs) - COVID-19 response


Our Health Integration Teams (HITs) are responding to COVID-19 in the following main ways:

  • Developing new services
  • Evaluating service changes and investigating behaviour change
  • Co-ordinating and improving communications

The HITs can also act as networks for contacting clinicians, public health professionals, patients and academics to gather feedback on issues relevant to the COVID-19 response.For example, the Bristol Health Partners core team is sharing research requests with appropriate contacts.

To find out more, please contact Oliver Watson, Joint Chief Operating Officer (interim), Bristol Health Partners - oliver.watson@bristol.ac.uk.


Developing new services

Our Active Older People (APPHLE) HIT and Active Ageing Bristol are working with a local consortium to support the mental and physical health of older people during lockdown. This includes: Age UK Bristol newly-launched helpline; OASIS Talk telephone befriending and counselling service; support to access food and medications; development of virtual physical activities. Organisations involved include: Greenway Centre, LinkAge, Alive, Bristol After Stroke, Bristol Ageing Better, Active Ageing Bristol.

Our Movement Disorders (MOVE) HIT is developing a new pathway which will include access to a specialist neurology advice line for healthcare professionals working in the community. It will link to co-ordinated work on end of life care that is being led by Dr Kate Rush (Medical Director, Sirona care & health).

Our Stroke HIT is investigating using AI to support image interpretation and diagnosis, and also increasing telecare.

Members of our Bristol Bones and Joints HIT are working with other researchers on a project to investigate the best strategies for self-management of COVID symptoms post-hospitalisation.

Our Kidney Disease HIT is accelerating plans to establish a virtual chronic kidney disease service. This was planned prior to COVID-19 and has taken on increased importance. The project is supported by Research Capability Funding.

Our Dementia HIT has mapped service changes during COVID-19 and is supporting partners in their transition to online provision of information and support sessions. This includes the 'Dementia Friends' programme, alternative formats for social groups and establishing a new 'companion calls' service, whereby volunteers phone people affected by dementia.

Our Chronic Pain (formerly known as Integrated Pain Management) HIT has worked with Silvercloud, Vita Minds and other partners to develop electronic CBT for people with chronic pain. This HIT has also been working with colleagues in Wellspring Settlement to develop “The Virtual Hub”, funded by St Monica Trust. This brings together different organisations across Bristol to run virtual activities during the current situation caused by Covid19.Lead by Alive! activities in partnership with Active Ageing Bristol, the “Virtual Hub” will support activity classes to happen on- line or on the phone, enabling people aged 65+ in particular to still take part in their previous activities- or try new ones- whilst continuing to stay safe. This complements previous shifts in services which have included telephone befriending and arranging prescription delivery.

--

Evaluating service changes

Several of our HITs are interested in evaluating the service changes being made in response to COVID-19. We are in contact with the CCG’s Research and Evidence Team and ARC West to get a better understanding of similar evaluations and generic tools that HITs can use in evaluating their virtual consultations.

HITs are involved in mapping changes and adaptations to services in response to COVID-19 across their clinical/social care areas. This includes information on the various types of remote support and virtual healthcare being offered to patients and service users. This information is being collated and shared with others for evaluation purposes. Detailed information is available on request.

Our Bladder and Bowel Confidence HIT has surveyed health professionals from primary, secondary and pharmacy settings to investigate the service changes being made and perceived issues and opportunities (initial findings available on request). Issues identified include: A) lack of access to patients in care homes; B) concerns that interactions have become more transactional to access continence aids only, missing wider preventative opportunities and C) that a blended approach of initial face-to-face with remote follow-up appears most successful.

Our Perinatal Mental Health HIT is evaluating online, evidence-based tools for managing wellbeing during pregnancy – this is a part of a national evaluation.

Our Stroke HIT will investigate: the impact of COVID-19 lockdown on stroke survivors’ mental and emotional wellbeing and the long-term impact of the current drop in number of patients presenting with TIAs. They are also planning to explore impact of earlier hospital discharge following a stroke, (resulting from shorter length of stay) than was usual practice pre-COVID.

Our Suicide and Self-Harm (STITCH) HIT is determining the change in A&E presentation for self-harm during COVID-19 and the long-term impact of these changes. An immediate priority is to investigate a sudden recent increase in suicides and in people presenting at emergency departments with severe mental illnesses because they can’t (or perceive that they can’t) access community services and crisis teams.

--

Investigating behaviour change

Our Active Older People (APPHLE) and Healthy Neighbourhood Environment (SHINE) HITs are investigating the impact of reduced traffic and air pollution on people's willingness to walk and cycle on local roads. This includes analysing data regarding physical activity among different population groups in response to Government exercise guidelines during lockdown. It will also include review of air quality data from a soon to be installed sensor outside the Bristol Royal Infirmary.

Our Sexual Health (SHIP) HIT are keen to analyse the effect of COVID-19 on STI rates in Bristol using routine data (both GUM, online testing and CSP). They are currently seeking capacity to do this analysis.

Our Suicide and Self-Harm (STITCH) HIT is reviewing studies into levels of self-harm and suicidal thoughts amongst population groups during COVID lockdown.

Members of our Psychosis HIT are involved in an application to collect information about mental health and COVID-19 in 40 countries using an online survey tool.

--

Co-ordinating and improving communications

Our HITs are sharing best practice in patient communications during the pandemic. This is both within HITs (using the network to develop and disseminate core communications), and between them (for example, sharing communications from different specialties and adapting).

HITs are also using their networks to disseminate new clinical guidance to relevant practitioners.

Our Perinatal Mental Health HIT is creating a new website, funded by the CCG, which will bring together all of the perinatal mental health services available across BNSSG, including Voluntary and Community Sector and NHS. It will act as a one stop shop where parents or professionals can go to access the latest information on services, easily.

Individuals for the Eating Disorders HIT have been part of working on a COVID-19 health information patient app which includes advice on symptoms, mental health and wellbeing support and signposts to validated resources. The app covers all aspects of physical and mental health.The HIT has also written a section on Eating Disorders that has been reviewed by a PPI group as part of this app (a separate Eating Disorders app will also be developed shortly).


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