PPI IS IMPERATIVE FOR SUCCESSFUL COMMISSIONING BECAUSE:• It’s a financial imperative – Save money – Get pathways used• It’s a moral imperative – Who’s NHS is it anyway?• It’s a political imperative – No democratic legitimacy• It’s a practical imperative – Safer – Better design• It’s a legal imperative
COMMUNITY INVOLVEMENT AND COMMISSIONING Dr Brian Fisher MBE Chair of the Socialist Health Association
WHAT KIND OF INVOLVEMENT?• Democratic• Participatory –Influence through engaging with –Individuals –Groups• Listening Responding
CONSORTIUM GOVERNANCE OPTIONS• DEMOCRATIC – Democratic elections to the Board – Councillors/LA on the Board (?)• PARTICIPATORY – HealthWatch on the Board – Other lay people on the Board – Foundation Trust consortium – Lay reps on every key committee – A super patient participation group – Community development
HEALTHWATCH• Son of LINKs, grandson of Fora, great- grandson of CHCs• A network of networks and groups• To influence commissioning of health and SC by understanding key issues for local people.• Future responsibilities? – Complaints – Shared decision-making
HEALTH AND WELL-BEING BOARD• Consortium, HW, LA, NHS CB if relevant• Chaired by LA• Joint decision-making on commissioning• Start with Joint Strategic Needs Assessment• Has the semblance of democratic legitimacy, but no substance
WHAT TO BECOME INVOLVED IN• The consortium’s agenda – Priorities – Service development – Setting standards – quality in SLAs – Service monitoring – How to spend savings• The community’s agenda
PROACTIVE DIALOGUE, DEEP AND WIDE• Experience based design• Database• Community development
HEATH AND WELL-BEING BOARDCONSORTIUM HEALTHWATCH HW LOCAL VOLUNTARY GROUPS
COMMUNITY DEVELOPMENT/ORGANISING• Improves PPI• Improves health protection• Tackles health inequalities• Supports behaviour change
ASSET-BASED COMMUNITY DEVELOPMENT• People as assets, not problems• Individuals, organisations and statutory services working together to improve civil life• Both local people and statutory services have skills that need to be combined for maximum effectiveness – co-production• Enhancing health promoting/protecting mechanisms• Strengthening the capacity of indiv and communities
CD Stronger and deeper SNsRESILIENCE ENHANCED CONTROL Health protection Can negotiate with services Resilience to economic More strength for self-care adversity Health inequalities reduce Better mental health
7 STEP MODEL• Listening event• Brings together local agencies (health, police, education, SC) and residents• Partnership• Forms ‘organizing hub’ for activities and initiatives• Leaders appear• Rapid changes in commissioning
HELP - COMMISSIONING @ 9 MONTHS• Company formed• Playpark• GP surgery• Dental surgery• Benefits advice• Tai Chi• Plans for radical change
HELP – OUTCOMES @ 5Y• Life expectancy + 6 yrs• Increased Breast Feeding 50%• Postnatal depression rates down 60%• Child accident rate down 50%• 78% reduced fear of crime• Other benefits .. escalated impact of other Public Health programmes, and changes to services and commissioning• Estimated savings based on 5% reduction across a basket of conditions = £70k per year for 5000 population.
BIG SOCIETY?• REDUCED STATE PROVISION• SOCIAL JUSTICE• INCREASED ACCOUNTABILITY• TRANSPARENCY• ENHANCE PUBLIC SECTOR MARKETS• LEADERSHIP BY FRONTLINE PROVIDERS• FUNDING• IMPROVED LOCAL COMMISSIONING• NEIGHBOURHOOD GROUPS MUTUALS AND COOPERATIVES• CHARITABLE GIVING• VOLUNTEERISM
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