1. Stephanie Best PoWIS Rural Health PhD Student Dr Fiona Williams Research Manager, IRH Highlights on Rural Health Innovation in Wales

2.  From the Latin innovatus meaning to renew or change in -"into" and novus -"new"  Majority of innovation is derived by inspiration from others – reinvention  A “good idea” is not enough  Spread of innovative rural health and social care is dependent on sharing knowledge What is Innovation in Rural Health and Social Care? Access, Integration, Community Cohesion and Engagement

3. The Process of Innovation Access, Integration, Community Cohesion and Engagement Innovati on Idea Actio n

4. Aims  Stimulate and support innovative and sustainable solutions  Develop and test new models of integrated, sustainable working  Strengthen local ownership, engagement and rural networks  Support joint workforce training and developments  Identify and share examples of good practice to inform service delivery Rural Health Innovation Projects Access, Integration, Community Cohesion and Engagement

5. Rural Health Innovation Projects Designed for Competence Community Support Networks Telerehabilitatio n Capable Coping Communities Palliative Care Service Redesign Sp&L Therapy in a bag E Xray Link Nurse Led MIU IT Paramedics Rural Carers Recognition Rural Carers Survey Innovative Rural Pharmacies Outreach Mobile Units Third Sector Coordination Care Farming Diversity of Projects Access, Integration, Community Cohesion and Engagement

6.  Tight timescales  Procurement  New referral routes  Assessment of small client populations Challenges Access, Integration, Community Cohesion and Engagement

7.  The need to embed evaluation frameworks  Measuring the unquantifiable  Integrated working  Benefits of a good network  The need to share outcomes What has been learnt? Access, Integration, Community Cohesion and Engagement

8.  Increase understanding of the practicalities of implementing improved service delivery in a rural context  Strategic approach to a different way of working:  Intertwined – wider strategic framework  Focus on geographically-based initiatives  Not ‘bolt-on’ initiatives  Evaluating the ‘learning’ Development Sites Access, Integration, Community Cohesion and Engagement

9. Overview: Hywel Dda Access, Integration, Community Cohesion and Engagement Access Community cohesion Integration Crymych Joint delivery systems – transport Community networks established Service maps redrawn – local intelligence Integrated planning & delivery teams Integrated Workforce Plan Greater use joint care packages Gap analysis – identify lack alternative care

10. Overview: Powys Access, Integration, Community Cohesion and Engagement Rural Health Practitioner Governing Framework Telehealth & telecare services Citizen & stakeholder engagement Powys-wide Agreed role profiles Training programme Identified ‘champions’ Emphasis on Mental Health Plan for ‘roll out’ as appropriate Systems of engagement at local level Mapping exercise Tier 1 services initiated

11.  Perceptions of good and poor access – challenging our understanding of access issues  Rural isolation – reaching people (community intelligence)  The role of telehealth and telecare opportunities What has been learnt? Access Access, Integration, Community Cohesion and Engagement

12.  Locality working – understanding the interface between community and primary health care services  Workforce – potential impacts on planning What has been learnt? Integration Access, Integration, Community Cohesion and Engagement

13.  Understanding the third sector and civil society – developing relationships  Access to information  Confidentiality issues and concerns  Flexibility – working with the community dynamic What has been learnt? Community Cohesion & Engagement Access, Integration, Community Cohesion and Engagement

14.  Project activities and outputs are still ongoing  Impacts are difficult to disentangle from related activities  Useful learning achieved through the project process to date – potential to shape services  Basis of framework for evaluation and critique in the medium-longer term Challenges and opportunities Access, Integration, Community Cohesion and Engagement

15.  Early days  The Rural Health Plan has provided a ‘lens’ for observation  Initiating a culture shift in service provision  Generating the evidence-base - a need for ongoing monitoring, review and evaluation  Wales is on the international stage for rural health and social care provision The “so what” slide Access, Integration, Community Cohesion and Engagement