Project Background

The idea for the Jigsaw project developed from conversations between COPE Scotland and the lead GP for the local Cluster around their experiences of supporting people with mild but enduring mental ill health which had no immediate solution from recognised evidence-based interventions as often issues were so complex as well as complicated that a ‘mechanical’ health intervention approach would not work. To test this idea further, a community of interest focus group was held including the voices of Lived experience, third sector, patient experts and the local cluster lead Dr Peter Cawston. The outcome of this informed an application to the Primary Care Transformation fund which was supported by Glasgow City HSCP and funded by Scottish Government.

Aim

To support the health and wellbeing of people and families in Drumchapel and Yoker by improving connections between primary care, mental health services and community assets, and to share the learning across Scotland and beyond.

Objectives

Establish a GP-cluster led steering group and partnership initiative to co-design new pathways of intervention in mental health involving GP’s, Community Groups, the Voices of Lived experience and the third sector.

Co design a new ‘Jigsaw Toolkit’ which offered a visual reference for different stakeholders to understand each other’s perspectives around issues of mental wellbeing

Improve mapping of assets and sharing intel with GP’s in order they can make better use of community and third sector assets

Recognise the inequality issues and inverse care law as applies to the people in the target group and ensure action taken does not widen the gap

Seed fund ideas arising from communities of interests themselves to increase and or build on existing community assets

Impact

• People have an improved experience of integration of primary and community-based services

• Reduction in appointments as individuals are making more use of community-based services

• There is a new understanding and experience of Shared Decision making

• GP’s have a new model of working

• Community resources notice an increased uptake of what they offer

• The Community has more confidence to explore self-reliant groups
• There are new relationships between primary care and the third sector and new opportunities to explore joint funding bids

What was achieved?

1 – Readiness to change

The project highlighted a real enthusiasm and willingness from all stakeholders to explore change and new ways to build connections:

• GP’s held new conversations with Primary and Community health teams and addiction services about challenges, opportunities and referral pathways and new understandings and ways of connecting are being explored
• GP’s invited third sector and community groups to lunch with them once a week, to share what was happening, build connections and remain in the surgery for the remainder of the afternoon to connect with others visiting the surgery that day
• Third sector services responded positively to building improved connections and signposting/referral pathways between what they do and primary care

2 – Structure and Governance

• A GP led multi partner stakeholder steering group was established to oversee the project
• Within GCHSCP there were regular updates of work being done and reporting of spending against targets
• A funding application subgroup was set up to oversee the administration of the seed fund, reporting to the steering group who reported back to HSCP
• To ensure the voices of lived experience were involved in helping shape the direction of travel there were many engagement activities the results of which were fed into the steering group

3 – Information and Health Services

A significant amount of Jigsaw was around understanding need in order that the information people were looking for could more easily be found

• Focus groups with stakeholders informing development of Jigsaw Lids
• Courageous conversations between GP’s and voices of lived experience to co design new information sheets on issues of low mood and anxiety
• Development and launch of booklets what’s in Drumchapel for you and yours and One for Yoker and the Dumbarton Rd Corridor
• Information sessions to promote the ALLIS search engine
• A community connection event was helped to link the public to services they identified as helpful to promote mental wellbeing, with additional emphasis on tackling inequality issues of fuel and food poverty

For more information on the Jigsaw project we have attached two reports, one by Dr Peter Cawston and one by COPE Scotland sharing their perceptions as a piece of the puzzle. A final report is in production and will be available soon.

GP Jigsaw report

Cope Jigsaw Report

Hilda Campbell is Chief Executive of the Drumchapel based charity COPE Scotland