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July 2017 EdgeTalks - A new mandate to support community action

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Transcript from the #edgetalks in July 2017

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July 2017 EdgeTalks - A new mandate to support community action

  1. 1. [Max.Uk.Captioner is Live] SPEAKER: Good morning, everyone. Thank you to everyone who has joined us and contributed to the conversation going on in the chat room. Great to have so many people joining us today on this important session. My name is Janet Wildman and we will be talking about a new mandate to support community action, and we are looking at the practical insights that will come out of the insight today. We have Cormac Russell on the line, waiting to go. If you are joining us today, we would like to make this as engaging as possible. We know you have spared the morning to come onto this call because you have questions you want answered. Why not tweet using the hash tag #EdgeTalks amd the handle @Sch4Change, and let's get as much opinion and perspective on this important issue. So, let's move on. This is who I am and what I look like. Obviously not today, but generally that is how I look! I will be chairing the session, and also, I will be keeping an eye on Twitter and feeding back to you at different times, just to give you an update on what the conversation is like on Twitter. I will also introduce you to Paul Woodley, the technical guru of the team. He will be looking at the chat room conversations. Here's a fantastic way to get to know and a pleasure to work with. I would like to introduce you to the presenters today. First on the deck is Cormac Russell. He is the managing director of development, and the thing… He is very passionate with how to engage, and he has also written a book, looking back to look for words. I haven't read that yet, but I am looking forward to a deep dive into that, and perhaps you will tell us more in the session today. We will hopefully be joined by Jeremy Taylor, the chief executive of National voices, and he has the passion in terms of person centred care, and he works very closely with the voluntary and community sector. So, those are the presenters today. I am going to hand over to Cormac Russell, and if you have questions for him during the session, please enter that into the chat room or post it on twitter and we will keep an eye on that. So, over to you. Edge talk webinar (UKEDGE0707A) Page 1 of 16 Downloaded on: 07 Jul 2017 12:07 PM
  2. 2. CORMAC RUSSELL: For about 20 minutes or so, I will talk very practically about something that… It is all about how you quote connected communities that are health producing and health creating. That is a very different question to the question most folks are asking in health at the moment, and I think the predominant narrative is around personal centric care and strength based practice, which is good, but I am interested in creating a culture of health production at community level, so that is what I will talk about. I will try to stay away from theory and stay practical. Effectively, but I will give you is eight top tips around what we have learned from working at neighbourhood level. A lot of neighbourhoods that people have written off, quite frankly, and there is not a Hollywood ending to any of these stories, but what has happened is that people, despite the challenges they faced, have really begun to use what they have to create much healthier outcomes for themselves and their neighbours. The top tips are what I call the touchstones which are listed in this slide. I will go through them quickly because 20 minutes is not a lot of time. It is all about going in, having been invited into a neighbourhood as someone who walks alongside a community and supports them. This goes right through to exit strategy and how you can leave behind a legacy. I think this is an important thing to point out, that what we are talking about is not empowering people but liberating power that is in communities and undervalued, and connected or invisible. So, we all know the metaphor of the glass half full or half empty. The solution to is a glass half full or half empty is yes, because it is based. I want to make the half full part more visible, enabling communities to do it together. We have spent the last eight years in the UK working at learning sites, and essentially, you will see some of them listed. You can see 12 on the map, and there are 15 listed, and there are about 100 neighbourhoods but we have asked the question of how is helping as volunteers or people living in a neighbourhood… How can we be helpful in creating space for connection? Helping people matters. This will not answer every single issue or problem that we face in health or social care, and I am not presenting this as a panacea. This is just one way to look at the issues that we face. So, I will look at the primary unit of change and not the individual, pathology or condition. The learning sooner just come from the UK that 35 other countries including Australia, and you will see some of the learning sites where we are working quite deeply at street level with local people to figure out what they help producing community looks like. This is an example of people using social media and connecting online. Three women wanted to organise a teddy bears picnic with local mums and they were told by the council that they needed a permit, so they sent a message out on Facebook and 495 other people came. This reminds us that an awful lot of community action is about fun and being mischievous and asking for forgiveness rather Edge talk webinar (UKEDGE0707A) Page 2 of 16 Downloaded on: 07 Jul 2017 12:07 PM
  3. 3. than permission. These guys didn't even ask for forgiveness, bless them. These touchstones are not linear. They are messy and look like this. They are neither simple nor complicated. It is not like baking a cake or syndicate rocket to the moon, but it is more like raising kids. We want the work to be simple and a science, so we wanted to be simply measured but we wanted to solve all the world's problems. It does neither. First, find a group that wants you to be active. People don't chair meetings or want anything to do with the professional world, but they are pretty cool and do a lot of awesome stuff. A lot of time, they avoid bureaucracy like the plague, but in terms of creating a culture of community at local level, I think we need to find a different way of doing things. We should be trying to get ourselves invited to parties instead of inviting people to meetings. In community life, there are lots of different players in their village or state. We had the leaders who are really important. These are people who are good at bringing people together. We had gift givers. So many people are willing to contribute to the well-being of the community. We also have a lot of unlabelled people who have been rendered invisible, and we need a way to invite the gifts into community life, whether it is making a cup of tea at the AA group or whatever. It doesn't have to be something tremendously earthshattering or world changing, but it is about participation. I was at an event in Doncaster, and my colleague made an important point, that it is not enough if you are in recovery to turn up at the back of the room. You have got to be involved. It is the participation that determines recovery, not just showing up. Connection is critical and the connection has to be about participation, about reciprocity, so we have to show up and contribute. The people who are fantastic at bridging people into communities are what I call community builders, or sometimes I call them connectors. A connector is not someone who is trying to lead you somewhere. They want to connect you to somebody else. They have not predefined a relationship, they just like the idea that people are coming together. We all have problems, but they see the gifts in people and can see beyond your history, your story. If you have a community of 5000 people, it is fantastic that there are so many people who are weaving their community together and building connections, but it is hard work when you are trying to raise kids and live your life, or trying to live with the condition and live well within it, supporting somebody to live well with dementia, or whatever life is throwing at you. It is not easy to do that and, on a voluntary basis, continue to build the connections of your community. In modern life, communities are places where people are probably more likely to be watching an episode of neighbours or friends and making friends with their neighbours. We have really become quite disconnected in an awful lot of the places we live in. Edge talk webinar (UKEDGE0707A) Page 3 of 16 Downloaded on: 07 Jul 2017 12:07 PM
  4. 4. One thing we have learned is that there is something really powerful about enabling the community to have a little bit of support, not somebody who comes in top-down from an outside agency and says, "I am here to heal you." It is about somebody who comes in and says, "The objective of building community is building community." It is not to get better social or healthcare outcomes, to reduce crime or demand. It is because community matters. [Katrina.Captioner is Live] And here reaching this service to enable you to get connected at that level. That is such a powerful thing to be in a position to do. I often described as as a community animator, their job is to use than networks, it is to be the caddy. Only the people that build community life and those that live in that community, built the community, and trade in that community. These people make it more vibrant and powerful. While pursuing endeavours. The connector is there to be the site person, but not the fixed or inventor of solutions. Having a community animator enabler knows how to build relationships, not just individual or to individual, but relationships that are very tired and two associational life and networks, particularly people who are concerned about her maybe pushed or estranged. An animated as an important feature and they have all the characteristics that we will know about folk who are really good at building relationships. They are facilitators, not providing a service or fixing people, they are not about helping so much is being career is really trying to find ways of connecting people for their gifts into the well-being of community. This is about being independent and life rather than signposting people to programs. It is not that activities and programs that matter, but I'm really, really getting concerned at the amount of stuff that is being called 'Community work,' and it really is signposting. I heard of a story where a lady was at a basket weaving group that she didn't really want to be there but she was there simply because it was called 'Community work,' and it is about fundamentally being about life and as peoples and the chat room. "People want to live, not a service, they want relationships." Of course they want the service, but they want that as the backdrop, not as the only game in town. What is it that community connectors do to build that interdependence? The oldest trick in the book? That this wonderful think of conversations. I love the fact that we live in a digital age up to a point. To have conversations online as well as on land, they can complement each other and to add value to each other. So hosting conversations, it is about discovering the community as a starting point and what we have and securing what we need. This shift the narrative, which dominates social care which is about, "What are we going to deliver today, the most needy person at the cheapest price?" So we're shifting from the scope, this delivery Edge talk webinar (UKEDGE0707A) Page 4 of 16 Downloaded on: 07 Jul 2017 12:07 PM
  5. 5. model to this discovery model. How can we run from deliverables to discoverables, so this is what we are trying to do and it's about listing conversations that are nerve what is in the community but also in people. Sadly, an awful lot of people have gifts, skills and passions that are languishing in people have not discovered them and there is this a wonderful 70,000 Herald device that enable us to have the gifts that people have. We also engage with clubs and groups, not just talk with people. Association groups are wonderful because they are the engine room of community Power exchange. Clubs and groups and all their modesty other sociological basis upon which we take individual gifts and talent and become amplifiers and multiply. In plain English, what that means is that associations is where we go to to do things that we can do our own. I cannot saying apart from in the shower, but it can sound better at a quiet because the choir can cover a lot of my cell abilities as well is exaggerating my modest gifts when it comes to singing. So we spend a lot of time with sports groups, women's groups, men's groups, AA groups, environmental groups, this is the basis of whether groups are really understanding what is going on, what are they doing. My wife is a member of a book reading club, she has the 17 years and they have never read a book. It is just wonderful. Obviously, it is the fact that they are building mutuality. We see people building Associational life from cafes, to map creating an all sorts of things. It is about understanding the topology of associational life, and it is understanding how to map what we are seeing and understanding associational life in the UK. What I mean by this, members do the work and don't get paid. That is what I'm talking about. The list is not exhaustive, but is thorough. We do a bit of mentoring, and I often ask, "How many of these groups we know?" And we want to get out there and meet those groups. It does not matter as to whether they are interested in our agenda or not, they make you absolutely nothing about health and the narrowest sense of the definition. But actually, they might have a huge amount to contribute to the help of being of the community. As well is building relationships and having conversations, we're really interested in working with people who have been marginalised people who are really, really vulnerable to not having the gifts received. I don't like using the term 'vulnerable people', and we use this as a way of making them less capable, but we address this in terms of neighbourhood life is to figure out how we create social interaction activities. Share the moments where we can really actively say to people, where have you been all of our lives and how have we lived about you? Really, to enable people to feel welcomed, and we have more time to tease that out with you, but please come to a workshop if you want to spend more time thinking about this. Ultimately, all relationship building, it is important and intrinsically valuable. It is also going somewhere. Strategically, Edge talk webinar (UKEDGE0707A) Page 5 of 16 Downloaded on: 07 Jul 2017 12:07 PM
  6. 6. if you like to use that term at the neighbourhood level. We are trying to understand how you understand 35,000 people and abound a place to connect at each other, the environment, culture and economy because we think when you connect associational life of these capacities with the possibilities of the ecosystem, the economy, culture, and environment, then watch you create is a whole range of health producing possibilities. When we get to a point, physically, sometimes this can take a couple of years of good, solid street- based community working and lots and lots of conversations, thousands of conversations, ultimately we get to a point where we invite all associational life to come and join the conversation and we say, "What are we actually learning and what have we figured out? This would am thinking about planning." And you see this sequence of these three questions which will form part of a conversation later on. It is about building the community and looking 10 years on, what, you do ourselves that we don't need any outside help for permission to do? Second question, what's, do ourselves to lead, but with help from the outside? You could call this production, but the citizens are the lead. Final question, what can the outsiders to frost that we can do together, and not alone? They become transparent in many ways. This seems an important sequence and I suggest that after we only ask the third question and leave the other two lying there. The conversations look exactly like this is not new ground in this. The critical thing, a lot of our work is about making into action, doing stuff and getting engaged, participating. Not doing so well or badly, I think best practice is the enemy of better practice. I really think it is unhelpful. Particularly in communities where we try to encourage people to have a go, whether we do yard sticks, metrics and measurements, this does not come into this world. However, there is plenty you can measure, and you can measure Associational life in terms of being connected, and interdependence and whether communities are taking civil action to drive change. I suggest that sometimes it to measure them, but the number of clients we have and the amount of money we can possibly get. We are so hung up on efficiency, scalability and measurability that we really are not actually the same and in terms of what should be treasured. It builds collective efforts, the sense of, 'I am worthy and I'm surrounded by people that are moving here to build a better tomorrow.' And that is a tremendous source of celebration. We spend a lot of time having parties instead of meeting. I will say this again as my concluding thoughts, communities like football matches where you've got thousands of people telling everyone else what to do. Ultimately, this 22 people in the football game who are doing all the hard work. There are people who are on the whole scene, the people that do less exercise. Either they squash responsibility of doing this. But we often hear people, volunteers asking how to get Edge talk webinar (UKEDGE0707A) Page 6 of 16 Downloaded on: 07 Jul 2017 12:07 PM
  7. 7. more people involved, I think what we should be asking is how do we discover what people care about enough to act upon? How do we tokens by with them to enable them to get connected and do the things that they love? The thing that makes the eyes dance on the head. This will not solve all problems, but it will get people alive as well as a quality service. This is about driving the service, true deliverables, not as clients but as citizens. Thanks, folks. That is me. LEIGH KENDALL: Cormac, thanks very much for that. If I take the chat room first, people love the language that you are using. We, hear more about that because it is very real. We'd be here. Someone talk about community from that perspective, from your perspective. So the issue around, for example, gifts, and how we make use of that and issues around power and the way you frame that is so, so useful. How do we, as practitioners who want to support and want to get involved, how do we are and are some of the language we are so used to use it because it can be quite patronising. How do we adopt some of those? CORMAC RUSSELL: Practically speaking, there's a set of open workshops that were running throughout the country starting in September and we will be running some We are so hung up on efficiency, scalability and measurability that we really are not actually the same and in terms of what should be treasured. It builds collective efforts, the sense of, 'I am worthy and I'm surrounded by people that are moving here to build a better tomorrow.' And that is a tremendous source of celebration. We spend a lot of time having parties instead of meeting. I will say this again as my concluding thoughts, communities like football matches where you've got thousands of people telling everyone else what to do. Ultimately, this 22 people in the football game who are doing all the hard work. There are people who are on the whole scene, the people that do less exercise. Either they squash responsibility of doing this. But we often hear people, volunteers asking how to get more people involved, I think what we should be asking is how do we discover what people care about enough to act upon? How do we tokens by with them to enable them to get connected and do the things that they love? The thing that makes the eyes dance on the head. This will not solve all problems, but it will get people alive as well as a quality service. This is about driving the service, true deliverables, not as clients but as citizens. O London and another major places in the UK as well. You can find out about them on our website and I think there is some information on the chat room, I would just put up a website. The TED Talk, TEDEx, could be something that people could check out as well. I also think the ABCD Institute is a good place to go to really spend a little bit of time listening to folks very much speaking this language, and speaking from the heart as well. They are not just the rising, but talking about how Edge talk webinar (UKEDGE0707A) Page 7 of 16 Downloaded on: 07 Jul 2017 12:07 PM
  8. 8. this works in practice. I said that there are a few people from Bristol and Langston, there are some beautiful work that is happening at a neighbourhood level and I'm really struck by the power of just going out and actually spending some time and communities, listening to folks telling you what they are doing to build community. So there are lots of opportunities, I think, check out the link that I put up there as a starting point and check out the workshops and we can keep the conversation going. LEIGH KENDALL: Thank you, Cormac, will keep this conversation going later. What I'm seeing, chat room is that everyone sees as such an inspiration and they are going to take away their learning. And it is just been energising for a number of people who are making comments on the chat room. I will have straight over to Jeremy who is now a plus. Are you there with us, Jeremy? Fantastic. Jeremy will talk about healthy communities, powerful patients, what can help and care professions do? I will quickly handover to Jeremy and please keep the conversation going and the chat rooms and if you have not joined us on Twitter, please do so. If your particular questions. Also, any one of our presenters, please raise your hand or let me know in the chat room and we will make sure your voice is heard. So over to you, Jeremy. [Max.Uk.Captioner is Live] JEREMY TAYLOR: Sorry I missed Cormac's presentation. There is a connection between it and my one, and I guess mine is about how you take some of the wisdom and understanding that Cormac has shared into a world of formal health and care service? What do people need to know that taps into the energy and strength of communities, rather than always assuming that they are source of problems to be fixed, and that is kind of our world. Incidentally, I am looking pretty horrible with a phone to my ear. I don't know if I am being videoed to everybody. I might just kill it because it is slightly putting me off. Also, can I move my slides? I don't know. Perhaps somebody can tell me. SPEAKER: You should be able to at the top of the screen. There is a box with arrows between them, so you should be able to… Edge talk webinar (UKEDGE0707A) Page 8 of 16 Downloaded on: 07 Jul 2017 12:07 PM
  9. 9. SPEAKER: Or the arrow keys. JEREMY TAYLOR: While I try to work that out… Or maybe somebody can do it for me quiz make SPEAKER: I will do it for you. JEREMY TAYLOR: Let's move on. So, next slide please. I have just found a way of doing it. Maybe I have skipped the slide. There we are, National voices. For those of you who do not know, we have been going for nearly 10 years. We are a coalition of about 160 charities in the health and care world, and essentially, we found two things, that people should be as much as possible in control of the things that affect their health and care, and is part of that, as much as possible, partners in decisions that affect health and care. To the extent that there is a tension between the world we describe and the world that Cormac describes, there is some good opportunity for discussion. We are also about the role that our sector plays. Big and small organisations making a huge contribution to helping people have a voice and have a good quality of life with good quality care. So, that is us, and all the work that we do is relevant to those big themes. We talk about personal approaches to care, or people powered health, but actually, there is not a consistent terminology that is used, and in fact, that is an interesting fact for discussion. We tend not to talk about public involvement because that sounds like a process invented by the NHS to get people to play on the NHS' turf, rather than thinking holistically as to what matters to people. So, we think health creation is really powerful, but meanwhile, there is still sickness, disease, frailty and death, and many people living with long-lasting conditions. There are lots of opportunities to help people help themselves and do more for each other, to be less dependent on statutory services, but there is still a need for agencies to come in, so going back to the three questions from earlier, the third question is when do agencies need to come in and what do they need to do? What the evidence and learning tells us is that the more that the agencies work, interviewed by the philosophy that Cormac the script, the better quality will be offered, and then the question is what is the role of people working as health care professionals, as commissioners, as practitioners in the NHS Edge talk webinar (UKEDGE0707A) Page 9 of 16 Downloaded on: 07 Jul 2017 12:07 PM
  10. 10. and the wider health care system. What is your role in working with these asset-based people powered ways, rather than in ways that have tentatively characterised the NHS for many decades, which is a tendency to assume that you have all the answers, a tendency to assume that the patient has no agency or ability to do things for themselves, and it is what we call paternalism, married to bureaucratic managerialism. Those things coming together can be a toxic mixture. This is a caricature, and NHS is moving away from this approach, but it hasn't got away from it entirely. Healthcare, delivered through large bureaucratic agencies tend to assume certain characteristics and paternalism as well. So, we think people powered approaches are really important, and we think there is a big evidence base to support that. I will go to my next slide. I know this is not very up-to-date, but never mind. I have some questions for people, and I am not quite sure how this will work, but I wanted to check where people were on a spectrum from being entirely comfortable with the role is or not at all, just to get some sense of the audience. I don't know whether we can still do that. I will ask you, Janet, if there is a way of polling people. SPEAKER: We have got the poll ready to go. It will run for a few minutes when ever you indicate for me to start. People will see it appear on the right-hand side of the screen. JEREMY TAYLOR: We thought it would be quite interesting for people to plot their own position, which you can do anonymously or in a named way, so over to you, Paul. SPEAKER: I have started the poll now. You should be able to see the separate questions, and several of you have started doing that already. Anybody who is on an iPad might not have the functionality to do this, but the poll will only run for 2 minutes. So just bear with us. You won't have to wait for long. Once the results are completed, I will share them with the groups are you will be able to see them and talk about them with anybody. JEREMY TAYLOR: OK, I will say a bit more about the themes of these questions, but this is to check if you are familiar with some of the approaches. Are they important? Is it important for you to be doing them? Some of you may be looking at this already, looking at embracing people's agency, and some of you Edge talk webinar (UKEDGE0707A) Page 10 of 16 Downloaded on: 07 Jul 2017 12:07 PM
  11. 11. may not be, but I am interested in getting a sense of your own investment in this agenda. I will check whether what I have said makes sense. I think… Am I right in saying that once the poll is done, we get a plot chart on the screen that shows…? SPEAKER: That is correct. You will get bar charts for each of the answers to show the percentage of people who answered each question. JEREMY TAYLOR: That sounds fun. SPEAKER: It is just compiling the data at the moment. I will let you know once it is up. JEREMY TAYLOR: Well we are doing that, shall we move on? So, just a bit of background around the basis in law for some of these approaches. The Health and Safety Care Act created a new duty to make sure that patients and carers were involved. The Care Act of 2014 is a radical piece of legislation because it started with the principle of individual well-being and the duties of statutory organisations to nurture people's well-being. This is not a complete list of relevant laws. It is just some highlights. The social value act… This is a really interesting piece of legislation. It requires public authorities for people not only to think about the bottom line and cost but you consider wider social economic and environmental benefits. This is what we undertook a social enterprise UK earlier this year, but it is very little used by the NHS and by local authorities. These are important duties, but they are not put into place in practice. I think it is important to have some regards to the legal basis. Lawmakers and policymakers believe it is really important that health and care are collaborative exercises, not just things where agencies do things to people. I think that is sufficiently interesting in law, but it hasn't always influenced practice. Do we have the results of our survey yet? SPEAKER: The results are available, yes. JEREMY TAYLOR: If you look on the right-hand side of the screen, there is a polling option. If you have a look at that, you can see how the results have come in. For those who can't see, we can talk you through. Edge talk webinar (UKEDGE0707A) Page 11 of 16 Downloaded on: 07 Jul 2017 12:07 PM
  12. 12. It comes to how important everybody thinks this is, and there is overwhelming support for this being a very crucial piece of work, but interestingly, far less people are very comfortable with the idea of it. It could be that more education is needed, or people haven't had direct experience. Jeremy, you can go into more detail for more people. JEREMY TAYLOR: It is interesting, and people think this is really important. People think it is crucial for them to have a role in it, and actually, that it can make a big difference. I take that I am talking to a well-informed group of participants, so I will have to make sure that I picked it up and not down. Thank you very much for that. [Katrina.Captioner is Live] You will let me go to the next flight, the basis of the evidence. Particularly important and a culture where the NHS medical research, lots of scientists, and people trained in scientific ways, but people like evidence in all sorts of things, they like evidence of that, and whose evidence, and what kind of evidence. Sometimes in the world. We seek to influence it sounds like people already take randomised controlled trials with no other forms of evidence. All of that aside, there's a load of things, shared decision-making when it comes to clinical treatment decisions, personalised care and support planning with long-term conditions, education and various kinds of support for people who are self managing a long-term condition. Peer support, coaching, group activities and an asset base approach not unlike the ones Cormac was taking us through but with a particular context of help and care. There is a big and growing evidence for these approaches and more. I noticed in the chat were someone mentioned about committing people and it is about using evidence- based approaches. So the slide is sometimes used as a snapshot for various surveys. We are undertaking and health and social care, the adult inpatient care survey, the GB survey and mental health, and identified care. So a reality check on how Person centred the care is that people are receiving. In different parts of the NHS and the care system. People rely on the family and friends test, they would get high figures of satisfaction and rating. If you ask people slightly more considered questions about the experience, you get a mixed picture about all that data but we don't have time. We tend to show this to people in NHS leadership courses when we talk about engagement and Edge talk webinar (UKEDGE0707A) Page 12 of 16 Downloaded on: 07 Jul 2017 12:07 PM
  13. 13. person centred care and working with people and communities. Even against the measures that the NHS self-users are quite clunky, we have a mixed picture. There is a lot of room for improvement. We spent a lot of time at national voices in the national umbrella group working nationally, at that interested in what happens locally trying to work out with health and other agencies need to do to create conditions in which people can work and much more people powered ways when they could be working partnership and communities, when they could be doing decision-making and actually putting into practice in terms of the law. So we say these things and they will be less relevant to individual practitioners but relevant to the context. We are saying we've got all this policy, we've got the NHS you, and this sets out a lot of the agenda, with a social value act, policy going back several decades on important and involving people. Why don't you make the stuff of priority because it does not feel like a priority with everything else we are focusing on? We say it's really important to target things that matter to people which is not the same as the NHS measures. We say we measure what matters. I think you are saying, Cormac, you are saying that what you say to matter. These things do matter, whether people are treated with dignity and respect and the thing is people are not held to account in terms of their performance for that data. So if you are at an control of waiting time targets, you could lose your job. If you are in that position. If you deliver a crap experience involving people, not doing care planning, people do not seem to care. There is something about focusing on what really matters to people on measuring it, but also holding people to account about what is happening against that. We also think that payment and information systems reflects these outcomes and we think it is really important that people in health and care training to enable them to work and more people powered ways and there's not much of that except that the margin. After an impressive as the prequalification training is forgotten later on when the real learning comes from a meet your superiors and you pick up bad habits. So people are welcome to challenge any of this by the way, because some of it is slightly an assertion. But this is the thing we are saying to national bodies, we are saying that you should create conditions for an engaging system along the lines of the principle of communities, looking at the front and allies and colleagues to develop a couple of years ago as a five-year view of work, and I can say more about that if people are interested. We also say that this is not just about going through the motions, this is about actually trying as much is possible to do things with people, not doing them to people and even doing for this paternalistic. When people talk about patient engagement and involvement and things the NHS does which is sort of managing processes involving people and power processes rather than their lives, if you like. That is probably mostly in the 'doing for' part of that matter, not co-production. So that is the stuff about how we think the whole system should be moving. I'm going to finish with some tips based on understanding and learning and practice and work in different parts of the system about what individuals can do. What can I personally do that makes a difference? All of this, regardless of wider policy and something context. Edge talk webinar (UKEDGE0707A) Page 13 of 16 Downloaded on: 07 Jul 2017 12:07 PM
  14. 14. We think it is about desire to improve things, so if you want a quiet life, then you are probably not starting in the right place, so having joint national voice several years ago, I went to a roundtable for… There are too many of those, but it was about including quality and at the end of the round table as we were walking out, one doctor leapt across to me and said, you know, Jeremy, you need to understand that a lot of doctors just want a quiet life. They don't want to be involved in all this improvement stuff." I hope his view is not representative, if they are, that's depressing. So you want to be identified that the status quo of "I want to improve it". As I showed you earlier, it is about something that matters to people and having conversations. Something about focusing on what is most to gain from people centred approaches and there's a lot of evidence amongst the various bases of research and evidence that people do have the worst healthcare outcomes and access to services of those that benefit from a different approach. So for us, a person centred approach, and the approach to quality art much of the same thing. Valuing people themselves can contribute, which is connected back to Cormac's presentation and when people are able to bring what matters to them and agencies that bring things to the table, this makes a difference outcomes. Being humble is important and, "I don't want to service, I want to live" And you could have this approach, and it is about having a view to accept that not all of your professional validation can come from your peers, it has to come from. Whether it is working for the people you are serving and being courageous enough to recognise that you may have got it wrong and some key respects. All of this is about social leadership, leadership policies that are not about hierarchy but about making things happen by making other people come along in a shared enterprise. So this is about values and mindset, and now practices. Well, I tried to get this basic, having conversations with people and communities, carers, and in the healthcare world, there is a fear of people that outside the parameters of the protocol driven conversation about medical matters or outside process of engagement that has been agreed, people get scared to have just have human conversations. Process, almost goes without saying. Sharing goals in that review process. I guess, that goes without saying, almost. We've got lot of evidence, this comes back to the work of a program called 'Realising The Values', which is something I mentioned before I finish. If you want to talk about your organisation and people centred ways, you have to see if your organisation is friendly to that and, along with individuals, trying to find friends and peers, develop networks, the power of networks, there is an important to this. It is important to make friends with the sector, community groups, local, and national. And we do not have an monopoly on wisdom, the community themselves have a lot of wisdom and that goes back to Cormac's point and colleagues in the sector, it gets mixed up. Edge talk webinar (UKEDGE0707A) Page 14 of 16 Downloaded on: 07 Jul 2017 12:07 PM
  15. 15. Other colleagues in the public sector and the business world and the private sector because of the role in creating or underlining a healthy environment is important. This is about being humble enough to know that you don't have all the answers and if you want good answers, work with other people, patients and communities that are a source of answers, though not all of them, if you want an operation. You need a doctor to do that. But if you are living with COPD, you need medical help but you need a lot of things are not about medicine. This is about having realistic conversations and recognising that healthcare is a human relational thing as well is that technocratic thing. You are a pretty wise up audience looking at the poll, so it was a fantastic presentation that we had from Cormac, and now I use it all the time, but now I will shut up, and I have a couple more slides that how it will make available. That is, thank you very much. LEIGH KENDALL: Thank you very much, Jeremy, and everyone in the chat room, it's been really engaged of all the things you presented to us. We only have 1 minute left and I wanted to ask you and Cormac, what would you say is the number one thing you would include when you think about social leadership? So you mentioned, both of you mentioned, across your presentations today, give me one thing you think would be absolutely critical. When you talk about social leadership? I will handed over to you both, Cormac? CORMAC RUSSELL: Can you hear me? Great. I think the critical thing to do is to advance the conversation beyond the person-centred and people leadership capacity even and social leadership and not to replace that, but as well is that, to talk about cultivating good, solid leadership across associations. We also talking about culture change as well is personal behavioural change and person-centred change. I think we need both in the conversation, my fear is that we are getting side loaded and person centred work and not enough about community work and leadership of culture and the leadership of associational life, we need both, it is not an either or. LEIGH KENDALL: Thank you, Cormac, over to you, Jeremy. JEREMY TAYLOR: I would keep it simple and set those working in the health-care system, have better conversations - there's quite a lot you can do there, believing your own power to make changes other people. LEIGH KENDALL: We want to thank you very much to both of our guest, to Cormac Russell and Jeremy sharing your thoughts and insights on this complex topic and it takes us back to being human again. Thank you very much and I want to thank all of the participants who have been so active in the chat room and Edge talk webinar (UKEDGE0707A) Page 15 of 16 Downloaded on: 07 Jul 2017 12:07 PM
  16. 16. while I am slightly over the time limit. Today, it's an interesting subject. If you want to continue the conversation, talk on the chat room, and we will continue to talk to there. So now, we just want to say thank you, goodbye to everyone and have a fantastic weekend. CORMAC RUSSELL: Bye-bye, thank you. JEREMY TAYLOR: Thank you. (Captions off) Edge talk webinar (UKEDGE0707A) Page 16 of 16 Downloaded on: 07 Jul 2017 12:07 PM

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