Improving the lives of people with long-term conditions by taking action for person-centred care - #A4PCC

1. Our Declaration, My Declaration: Action for
Person Centred Care
Monday 12 October 2015
11.15am – 12.15pm
Dr Martin McShane,
Medical Director for Long Term Conditions, NHS England
&
Beverley Matthews
LTC Programme Lead, NHS Improving Quality
#A4PCC #LTCimp #LTCyearofcare

2. LTC Year of Care Commissioning
Developing a Year of Care Capitated Budget approach for those
with Complex Care Needs
• Programme information
• 5 Early Implementer sites
• 35 Fast Followers
• Whole Population Datasets
• Simulation Model
#A4PCC #LTCimp #LTCyearofcare

3. LTC Person Centred Care:
Delivering Person Centred Care for People with LTCs
• Improvement Sites
• LTC Toolkit
• Snapshot Survey
• Simulation Model
#A4PCC #LTCimp #LTCyearofcare

4. LTC Learning Community
Establishing a Virtual Community for All to Share and Learn
• LTC Dashboard
• Case Studies
• Lunch and Learn Series
• The Bulletin
@NHSIQ @bev_j_matthews #LTCImp #LTCyearofcare
#A4PCC #LTCimp #LTCyearofcare

5. Action for Person
Centred Care
o Taking action to make person-centred care for
people with long-term conditions a reality
o Looking at what needs to change and why we
need to change
o Co-produced with NHS England and Coalition
for Collaborative Care and developed with
health and care professionals, policy makers
and people with long-term conditions
o What you can do:
o Make a commitment embedding
patient-centred care in your work at
www.engage.england.nhs.uk/survey/ltc
-declaration
o Tell your teams about our work
o Use the hashtag #A4PCC when you see
work that is relevant to person-centred
care for people with LTCs
o Let us know of any events, activities or
social media opportunities that we can
join forces with you
#A4PCC – Action for Person-Centred

6. Date Topic Guest Speaker(s)
15th Oct 2015 Health coaching for people with long term
conditions
Penny Newman, Medical Director,
Norfolk Community Health and Care and
National Innovation Fellow
Andrew McDowell,
Director The Performance Coach
15th Oct 2015 Practical strategies for innovating in
health and housing
Tweetchat with @wecommissioners
Paul Taylor
Innovation Coach - Bromford Lab
Will Lilley
New Ventures Manager, Bromford
Tweetchat in partnership with @wecommissioners
4th Nov 2015 Writing letters directly to patients
Tweetchat with @wecommissioners
Bev Matthews
Programme Delivery Lead
NHSIQ
Coming soon Continuing the discussion about
behavioural change and care planning
Angela Coulter
Kings Fund
LTC Lunch & Learn E-Seminars
Establishing a Virtual Community for all to share and learn
#A4PCC #LTCimp #LTCyearofcare

7. #A4PCC – Action for Person-Centred
Care
Action for
Person-
centred care
with
A conversation
with Katie

8. Not Just a
Headache: Katie
o Long-time chronic cluster headache patient
who blogs to tell her story and support
others
o @notjustaheadach
o www.clusterheadachelife.blogspot.co.uk/
#A4PCC – Action for Person-Centred
Care

9. Dr Martin McShane
National Clinical Director
Long Term Conditions, Older
People and End of Life Care
I
#A4PCC – Action for Person-Centred
Care
Action for
Person-centred
Care:
Our Declaration

10. Long term
conditions: the
facts
2
o 15 million people in England with long term conditions
have the greatest healthcare needs of the population
(50% of all GP appointments and 70% of all bed days)
o Their treatment and care absorbs 70% of NHS and social
care budgets in England
o 30% have more than one LTC, which increases with age
and deprivation
o People living longer but not always well
o Focus on treating the disease not the person
o Increasing evidence on over-treatment and harm
o System working as individual components
o 99.9% self management, 0.1% clinical time#A4PCC – Action for Person-Centred
Care

11. No LTCs (yet)
Single/dominant
condition
Multiple
conditions
End of life
25m 15 - 20m 5m 330k
'Brief
interventions'
Self -management
training and apps
PAM 1
Care and
support
planning
Advanced care
plans / advanced
directions
Access to
EHR
Digital care
plan
Year of care
funding
PHB 2
IPC 3
1. Patient Activation Measurement
2. Personalised Health Budgets
3. Integrated Personalised Commissioning
Wearables /
apps
Enablers:
Interventions:
Priority actions to support self care
#A4PCC – Action for Person-Centred
Care

12. LTC Framework 4
House of Care
o Empowered patient and carers
o Professional collaboration
o Best practice (clinical and
organisational)
o Commissioning
Delivering person-centred co-ordinated
care
#A4PCC – Action for Person-Centre
Care

13. Why is person-
centred care
important for
people with long
term conditions?
5
o Wellbeing is about more than just medically
managing a condition
o Is it acceptable for life to be just endured and
not really lived well?
o It’s an ethical, social and financial issue
o Shared decision-making is key
o We need to take account of self-care, feeling
in control and the impact on mental health
o No one knows more about their condition
than the patient#A4PCC – Action for Person-Centred
Care

14. Our Declaration 6
o Launched at Expo 2015
o The importance of person-centred care for
people with long-term conditions, what needs
to change and why we need to change
o Co-produced with NHS England and Coalition
for Collaborative Care and developed with
health and care professionals, policy makers
and people with long-term conditions
o We need to motivate and support health and
care professionals to help us make it a reality
#A4PCC – Action for Person-Centre
Care

15. 7 My Declaration
o We want health and care professionals to
declare their commitment to embedding
patient-centred care in their work
o On a postcard or online at
www.engage.england.nhs.uk/survey/ltc-
declaration
o We want to create a two-way dialogue
o We want to hear what you are doing in your
local area to support person-centred care
o We want to know how can we help you
#A4PCC – Action for Person-Centred
Care

16. 8
Using behavioral
change to open
mindso Our Declaration, My Declaration
o Building the brand
o Using social and digital media to spread the message
o #A4PCC (Action for Person-Centred Care)
o Mini case studies to inspire and share best practice
o Grassroots campaign – foundation and acute trusts
o Understanding what CCGs and GPs need
o Bespoke improvement support
o Animation and eBook about Our Declaration
o LTC monthly newsletter
o Ethnographic work with Ipsos MORI
o Toolkit of resources and products
o Lunch and Learn webinars and Tweetchats
o Clinical champions #A4PCC – Action for Person-Centred
Care
Person
with long
term
condition

17. 9 What part will you
play?
o Make a declaration at
www.engage.england.nhs.uk/survey/ltc-
declaration
o Connect and be part of the party
o Tell your teams about our work
o Encourage them to make a declaration
o Ask them to feed back thoughts and ideas
o Use our hashtag – #A4PCC – when you see
work that is relevant to person-centred care
for people with LTCs
o Let us know of any events, activities or social
media opportunities that we can join forces
with you
o Email us at ltc@nhsiq.nhs.uk
#A4PCC – Action for Person-Centred
Care
YOUCAN MAKE A
DIFFERENCE

18. Date Topic Guest Speaker(s)
15th Oct 2015 Health coaching for people with long term
conditions
Penny Newman, Medical Director,
Norfolk Community Health and Care and
National Innovation Fellow
Andrew McDowell,
Director The Performance Coach
15th Oct 2015 Practical strategies for innovating in
health and housing
Tweetchat with @wecommissioners
Paul Taylor
Innovation Coach - Bromford Lab
Will Lilley
New Ventures Manager, Bromford
Tweetchat in partnership with @wecommissioners
4th Nov 2015 Writing letters directly to patients
Tweetchat with @wecommissioners
Bev Matthews
Programme Delivery Lead
NHSIQ
Coming soon Continuing the discussion about
behavioural change and care planning
Angela Coulter
Kings Fund
LTC Lunch & Learn E-Seminars
Establishing a Virtual Community for all to share and learn
#A4PCC #LTCimp #LTCyearofcare