Objectives / Targets:



Abdominal Aortic Aneurysm Screening in North Central London:

Stakeholders, Strategy and Actions - An Uptake Communications Strategy and Action Plan 2011 to 2015 (UCSAP)

The Royal Free Hampstead NHS Trust

Section 1

Introduction

Rationale

Overall indicators of success

The NAAASP

The NAAASP Programme Vision and Objectives

Challenges to Uptake, Promotion and Communication

Screening Programmes Development in the UK

Evidence Base and Best Practice

Social Marketing Core concepts

The National Social Marketing Centre

Section 2

The Uptake and Communications Strategy

Overarching Aims for Uptake and Communications

Key Messages for Uptake and Promotion

Methodology for Delivery of the UCSAP

NCL Screening Round

The Uptake And Communications Action Plan (UCSAP)

Measuring the success of the action plan

Timeline

Evaluation

References and acknowledgements

Appendices

Appendix A – Action Plan

Appendix B – Map of Medicine – AAA Screening Pathway

Appendix B – MOSAIC Groups

Section 1

Introduction:

Rationale

This strategy and action plan have been developed in response to requests from local Commissioners in NCL and the National Abdominal Aortic Aneurysm Screening Programme (NAAASP), and in response to the challenges above the following strategic aims and objectives have been generated. It is an ambitious but achievable strategy with a clear vision of what success would look like

Overall indicators of success – by 2015 we aim to have in place:

1. Continual year on year uptake for the programme of over 70% with a marked reduction of initial and subsequent multiple DNAs (baseline to be established)

2. A Local and Sector Screening Champion with enhanced third sector co-operation and identification of the AAA “brand”

3. A  Data Intelligence informed approach to DNAs, uptake and quality.

4. A well used learning network within London to share with other National and London specific AAA programmes with specific regard to cross border issues and uptake/promotion

5. A communications plan utilising national and local level resources/partnerships that is embraced and adopted in part by the NAAASP

6. Increased opportunities available service users to make healthy choices and take up the Triple A screening offer via a wider selection of screening venues and health interventions available via referral, promotional materials, direct interface

7. Systems in place to enable regular monitoring of screening uptake and the sources of self referrals and those invited via the NAAASP SOP

8. A rolling programme of awareness and where required training for primary care and allied health professional staff on the screening programme to encourage opportunistic raising of the AAA offer and signposting

9. An established and responsive network of venues and human assets to promote AAA screening across a number of settings within NCL.

THE NAAASP - The National Screening Programme

The National Screening Committee’s Abdominal Aortic Aneurysm Screening Programme is being introduced gradually across England.

Phased implementation commenced in March 2009 and it is anticipated that coverage across England will be achieved by March 2013.

Research has demonstrated that offering men ultrasound screening in their 65th year could reduce the rate of premature death from ruptured AAA by up to 50 per cent.

Ruptured abdominal aortic aneurysm deaths account for 2.1% of all deaths in men aged 65 and over.

This compares with 0.8% in women of the same age group. The mortality from rupture is high, with nearly a third dying in the community before reaching hospital.

Of those who undergo AAA emergency, the post-operative mortality rate is around 50%, making the case fatality after rupture 82%.

This compares with a post-operative mortality rate in high quality vascular services of 3-8% following planned surgery.

Treatment is available for these patients if their medical condition permits. In most hospitals the treatment is urgent surgery which requires the attention of a vascular surgeon, as well as the skilled attention from medical and nursing staff in the operating theatre, intensive care and on the surgical ward.

The AAA screening programme aims to reduce AAA related mortality by providing a systematic population-based screening programme for the male population during their 65th year and, on request, for men over 65.

An AAA is defined as a maximum aortic diameter of 3cm or greater in the maximum antero-posterior measurement. An aortic diameter of less than 3 cm is deemed to be within normal limits.

The NAAASP Programme Vision and Objectives

The NAAASP has an established Programme Vision and Objectives which aims to reduce AAA-related mortality among men aged 65 to 74 by up to 50% through early detection, appropriate monitoring and treatment.

It does this by providing a systematic population-based screening programme for men during their 65th year and, on request, for men over 65 who have not previously been screened.

The national screening programme’s objectives are to:

• Identify and invite eligible men for screening during the year they turn 65

• Provide clear, high quality information that is accessible to all

• Carry out high quality abdominal ultrasound scans on those men attending screening according to national protocol

• Minimise the adverse effects of screening, including anxiety and unnecessary investigations

• Identify AAA accurately

• Ensure appropriate and effective management of cardiovascular risk factors identified through screening

• Ensure high quality diagnostic and treatment services

• Promote audit and research and learn from the results

The programme is underpinned by the guiding principle that screening should be effectively integrated across a pathway from invitation right through to the recording of treatment outcome. The programme aims to ensure all individuals are treated with respect and there is equitable access to screening.

All men eligible to participate in the screening programme should have access to adequate information about the potential benefits and risks of screening to enable them to make an informed decision before participating.

Vision and objectives NAAASP 2011

Challenges to Uptake, Promotion and Communication:

The NAAASP is faced with significant challenges in terms of driving uptake and promoting the delivery of AAA Screening.

These include:

1 Low Uptake Levels – until recently Uptake in the NCL programme has been low and it is perceived by the RFH programme office and the NAAASP communications and uptake leads that a significant role in the recent upswing of take up (the NCL screening offer from 54%rising from to circa 62%) has been national level press lead story on the AAA programme (Daily Mail 2011) and linked announcement of the reiteration by the Secretary of State for Health the Rt Hon Andrew Lansley MP that AAA is a core screening programme with a national expectation for ubiquitous roll out by 2013.

2 Did Not Attends - As with many other screening programmes the NCL AAA screening programme is encountering significant DNA levels, the scale of which is difficult to assess given the relatively unsophisticated levels of reporting and scrutiny available through the programme ICT and Data solution Northgate. Currently NAAASP Standard Operation Procedures do not allow for a call recall system outside of the sending of DNA reminder letters. Whilst anecdotal evidence from other programmes exists for the efficacy of using DNA reminders repeatedly and over time whittling down and addressing DNAs, it is a time and resource expensive procedure ( both in terms of resource generation and

3 Overall System Change - The Nicholson Challenge and related organisation flux in Public Health, NHS and Local authority commissioning and provider structures resource bases and priorities have introduced a new level of complexity to uptake promotion and communication systems. Specifically with the rapid pace of change in existing delivery structures, shifts in responsibilities, overall national and local reductions in available uptake and communications resource and areas of responsibilities towards Liberated NHS structures post April 2013. Recent Department of Health Policy ( 2010 onwards) on what is appropriate spend (Circa £1000 ) and direction for communications have also acted as impediments to systems developed within health which have in the main relied on mass communications and campaigns to raise generic awareness at a national scale and lower level campaigns to generate local interest.

4 “Consumer awareness”- Low “consumer” ( i.e. patient and Health and social care economy ) awareness and identification of the AAA offer and NAAASP brand is overall low within the target demographic. Despite occasional coverage of AAA and related conditions the awareness of screening offer and specifics of conditions is certainly not at a level where public awareness can be readily mobilised.

5 Lack of Third Sector Champions - In comparison with other screening offers (both cancer and non cancer) the core issues and impacts of AAA are not significantly understood or recognised. In terms of third sector support the Circulation Foundation (an off shoot of the Vascular Society of Great Britain and Ireland) is a committed and innovative organisation, but cannot hope to have the same “footprint” ( overall awareness of the general public, brand recognition or embedding within cultural tropes, influence and so on) as other more established charities such as Asthma UK, Macmillan, Cancer Research, Breakthrough Breast Cancer, Diabetes UK, Alzheimer’s UK, RNIB etc and many more health sector charities or organisations. Accordingly status and understanding of the condition is low and the balance of offer versus demand ( the dynamic inherent in all screening offers between general populace request or demand for service access and information, and the need for services to actively promote their offer and engage the p[populace) needs to be addressed in order for the condition and treatment options to be generally understood and this relative risks and benefits of AAA screening to be delivered in a supportive non coercive manner.

6 Overall Health Service Championing of the AAA offer in London – Outside of the programme and commissioning team awareness of the AAA offer within the health and social care economy is low. General primary care awareness of the programme is patchy, with significant support in some areas of the UK (in particular the Gloucester area from which the NAAASP originated) and little in others, resulting in an overall push to take up or consider AAA screening as a routine health intervention offered to men in the 65th year and over. Currently the programme is not represented in QOF and until this occurs the financial incentive to engage with and promote is not present. We do not at present have an overarching “champion” for AAA screening either in NCL or London as a whole.

7 The national phased roll out - The iterative roll out of the programme has created areas of programme availability and areas where no programme exists. With the advice given to engage with AAA scans in areas of non availability via primary care and GP to acute referrals there is a functioning work around, but as yet the London Network has not achieved full maturation. With the South West and North Central London programmes up to speed and other areas either commencing shortly or still planning their programmes, there is a need to ensure that the London offer is advanced in a collegiate and collaborative manner and that accordingly this uptake promotin and communications plan is scalaeable to the other areas of London and can provide useful material to augment the NAAASP communications offer in support of the national Go Live in April 2013.

There are wider issues affecting general screening access in the UK which are worth examining here and to which specific responses are required in order for a mass screening programme to achieve success. Multiple barriers exist to uptake of screening programmes .

The following table is adapted from the COI and CSL research into barriers to uptake of Cancer and Non Cancer Screening access programme 2009

Table 1

|Summary of audience with low uptake and | |

|Barriers to screening | |

|1.     1 To co-ordinate the dissemination | |

|and further develop a range of materials to|Develop a partnership to better coordinate screening promotion programmes. |

|promote AAA screening services to service |Ensure all cohort service users are (if and when appropriate) regularly offered information |

|users in NCL localities and develop in line |and access to AAA screening services in their locality areas. |

|with the 2013 national roll out. |Ensure all relevant patient facing National and London AAA programme information is collated |

| |and available to address issues of “out of borough” and cross border service access prior to |

| |2013. |

| |Establish a segmented, time specific and realistic action plan to promote uptake and |

| |communications |

| | |

| |To prepare relevant health and social care partners for their roles is supporting the |

| |programme roll out |

| |develop a model that the NAAASP can utilise adapt or adopt for deployment outside of NCL |

| |address the large numbers of DNAs and low take up of the programme in advance of the main |

| |national roll out in 2013 and beyond. |

|2.    2 To provide access to screening | |

|programmes for service users in line with |Identify and support the role of primary care contractors and voluntary sector agencies in |

|screening rounds |service provision and or signposting for service users alongside existing networks of |

| |provision |

| | |

| |Deliver a high quality, assured and patient focussed value for money AAA screening programme |

| |for NCL |

| | |

| |increase the programme uptake rate from 54% to 70% in the run up to realisation of the |

| |national programme 2013 |

| | |

|3.   3 To promote the importance of AAA | |

|screening as part of the overall Public |Promote awareness and collaboration with the local and national programme with a wide array |

|Health and Primary Care offer |of professional, statutory and non statutory stakeholders (Primary care, Local Authorities, |

| |third sector, allied health professionals etc) |

| | |

| |Proactively promote the importance of a screening for service users and key clinical and |

| |other professional groups. |

| |Raise the profile of the importance of screening in relationship to maintaining a healthy |

| |lifestyle. |

| | |

| |Recruit and deploy a clinical and or professional screening champion (outside the programme |

| |clinical team) with experience of leading/influencing Primary Care practitioners to deliver |

| |screening both in and outside of London. |

| |Ensure AAA and related screening offers are represented within system operational, reporting,|

| |scrutiny and commissioning arrangements – CSP, Health and Wellbeing Boards QUOF, QIPP et al |

| |deliver target and promotional sessions supporting the programme in all localities of NCL |

| |before April 2013 to ensure stakeholder preparedness and drive uptake increase |

|4.   4 To provide access to a range of | |

|screening opportunities and materials to |Raise the profile of the importance of AAA screening for specific targeted communities |

|support access to programmes for diverse | |

|communities |Make available differentiated access resources and establish language and access support for |

| |the NCL programme |

| | |

| |Adopt and use existing cohort methodologies such as Mosaic ( SEE APPENDIX C) to segment the |

| |target cohorts and develop appropriate uptake responses to fit with multiple sub groups |

| |(Silver Surfers, Wetherspoons Generation etc) |

| | |

| |Map community assets and develop suitable outreach capability to engage and recruit them. |

| | |

| |Ensure internal programme communications ( within the screening session – reulsts and |

| |treatment options) are suitably developed and nuanced to improve user experience assist |

| |choice in a non coercive manner and allow for service users to balance risk and benefit for |

| |procedures post screen –ensure deployment of NAAASP risk communication tool when available. |

| | |

| |augment the reach of coterminous agendas and services seeking to expand the take up of |

| |screening and related health service offers in NCL. |

| | |

| |provide sustainable and future proofed uptake engagement and communications capacity across |

| |all NCL localities that adequately balances and addresses unique local circumstances whilst |

| |delivering the local and national programme aims |

|5.   5 Increase awareness and understanding | |

|of the health benefits of screening uptake, |Run a rolling programme of training for staff groups working with service users on the |

|in order to create a culture of change. |benefits of screening programmes and referral/self referaal options |

|6.   6 Develop an integrated care pathway | |

|and clinical guidelines for referrals into |Develop an integrated NCL/London/National facing care pathway for increasing self referrals |

|screening services for clinicians and |into screening |

|community assets. |Disseminate national policy and guidance NICE, VSGBI, etc in support of AAA screening |

|8.    7 Empower local communities to make | |

|choices regarding screening uptake address |Develop a partnership to promote an environment in which is it easier to access /normalised |

|the barriers to access and address service |to access screening services |

|user experiences. |Develop a plan to produce and communicate consistent messages about screening to the public |

| |and to staff groups |

| |Scope local /national media ( print/web/broadcast) in line with NAAASP steer to work up |

| |channels and messages prior to 2013. |

|9.   8  Address need by identifying and | |

|acknowledging cultural, religious and gender|Develop an intelligence lead plan to produce and communicate consistent messages about |

|issues affecting those individuals who |screening to the public and to staff groups |

|would benefit most from accessing screening | |

|services offers |Develop low cost high spread promotional resources ( web 2.0 etc) to ensure scaleable |

| |promotion is delivered in synergy with community development and stakeholder enagement. |

| | |

| |Capitalise on core demographic cultural assets and positive actions to support the programme |

| |– ie Use the Silver Surfers” |

| | |

| |Capture and develop case studies portfolio and advocates to deliver AAA to any community sub |

| |group or wider network |

|10. 9  Promote an environment and culture | |

|where screening is de stigmatised  and |Ensure that the wider community in involved in the future implementation of the strategy, to |

|screening interventions are the norm. |ensure ownership participation and maximise community advocacy |

| | |

| |Run a rolling programme of training/awareness for staff groups working with services users on|

| |the overall principles and purposes of screening |

| |Ensure that staff in primary care are trained, resourced and supported to manage refer and |

| |support service users in the first instance in the primary setting, making use of the range |

| |of community based interventions available |

| |Develop a plan to educate and develop the skills of the whole population to enable the |

| |population to influence and access coordinated screening promotion programmes. |

|11. 10 Ensure that all actions are based on | |

|reliable evidence and that evaluation is an |Identify an evidence-based service delivery model for the delivery of screening in the |

|integral part of all work. |Consortia |

| |Work with primary care to encourage referrals, opportunistic discussion of screening offers |

| |in line with screening rounds and early identification of patients who would benefit from |

| |referrals. |

| |Develop an integrated care pathway across primary, secondary, tertiary and community care |

| |services |

| |Analyse and through system development reduce session DNA rates from 50% to 30% |

Key Messages for Uptake and Promotion

Key messages for implementing this strategy (through the action plan) are in line with good practice derived from the national level resources, social marketing principles and address the key themes of screening campaigns:

1. Screening is a serious issue – with life threatening consequences if we do not get better access available to all who require it (ALL)

2. Taking up a screening offer is an important and vital step in looking after your health ( individuals)

3. Individual’s need to have the right information to make a decision on the relative benefits and risks of screening ( All)

4. It is widely believed that Screening doesn’t have merit as a clinical approach IT DOES HAVE AN ENORMOUS CONTRIBUTION TO MAKE!! (ALL)

5. Screening uptake is a major challenge for the NHS and the community and we all have to take action if we are going to successfully address it (ALL)

6. NHS, Local authority, third sector and other organisations are working together to deliver screening and improve uptake((ALL)

7. The costs to individuals and the NHS and to all of us can be very serious if we do not take up the offers we are given (ALL)

8. We need you to support the screening strategy by seeing how you can help with the screening strategy (clinical professionals)

9. We need you to help us to act now to address screening uptake levels in NCL and the UK (Political, community leads, individuals)

10. We need you to help us to act now to address screening in Partner areas (Commissioning Leads in local NHS and authorities, Allied health professionals etc)

Methodology for Delivery of the UCSAP:

NCL Screening round

To encourage a proactive management of capacity and the optimal use of uptake and promotion resource a “screening round has been established. Broadly speaking this allows for the targeting of materials within specific NCL localities within the context of general screening delivery available throughout NCL.

The programme for North Central London will roll out to the following areas:

|NCL Locality area |Date screening invites go out |2012/2013 Date screening starts |

|Camden |Tbc | |

| |tbc | |

|Barnet | | |

| |tbc | |

|Enfield | | |

| |tbc | |

|Haringey | | |

| |tbc | |

|Islington | | |

The Uptake And Communications Action Plan (UCSAP)

The UCSAP broadly addresses four groups and has four overlapping core themes

This communications and uptake programme is specifically designed to address the current low levels of enagement wihyt our core stakeholders ranging from our patients and their families and communities and primary care and other allied health and social care representatives and organisations. There are three phases for the overall communications programme within which these initiatives sit.

|Group |Core actions |

|The Public (Patients and their families) |Analysis of take up/ efficacy of communications access to |

| |screening, development of refreshed communications offer. |

|Community Partners |Promotion of AAA – provision of revised materials and |

| |briefings |

|Professional Partners |Promotion of AAA – provision of revised materials and |

| |briefings |

|Media Partners |Development and delivery of appropriate messages through |

| |available channels |

Core Action tables

To address the needs delivery action plan has three specific components

1 General Uptake and Promotion - patient and community facing

2 Primary Care Engagement, Prior During and after screening round

3 Addressing Barriers, Health and Social Care Workforce Development/Awareness & Coterminous Agendas

The Core Actions tables below capture the basic methodology for delivering against the action plan.

|Title |AAA Screening Programme UCSAP Strand A Core Actions |

|AAA Screening Themes this delivers against: |General Uptake and Promotion |

|Project Lead |Hilary Sales |

|Objectives (these are| |

|the key deliverables |A Analysis of population and system factors affecting take up of offer and DNA rates |

|required for the |B Assessment of screening round and segmentation by locality/core communities to be accessed |

|project to be |C Creation of deployment plan for public engagement supported by Health and social care information networks et |

|successful) |al - segmented to 3 Wave response(Pre, mid and post screening round) per locality per phase of programme ( |

| |community leaders/special interest groups etc) and additional advisory comms to third sector advocates |

| |D Capture of positive case studies and human interest examples to drive media campaign through local/national |

| |channels |

| |E Engagement of patient voice in design of delivery phase – in line with national programme focus group response.|

| |F Round launch event - small event to publicise “spearhead screening round 2012 with build up to 2013 National |

| |rollout – if budget available |

| |G Phased send of comms packages via available channels community groups according to area and take up rates |

| |H rolling evaluation of phases and screening round – feedback to sectors and practices on penetration |

| |I Remedial communications push as per D for low penetration areas |

| |J LD/special needs access requirements to encourage differentiated needs service user take up of screening offer |

| |K End of round comms penetration assessment – present findings to NHSL and NAAASP |

|Budget (if relevant) |TBC |Proposed timescales |Ongoing Nov 11 |

|Title |AAA Screening Programme Comms strand B Core Actions |

|AAA Screening Themes this delivers against: |Addressing Barriers, Health and Social Care Workforce Development/Awareness |

| |Coterminous Agendas |

|Project Lead |Hilary Sales |

|Objectives (these are| |

|the key deliverables |A Assessment of screening round and segmentation by region/access/Health needs and mapping of Health and Social |

|required for the |care resources and workforce |

|project to be |B Creation of engagement plan for wider health and social care in sync with screening round per locality( |

|successful) |Statutory and non statutory providers) and additional advisory comms to LA and PCT/CCG leads with coterminous |

| |agendas ie PH Pharmacy campaigns, optometry services, dentists etc |

| |C Verification of contact lists for hardcopy and e communications – script generation for follow up with ”fellow |

| |traveller” services |

| |D Script and FAQ developed to facilitate enquiries and courtesy call follow ups |

| |E Screening Round launch presentations - small event/presentations to publicise AAA offer in context of local |

| |PH LA 3rd sector and non GP primary care services - Health and Wellbeing Boards etc |

| |F Phased send of comms packages via available channels to LMCs and CCGs and practices according to plan (Action |

| |A) |

| |G Rolling evaluation of phases and screening round – feedback to sectors and partners on penetration |

| |H Remedial communications push as per F for low penetration areas |

| |I End of round comms penetration assessment – present findings to NHSL and NAAASCP |

| |J Feedback to individual partner organisations on programme penetration by locality. |

|Budget (if relevant) |TBC |Proposed timescales |Ongoing from Nov 11 |

|Title |AAA Screening Programme Comms Strand C Core Actions |

|AAA Screening Themes this delivers against: |Primary Care Engagement, Prior During and After screening round |

|Project Lead |Hilary Sales |

|Objectives (these are| |

|the key deliverables |A “mini” consultation on info and comms content and channel issues with GP practices and feedback into overall |

|required for the |programme strand |

|project to be |B Assessment of screening round and segmentation of practices – heuristic assessment by region/access/Health |

|successful) |needs |

| |C Creation of deployment plan for GP engagement - segmented to 3 Wave response(Pre, mid and post screening |

| |round) per practice per phase of programme ( GP/Practice Managers/Practice Nurses) and additional advisory comms |

| |to LMCs and emergent CCG stakeholders |

| |D Verification of contact lists for hardcopy and e communications – script generation for follow up with |

| |practices |

| |E Script and FAQ developed to facilitate enquiries and courtesy call follow ups |

| |F Round launch event - small event to publicise “spearhead screening round 2012 with build up to 2013 National |

| |rollout – if budget available |

| |G Phased send of comms packages via available channels to LMCs and CCGs and practices according to plan (Action A|

| |H rolling evaluation of phases and screening round – feedback to sectors and practices on penetration |

| |I Remedial communications push as per D for low penetration areas |

| |J End of round comms penetration assessment – present findings to NHSL and NAAASP |

|Budget (if relevant) |TBC |Proposed timescales |Ongoing from Nov 11 |

In addition to these theme actions a broader action plan has been developed. – See appendix A

Measuring the success of the action plan

Performance monitoring will be collected each quarter by the RFH AAA Screening programme and submitted to commissioners who have overall responsibility for ensuring the uptake and implementation of the UCSAP and commissioning the impact assessment and evaluation of this strategy. The Action Plan will also be subject to annual monitoring as part of the annual commissioning assessments which includes a requirement that:

• Partners receive appropriate information

• Communities are engaged and informed

• Men including those at targeted by the screening round – are involved and informed

• Clinical leaders and professional groups are engaged and appropriately briefed

• There is a programme strategy for dealing with the media in line with NHSL and NCL provisions especially with regards to roll out developments supporting the national development in 2013

Timeline

|NCL AAA Screening Programme Campaign Phases and Actions | |

|1.     1 To co-ordinate the dissemination and further develop a range of materials to |Develop a partnership to better coordinate screening promotion programmes. |

|promote AAA screening services to service users in NCL localities and develop in line with|Ensure all cohort service users are (if and when appropriate) regularly offered information and access to AAA screening |

|the 2013 national roll out. |services in their locality areas. |

| |Ensure all relevant patient facing National and London AAA programme information is collated and available to address issues|

| |of “out of borough” and cross border service access prior to 2013. |

| |Establish a segmented, time specific and realistic action plan to promote uptake and communications |

| | |

| |To prepare relevant health and social care partners for their roles is supporting the programme roll out |

| |develop a model that the NAAASP can utilise adapt or adopt for deployment outside of NCL |

| |address the large numbers of DNAs and low take up of the programme in advance of the main national roll out in 2013 and |

| |beyond. |

|2.    2 To provide access to screening programmes for service users in line with | |

|screening rounds |Identify and support the role of primary care contractors and voluntary sector agencies in service provision and or |

| |signposting for service users alongside existing networks of provision |

| | |

| |Deliver a high quality, assured and patient focussed value for money AAA screening programme for NCL |

| | |

| |increase the programme uptake rate from 54% to 70% in the run up to realisation of the national programme 2013 |

| | |

|33.  3 To promote the importance of AAA screening as part of the overall Public Health and| |

|Primary Care offer |Promote awareness and collaboration with the local and national programme with a wide array of professional, statutory and |

| |non statutory stakeholders (Primary care, Local Authorities, third sector, allied health professionals etc) |

| | |

| |Proactively promote the importance of a screening for service users and key clinical and other professional groups. |

| |Raise the profile of the importance of screening in relationship to maintaining a healthy lifestyle. |

| | |

| |Recruit and deploy a clinical and or professional screening champion (outside the programme clinical team) with experience |

| |of leading/influencing Primary Care practitioners to deliver screening both in and outside of London. |

| |Ensure AAA and related screening offers are represented within system operational, reporting, scrutiny and commissioning |

| |arrangements – CSP, Health and Wellbeing Boards QUOF, QIPP et al |

| |deliver target and promotional sessions supporting the programme in all localities of NCL before April 2013 to ensure |

| |stakeholder preparedness and drive uptake increase |

|4.   4 To provide access to a range of screening opportunities and materials to support | |

|access to programmes for diverse communities |Raise the profile of the importance of AAA screening for specific targeted communities |

| | |

| |Make available differentiated access resources and establish language and access support for the NCL programme |

| | |

| |Adopt and use existing cohort methodologies such as Mosaic ( SEE APPENDIX C) to segment the target cohorts and develop |

| |appropriate uptake responses to fit with multiple sub groups (Silver Surfers, Wetherspoons Generation etc) |

| | |

| |Map community assets and develop suitable outreach capability to engage and recruit them. |

| | |

| |Ensure internal programme communications ( within the screening session – reulsts and treatment options) are suitably |

| |developed and nuanced to improve user experience assist choice in a non coercive manner and allow for service users to |

| |balance risk and benefit for procedures post screen –ensure deployment of NAAASP risk communication tool when available. |

| | |

| |augment the reach of coterminous agendas and services seeking to expand the take up of screening and related health service |

| |offers in NCL. |

| | |

| |provide sustainable and future proofed uptake engagement and communications capacity across all NCL localities that |

| |adequately balances and addresses unique local circumstances whilst delivering the local and national programme aims |

|5.   5 Increase awareness and understanding of the health benefits of screening uptake, in| |

|order to create a culture of change. |Run a rolling programme of training for staff groups working with service users on the benefits of screening programmes and |

| |referral/self referaal options |

|6.   6 Develop an integrated care pathway and clinical guidelines for referrals into | |

|screening services for clinicians and community assets. |Develop an integrated NCL/London/National facing care pathway for increasing self referrals into screening |

| |Disseminate national policy and guidance NICE, VSGBI, etc in support of AAA screening |

|8.   7 Empower local communities to make choices regarding screening uptake address the | |

|barriers to access and address service user experiences. |Develop a partnership to promote an environment in which is it easier to access /normalised to access screening services |

| |Develop a plan to produce and communicate consistent messages about screening to the public and to staff groups |

| |Scope local /national media ( print/web/broadcast) in line with NAAASP steer to work up channels and messages prior to 2013.|

|9.    8 Address need by identifying and acknowledging cultural, religious and gender | |

|issues affecting those individuals who would benefit most from accessing screening |Develop an intelligence lead plan to produce and communicate consistent messages about screening to the public and to staff|

|services offers |groups |

| | |

| |Develop low cost high spread promotional resources ( web 2.0 etc) to ensure scaleable promotion is delivered in synergy with|

| |community development and stakeholder enagement. |

| | |

| |Capitalise on core demographic cultural assets and positive actions to support the programme – ie Use the Silver Surfers” |

| | |

| |Capture and develop case studies portfolio and advocates to deliver AAA to any community sub group or wider network |

|10.  9 Promote an environment and culture where screening is de stigmatised  and screening| |

|interventions are the norm. |Ensure that the wider community in involved in the future implementation of the strategy, to ensure ownership participation |

| |and maximise community advocacy |

| | |

| |Run a rolling programme of training/awareness for staff groups working with services users on the overall principles and |

| |purposes of screening |

| |Ensure that staff in primary care are trained, resourced and supported to manage refer and support service users in the |

| |first instance in the primary setting, making use of the range of community based interventions available |

| |Develop a plan to educate and develop the skills of the whole population to enable the population to influence and access |

| |coordinated screening promotion programmes. |

|11. 10  Ensure that all actions are based on reliable evidence and that evaluation is an |Identify an evidence-based service delivery model for the delivery of screening in the Consortia |

|integral part of all work. |Work with primary care to encourage referrals, opportunistic discussion of screening offers in line with screening rounds |

| |and early identification of patients who would benefit from referrals. |

| |Develop an integrated care pathway across primary, secondary, tertiary and community care services |

| |Analyse and through system development reduce session DNA rates from 50% to 30% |

|ITEM |AAA Screening |Core Actions |Lead |Implement by (when) |

| |Programme UCSAP| | | |

| |Strand A Core | | | |

| |Actions | | | |

|Local Press (NCL) |November 2011 |Barnet 55 Plus Forum Article - Melvyn|NCL prog approached via National programme to assist and |Story finalised – to be sent out via Forum. Presentation/drop in |

| | |Gamp |advise on a community facing article from the Barnet 55 plus |screening sessions to BOPA and other service users groups in New year|

| | | |forum. |is being arranged. |

|Local Communications ( |November 2011 |Audit of Media penetration to date on | |Case studies and patient focussed stories under development with |

|Royal Free Hospital) | |local level details – overall take up | |assistance of RFH communications and AAA |

| | |of stories has been low. | |

| | | |review-private-eye-%E2%80%93-first-50-years-z-adam-macqueen |Support screening round by precursor communications campaigns to |

| | | | |professional stakeholders and service user facing communications( |

| | | | |Before, during and after the screening round as appropriate) |

| | | | | |

| | | | |Use of patient / public facing internet sites from PCTs and NHS |

| | | | |Trusts - information |

| | | | | |

| | | | | |

| | | |Royal Free tackles the roots of major health |Production of differentiated media resources/ messaging for the |

| | | |Aug 10, 2010 ... Abdominal aortic aneurysm (AAA) screening |programme for diverse service user communities |

| | | |offered to men at age 65. This involves a simple ultrasound | |

| | | |test to detect a condition most ... |Multiple language/reading ability/LD sensitive resources |

| | | |royalfree.nhs.uk/default.aspx?top_nav_id=2&tab... |Outreach and support training for key worker support |

| | | | |groups/PALS/Patient Experience |

| | | |Our patient population | |

| | | |File Format: PDF/Adobe Acrobat |Assessment of segment penetration for each media release/support |

| | | |o leading the abdominal aortic aneurysm (AAA) national |product |

| | | |screening programme for men o providing opportunistic | |

| | | |childhood vaccinations o implementing a risk ... | |

| | | |royalfree.nhs.uk/pdf/Our-patient-population.pdf |Develop stakeholder segmented media for specific channels: |

| | | | | |

| | | | |GP packs /REFERRAL FORMS |

| | | |Men aged 65 – we need you! - News archive | |

| | | |Men aged 65 – we need you! posted 17/08/2009 expires |Comms/’Press releases and stories to be developed – deployed |

| | | |17/11/2009. Morris Hazan found out he had an aneurysm | |

| | | |completely by chance. Invited to attend the Royal ... |Mapping and use of existing patient information channels e.g. |

| | | |royalfree.nhs.uk/default.aspx?top_nav_id=2&tab... |Freepress at the RFH and equivalent hospital LBC and NCL area NHS |

| | | |New professional and patient facing web prescence under |and LA magazines which are sent to members / patients etc – RFH comms|

| | | |development | |

| | | | | |

| | | | |Capture of good news stories/case studies |

| | | | | |

| | | | |Celebrity Screening - Identification of MOSAIC segmentation high |

| | | | |profile campaign – High profile national level notables offered |

| | | | |screening and photo op to promotes NAAASCP and local iteration |

| | | | | |

| | | | |Segmented according to social classification and potential coverage |

| | | | | |

| | | | |Local VIPs |

| | | | |National VIPs – offer to significant Royal and political personages |

| | | | |House of Lords |

| | | | |House of commons |

| | | | |All local authority counsellors in NCL areas - briefing or |

| | | | |invitation as appropriate |

Appendix B MAP OF MEDICINE AAA SCREENING PATHWAY

[pic]

APPENDIX C - Mosaic groups

|Mosaic Group |Description |

|A03 Corporate Chieftains |Successful managers living in very large houses in outer suburban locations |

|F39 Dignified Dependency |Older people living in crowded apartments in high density social housing |

|E30 New Urban Colonists |Young professionals and their families who have gentrified older terraces in pre 1914 |

| |suburbs |

|D27 Settled Minorities |Multi-cultural inner city terraces attracting second generation settlers from diverse |

| |communities |

|E34 University Challenge |Halls of residence and other buildings occupied mostly by students |

|F38 Tower Block Living |Singles, childless couples and older people living in high rise social housing |

|E33 Town Gown Transition |Older neighbourhoods increasingly taken over by short term student renters |

|E28 Counter Cultural Mix |Neighbourhoods with transient singles living in multiply occupied large old houses |

|A01 Global Connections |Financially successful people living in smart flats in cosmopolitan inner city locations|

|F36 Metro Multiculture |High density social housing, mostly in inner London, with high levels of diversity |

|E29 City Adventurers |Economically successful singles, many living in privately rented inner city flats |

|A02 Cultural Leadership |Highly educated senior professionals, many working in the media, politics and law |

|F35 Bedsit Beneficiaries |Young people renting hard to let social housing often in disadvantaged inner city |

| |locations |

|I48 Old People in Flats |Older people living in small council and housing association flats |

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