Vantastic Health Route - Fingal (Pilot)

Vantastic Health Route - Fingal (Pilot): A community based pilot to deliver door to door health transport service in the rural and urban areas of Fingal for the over 65s

Dublin (Fingal Area), IrelandDublin (Fingal Area)
Project Stage:
Established
Budget: 
$50,000 - $100,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

This pilot service was designed, implemented and developed to accommodate the challenges that health-related transport presents for older people with impaired mobility in Fingal. The solution reached was based on the existing Vantastic Health Route model, with priority set on delivering a local, individualised service that was tailored to meet the specific requirements identified via the Age Friendly Initiative consultation with older people.

About Project

Problem: What problem is this project trying to address?

In Fingal the majority of mainstream public transport services are radial based routes that serve Dublin City Centre with very limited direct services to hospitals and other healthcare facilities. State funded non emergency medical transport is limited due to eligibility criteria and resources. In addition to the above older people identified themselves that taxis costs were unaffordable and that reling on family and friends to transport them to appointments was not always suitable. Due to the above in consultation older people said that they missed nearly half of all hospital appointments. This was very bad for the individuals own health, limiting their ability to live at home had a negative impact on the State Health Services purse.

Solution: What is the proposed solution? Please be specific!

We developed a demand responsive, door-to-door service localised for older people in Fingal based on the Vantastic Health Route Model. Clients registered with Vantastic for the service on-line or by post and then requested transport as required, usually by phone. A key element of the project involved the establishment of a standard service beyond pilot. This was achieved via the completion of a pilot project evaluation in mid 2013 which highlighted the significant increase in the attendance at health appointments and combined with a participant revenue model and public funds Department of Health and Social Protection the pilot rolled over into a standard service in September 2013. Today over 600 older people are using the standard service.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

A service user of Health Route lives in Skerries, He regularly travels to Beaumont hospital in Dublin 9 for medical treatment as he has a chronic condition. One-way is c 17 miles and can take 35-60 minutes by car. There is no direct bus route to the hospital and taking multiple buses is very stressful when he is unwell. Parking there is expensive so on one occasion he took a taxi at an unsustainable cost of €80. Relatives/friends have brought him however they had to take time off work. He registered for Health Route via a form and now on receiving his appointment he calls the professional customer support line to book his return journey on an accessible, warm vehicle where he can interact with others on a safe door-to-door service.

Spread Strategies: Moving forward, what are the main strategies for scaling impact?

In Ireland over 20 local authority areas have adopted the WHO Age Friendly County & Cities Programme supported by Age Friendly Ireland. It has the support of the very strategic stakeholders across governmental departments and leaders in public service and the NGO and business sectors. To date the Vantastic Health Route Fingal (Pilot)has been showcased as a model of excellence, an exemplar of how an Age Friendly Alliance can move a pilot to a mainstreamed service, by highlighting that reconfiguring existing budgets to deliver services in a demand responsive way can increase the cost effectiveness significanly and have multiple additional benefits. Locally we hope to see the role out of the model in the rest of Dublin as additional areas adopt the WHO Age Friendly programme. Additionally we see that all Age Friendly Counties across Ireland and further afield could adopt the model.
Sustainability

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

No other approach is providing the direct door to door provision. That said a number of transportation providers including Dublin Bus, a rural transport service called NIFTI funded by National Government, ad hoc Non emergency Patient Transport Services provided by the HSE, private Taxis and ad hoc lifts by friends and family do meet some need. In conjunction with these providers the stakeholders involved in the pilot and its subsequent roll-out to a standard service, now feel that a robust health transport service is now in place for older people in both the urban and rural areas of Fingal where the service operates. The issue of non emergency transport is a national agenda item within Ireland and Vantastic Health Route-Fingal (Pilot) represented a new departure where a service was developed and delivered under the auspices of Older people with the assistance of Public/NGO services.
Team

Team

The Fingal Age Friendly Alliance was formed to bring a range of stakeholders together to find practical and realistic ways to address issues of concern to older adults. The Fingal Age Friendly Alliance is chair independently by a former government minister and includes the most senior members of the many agencies including Fingal County Council, An Garda Síochána, Health Service Executive, County Dublin VEC, Dublin City University, Fingal Senior Citizens’ Forum and the National Transport Authority. Key to the delivery of the service and key performance indicator reporting was the responsibility of the Vantastic Management & Board.
About the Lead Co-Creation Partners
Organization:
Fingal County Council
Visit website
LEAD SOCIAL-MISSION ORGANIZATION
Type of organization (e.g. NGO, association, not-for-profit, foundation, social enterprise)

Not for Profit (Irish Registered Charity)

Total Number of Full-Time Employees

47

Lead Contact First Name

Cormac

Lead Contact Last Name

Moloney

Title

CEO

Country

Ireland

Twitter URL

N/A

Facebook URL

N/A

LEAD CORPORATE PARTNER
Organization Name

Fingal County Council

Total Number of Full-Time Employees

500+

Lead Contact First Name

Eithne

Lead Contact Last Name

Mallin

Title

Age Friendly County Coordinator

Country

Ireland

Organization Website
Basic Info
Project Starting Year

Pilot Started November 2011 - Completed August 2013 : Rolled into standard service in September 2013

Primary European Country where this Project is creating social impact

, DB, Dublin (Fingal Area)

Additional European countries where this Project is creating social impact
Select the category that best fits the type of your project:

Last mile distribution: Entries in this category focus on solutions that enable the physical delivery of life-changing services to people with restricted mobility or restricted access (senior people, people with disability, remote or difficult areas, etc.).

What awards or honors has the project received?

None

Project Summary
Co-Creation Model: Tell us about your main strategic partners and how the partnership truly create value. For each Partner please include its type (business/social/public), its name, a short description, its key motivation to participate in the co-creation project, and the key contributions it is making in the co-creation project. Please follow the format displayed below:

Lead Partner - Vantastic Ltd
Not for Profit (Irish Charity)
Vantastic provides Accessible Door-to-Door Transport Services for Individuals (People with Disabilities & Citizens 65 plus) & Not for Profit Groups/Organisations in the Dublin Area.
Vantastic has successfully been operating Health Route services since 2009 and felt that the model was a good fit with some modification for the Fingal Area. It would be our hope that the Health Route service would be available across Dublin city and County in the future.
Vantastic was responsible for the day to day delivery of services, reporting to all stakeholders on the same and liaised directly with all the other stakeholders to move the project from pilot to standard service.

Fingal Senior Citizen's Forum
Social Sector
Fingal Senior Citizen's Forum are a group representative of all older people living in Fingal
Part of consultation process through the WHO Age Friendly County Programme - A commitment to find solutions to issues of concern
Consultation, Strategy production and participation in the implementation of actions

Health Service Executive
Public Sector
The Health Service Executive is responsible for the provision of Health Care providing Health and Personal Social Serivces for everyone living in Ireland with Public funds.
Cost Effectiveness, Reduction in missed hospital appointments, improved health and well being for older people. Part of a commitment to participate in the WHO Age Friendly county Programme]
Provision of access to appointments to co-ordinate trips with appointment times; support of referrals by various front line staff; funding to sustain the service

Fingal County Council
Public Sector
Fingal County Council is the authority responbisilbe for local government in the County of Fingal in North & North West County Dublin servicing a population in excess of 280,000. It provides public services and is responsible for housing, community, roads, transporation, planning, amenities, culture and environment.
Fingal County Council hosts the Fingal Age Friendly Initative hosting the strategic multi agency alliance and dedicates resources, both human and fiscal, to the development and sustaining of Age Friendliness for all in County Fingal

Impact
Impact: What is the impact of the work to date? Also describe the projected future impact. Please specify using qualitative and quantitative data (e.g. # of indirect and direct beneficiaries); help us understand how this solution truly makes a difference.

Over 600 older people are currently registered with the service ensuring that they are regularly attending health appointments
1. Improved health and well being for older participants
2. Reduction in number of missed appointments (prior to health route 47% of older people missed hospital appointments due to lack of transportation)
3. Cost effectiveness and reduced cost to HSE
4. Reducing burden on family & carers to take time out to take people to appointments
5. Promoting independent living, accessibility to services and empowering older people
6. Huge social benefits as older people are talking, interacting, forging friendships and learning about other services and activities
7, Promoting service expansion thus promoting social enterprise and job creation
8. Increased awareness across staff within stakeholder organisation that inter agency projects are an effect delivery method

Sustainability
Funding: How is your project financial supported? [select all that apply]

Individuals, NGOs, Businesses, Regional government, National government, Customers.

Sustainability Plan: Has your project already reached financial sustainability? If not, what is this solutio’s plan to ensure financial sustainability? Do the main partners have enough stake to sustain the solution? If this project requires limited budget, how will other resources be secured to maintain or grow this work?

The pilot was completed utilizing multiply funding streams as at 31st of August 2013. Since then the service has operated as a fully sustainable service funded under a dual revenue model of public funding and individual participants contributions.
The aspect of individual participants contributions is a key underlying success of the standard service model that came out of the pilot. The pilot allowed the stakeholders to consult with older people, establish that the success of any future standard service was dependent on a contribution being made by the individuals using the service and agree that once not prohibitive to older peoples income levels that this was the right thing to do. The cost level for the standard service in 2013 was set and agreed directly under the auspice of the Fingal Age Friendly alliance with Vantastic.

Team
Founding Story: Share a story about the "Aha!" moment that led the Partners to get started and/or to see the potential for this to succeed.

There were many examples of when the Stakeholders saw the potential of the project and its outcomes including as follows:
1) When the Fingal Alliance members were informed that Vantastic had an existing Health Route model (including robust back-end software, staff expertise and experience) that could be easily adapted to met localised requirements.
2) Hearing directly from older people their experiences of missing hospital appointments
3)Cost efficiency and effectiveness of the service
4)Potential improved health benefits and the reduction of burden on family/carers
5)When all stakeholders learned the valuable lesson that expertise was available at no cost across multiple organisation and bodies and that a collective approach under the guidance of the key beneficiaries resulted in a robust solution that might otherwise have been achievable.

About the Co-Creation
Barriers: What main barriers may you have encountered to co-create during the creation and implementation of the project and how did you try to overcome them?

The challenge was not in the setting up of the service and/or getting the partners but rather the identifying of initial funding streams to produce evidence that the introduction of this demand responsive pilot service was going to be cost effective and have multiple benefits for all stakeholders including older adults. Vantastic Board agreed to allocate budget to the Fingal Pilot and initially secured funding for a small pilot. This coincided with the Age Friendly strategy by the Fingal Age Friendly Alliance. Additional funding was secured be the Fingal Senior Citizens Forum from the Dept. of Health National Lottery Fund allowing for a more expansive initial demonstrator pilot. In the opinion of all the stakeholders ultimately provided the foundation on which the pilot could be rolled over into a standard service.

Governance: What is the type of the relationship between the partners? (e.g. joint venture, contractual relationship, joint project...)

The Pilot Project was a joint initiative to demonstrate a solution with multiple partner involvement.
- The day to day service delivery was the responsibility of Vantastic.
- The in life monitoring and review of the pilot was the responsibility of both Vantastic and Fingal County Council, who jointly reported back to the Age Friendly County Strategic Alliance.
- Pilot direction and development strategy was completed under the auspices of the Age Friendly Alliance
- Evaluation of the pilot (see attached) was completed independent to all the stakeholders by Sinead Begley & Associates

Interaction model: How is the project a transformative partnership? How is the interaction transforming the partnering organizations and their employees/ leadership in terms of creating a new vision, new management practices, new skills and new organizational structures? Please provide for concrete examples

Because of the nature of the project various stakeholders had to undertake to think outside the traditional silo model and work together. This included the coming together of the relevant stakeholders including Vantastic, Fingal County Council, the HSE, Dublin Bus, Bus Eireann and others. Their thinking has been transformed in the sense that they are trying to adopt Age Friendly policies into their Service Plans. This will include all transport related issues i.e. location of bus stops, accessibility on buses, parking, route planning, drop offs at health related institutions/locations and many others.

How did you find out about this competition?

We found out about the competition from the Age Friendly Ireland Programme