Anticipatory Care Programmes
The national Anticipatory Care Programme includes Keep Well and Well North. Settings-based and population-based approaches have been introduced to support the delivery of Keep Well and Well North.
Keep Well
Keep Well is an example of anticipatory care in practice. It was developed as part of plans to tackle health inequalities in Scotland in 2006. The Keep Well model aims to increase the rate of health improvement in 45-64 year olds in areas of greatest need. It focuses on cardiovascular disease and the main associated risk factors, in particular blood pressure, cholesterol, smoking and diabetes. Treatments and referral to community and other NHS and voluntary services are offered, with regular monitoring and proactive follow-up. Resources are targeted where they are needed most – that is in areas where the risk of ill health is high.
The programme is operating in four waves across 10 of the 14 territorial health boards in Scotland with each wave commencing at a different time. Wave 1 began in 2006/07; Wave 2 2007/08, Wave 3 2009/2010 and Wave 4 2009/2010.
Well North
Well North is an anticipatory care test site designed to improve the health of people experiencing health inequalities in remote and rural areas in the North of Scotland, with a particular focus on early intervention with 40-65 year olds at higher risk of coronary heart disease and diabetes.
Settings-based approach
Keep Well and Well North have primarily focussed on GP practices as the route to deliver targeted health checks. However more recently alternative approaches have been tested to engage and deliver health checks to support the delivery of Keep Well and Well North. These alternative settings include: the testing of approaches in Community Pharmacy, the Scottish Ambulance Service through a mobile paramedic model in remote and rural areas and partnerships between Community and Voluntary Sector Organisations and Anticipatory Care being developed.
Population-based approaches
In addition to targeting using SIMD data (targeting the 15% most deprived areas) it has been necessary to target specific high risk populations irrespective of location. This has led to the development of a targeted population approach. Across local NHS Boards services have been designed around the needs of individuals including; those with long term conditions, mental health issues, learning disabilities, populations of specific ethnicity, travelling and homeless populations and those in prison.
Reviewed 20 April 2010