Slides from Dr Sue Roberts, Northumbria Foundation Trust and Linsley Charlton, HealthWORKS Newcastle presentation from the long terms conditions conference.
David Oliver: designing services that are age appropriateThe King's Fund
David Oliver, Visiting Fellow at The King’s Fund, looks at the challenges around providing health care for an ageing population, and the solutions to achieving better joined-up care.
Slides accompanying a presentation to participants in the NHS Leadership Academy's executive fast track programme. I did this in tandem with patient leader Lynne Craven.
“Experience based co-design (EBCD) on Betts Ward, Oxleas NHS Foundation Trust”
Betts Ward is an acute inpatient admission ward within Oxleas NHS Foundation Trust. Betts Ward Implemented the EBCD in July 2012.
Experience based Co-design (EBCD) is a way of improving healthcare services with patients. The patient and the patient only has the privileged knowledge of experience of the services we provide. This knowledge is unique and precious and we must tap into this if we are to make our services more effective and efficient. The recognition of the user experience has been late in mental health and it has tended to be facilitated by separating the user voice from the provider.
“Decisions of value – how the NHS can balance quality and finance in decision-making”
NHS decision-makers have to balance the priorities of quality improvement and financial sustainability, in other words they have to deliver value. This balancing act is increasingly challenging as the demands on the NHS change and grow, with more expected within an ever tighter budget. Decisions of Value is a project commissioned by the Department of Health and led jointly by the Academy of Medical Royal Colleges and the NHS Confederation. It has spent six months studying what influences how decisions are made and brings together a large amount of research to show how factors such as relationships, behaviours and environment influence the value delivered, extending beyond Whitehall to the front line.
The project’s findings have recently been published and emphasise the importance of the cultural, rather than structural, changes needed to move towards delivering better value and look at how they rely on having the right relationships, behaviours and environments in place. It presents insights into how people interact in the NHS and the crucial factors affecting how they operate within a particular context. In many cases, it indicates a ‘back to basics’ approach that involves a fundamental understanding of how humans interact and operate. As such, it doesn’t look to define good decisions, but rather gives an insight into the principles of good decision-making.
For more information, please see: http://www.nhsconfed.org/decisions-of-value
NHS Quality conference - Jonathan BostockAlexis May
“It’s your NHS – a community of influence”
Jonathan will announce the imminent arrival of healthcare’s largest community of influence targeted at engaging over 100,000 people passionate about the future of healthcare in the UK. It’syourNHS.NET will provide the space for providers and commissioners to engage and work collaboratively with service users in a true co-produced environment.
David Oliver: designing services that are age appropriateThe King's Fund
David Oliver, Visiting Fellow at The King’s Fund, looks at the challenges around providing health care for an ageing population, and the solutions to achieving better joined-up care.
Slides accompanying a presentation to participants in the NHS Leadership Academy's executive fast track programme. I did this in tandem with patient leader Lynne Craven.
“Experience based co-design (EBCD) on Betts Ward, Oxleas NHS Foundation Trust”
Betts Ward is an acute inpatient admission ward within Oxleas NHS Foundation Trust. Betts Ward Implemented the EBCD in July 2012.
Experience based Co-design (EBCD) is a way of improving healthcare services with patients. The patient and the patient only has the privileged knowledge of experience of the services we provide. This knowledge is unique and precious and we must tap into this if we are to make our services more effective and efficient. The recognition of the user experience has been late in mental health and it has tended to be facilitated by separating the user voice from the provider.
“Decisions of value – how the NHS can balance quality and finance in decision-making”
NHS decision-makers have to balance the priorities of quality improvement and financial sustainability, in other words they have to deliver value. This balancing act is increasingly challenging as the demands on the NHS change and grow, with more expected within an ever tighter budget. Decisions of Value is a project commissioned by the Department of Health and led jointly by the Academy of Medical Royal Colleges and the NHS Confederation. It has spent six months studying what influences how decisions are made and brings together a large amount of research to show how factors such as relationships, behaviours and environment influence the value delivered, extending beyond Whitehall to the front line.
The project’s findings have recently been published and emphasise the importance of the cultural, rather than structural, changes needed to move towards delivering better value and look at how they rely on having the right relationships, behaviours and environments in place. It presents insights into how people interact in the NHS and the crucial factors affecting how they operate within a particular context. In many cases, it indicates a ‘back to basics’ approach that involves a fundamental understanding of how humans interact and operate. As such, it doesn’t look to define good decisions, but rather gives an insight into the principles of good decision-making.
For more information, please see: http://www.nhsconfed.org/decisions-of-value
NHS Quality conference - Jonathan BostockAlexis May
“It’s your NHS – a community of influence”
Jonathan will announce the imminent arrival of healthcare’s largest community of influence targeted at engaging over 100,000 people passionate about the future of healthcare in the UK. It’syourNHS.NET will provide the space for providers and commissioners to engage and work collaboratively with service users in a true co-produced environment.
NHS Quality conference - Kerry Clarke and Samuel GyasiAlexis May
“Community Wellbeing Services tender – involvement team”
This engaging presentation will demonstrate how Northamptonshire Healthcare NHS Foundation Trust (NHFT) practiced: People first, working together for patients in everything we do. The team of service users, carers and staff supported the development of a Community Wellbeing Service bid from June to September 2014. All involved were valued as experts and important in the development of a robust tender submission. We are looking forward to sharing with you the journey experienced by the people involved in developing the service delivery model including the lessons learnt. We are hoping that you will be inspired to involve others more and to consider how our learning can support your organisation to take the next steps.
NHS Quality conference - Lesley GoodburnAlexis May
“Insight and involvement – creating the difference that makes a difference”
How to collate, aggregate and triangulate patient experience, clinical effectiveness and safety data across GP practices, NHS England, CCGs and providers to create themes and trends and make improvements to services based on patient and clinical feedback.
Jason Helgerson's keynote deck at World Health Congress EuropeSarah Crick
The Case for the CARE Model
Innovative health and social care systems
Jason Helgerson's keynote deck from the World Health Congress Europe in Manchester February 2019
“National Patient Safety Collaborative Programme”
The National Patient Safety Collaborative Programme, launched on the 14th October 2014 will be the largest patient safety initiative ever attempted in the world. Led by the 15 Academic Health Science Networks and supported by NHS England and NHS Improving Quality, they will be undertaking a challenging programme of work over the next 5 years. This session will outline the actions to date and the next steps moving forwards.
NHS Quality conference - Kerry Clarke and Samuel GyasiAlexis May
“Community Wellbeing Services tender – involvement team”
This engaging presentation will demonstrate how Northamptonshire Healthcare NHS Foundation Trust (NHFT) practiced: People first, working together for patients in everything we do. The team of service users, carers and staff supported the development of a Community Wellbeing Service bid from June to September 2014. All involved were valued as experts and important in the development of a robust tender submission. We are looking forward to sharing with you the journey experienced by the people involved in developing the service delivery model including the lessons learnt. We are hoping that you will be inspired to involve others more and to consider how our learning can support your organisation to take the next steps.
NHS Quality conference - Lesley GoodburnAlexis May
“Insight and involvement – creating the difference that makes a difference”
How to collate, aggregate and triangulate patient experience, clinical effectiveness and safety data across GP practices, NHS England, CCGs and providers to create themes and trends and make improvements to services based on patient and clinical feedback.
Jason Helgerson's keynote deck at World Health Congress EuropeSarah Crick
The Case for the CARE Model
Innovative health and social care systems
Jason Helgerson's keynote deck from the World Health Congress Europe in Manchester February 2019
“National Patient Safety Collaborative Programme”
The National Patient Safety Collaborative Programme, launched on the 14th October 2014 will be the largest patient safety initiative ever attempted in the world. Led by the 15 Academic Health Science Networks and supported by NHS England and NHS Improving Quality, they will be undertaking a challenging programme of work over the next 5 years. This session will outline the actions to date and the next steps moving forwards.
This workshop brought together, for the first time, the pioneers and the partner organisations of the Integrated Care and Support programme. It focused on building a learning community that will help develop, share and spread knowledge and solutions at scale and pace across the country.
More information: http://www.nhsiq.nhs.uk/news-events/events/integrated-care-and-support-pioneers-inaugural-workshop.aspx
More about the integrated care and support pioneers programme: http://www.nhsiq.nhs.uk/7862.aspx
NICE have now published three guidelines which are relevant to the care and support of older people:
Home care: delivering personal care and practical support to older people living in their own homes
Transition between inpatient hospital settings and community or care home settings for adults with social care needs
Older people with social care needs and multiple long-term conditions
Alongside hosting three workshops, the NICE Collaborating Centre for Social Care is hosting a FREE webinar to introduce these guidelines together and enable frontline practitioners and managers to consider how they can support practice improvement.
Health Promoting Palliative Care &
Developing Compassionate Communities
Understanding the drivers for and evidence supporting community development in health and social care.
Understanding how this approach has been applied to end of life care.
Learning about the Compassionate Cities Charter and how this may be implemented locally.
Isn't this about me? The role of patients and the public in implementing evid...NEQOS
Master Class, led by Professor Richard Thomson- focusing on the role of patients and public in implementing evidence-based healthcare- including shared decision making
Sharing and Learning Together to Deliver High Quality End of Life Care for AllNHS Improving Quality
Sharing and Learning Together to Deliver High Quality End of Life Care for All
Presentations from the Sharing and Learning Together to Deliver High Quality End of Life Care for All event held on
Tuesday 24 June 2014, Congress Centre, London, WC1B 3LS
#nhsiqeolcare
Bristol - building a truly healthy city, pop up uni, 12.00, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
"putting patients at the heart": the workforce implicationsJeremy Taylor
Slides I presented at the NHS Employers autumn workforce summit on 13 October 2015. They set out National Voices' perspective on what good person centred, community-focussed care looks like, and the implications for the healthcare workforce of making it real.
Six principles for engaging people and communitiesJeremy Taylor
Slides presented at King's Fund on 1 November 2016. How to make real the vision in the Five Year Forward View of "a new relationship with patients and communities"? We know a lot about the "what" and the "who" of implementation. But the "how" is still a mess. What high impact actions would make a difference to driving this agenda? I offer some thoughts. These slides are not entirely self-explanatory without the accompanying talk. Please feel free to get in touch to explore further!
John Williams, Professor of Law, Aberystwyth University Age UK
John Williams' presentation from the "Working towards a human rights convention" conference held by Age UK and Age International on the 31st July 2013.
Yvonne Doyle - High Impact Health Interventions Age UK
Yvonne Doyle, Director of Public Health, Public Health England - presentation from Age UK's For Later Life conference, 25th April 2013.
For more information, view: www.ageuk.org.uk/forlaterlife
David Regan - High impact health interventionsAge UK
David Regan, Director of Public Health, Manchester City Council - presentation from Age UK's For Later Life conference, 25th April.
For more information: www.ageuk.org.uk/forlaterlife
Tom Kirkwood - High impact health interventionsAge UK
Professor Tom Kirkwood, Associate Dean for Ageing, University of Newcastle - presentation from Age UK's For Later Life conference, 25th April.
For more information: www.ageuk.org.uk/forlaterlife
Nick Goodwin - Bringing integrated care to lifeAge UK
Dr Nick Goodwin, Senior Fellow, The King's Fund - presentation from Age UK's For Later Life conference, 25th April.
For more information: www.ageuk.org.uk/forlaterlife
Pam Creaven - Bringing integrated care to lifeAge UK
Pam Creaven, Services Director, Age UK - presentation from Age UK For Later Life conference, 25th April.
For more information: www.ageuk.org.uk/forlaterlife
1. Commissioning from
non-traditional providers
Dr Sue Roberts, Chair, Year of Care
Partnerships, Northumbria Foundation Trust
Ms Linsley Charlton, Senior Manager,
HealthWORKS Newcastle
Chair: Alice Fuller
Policy & Parliamentary Affairs Lead
National Council for Palliative Care
2. Workshop:
Commissioning from
Non traditional Providers
Living Well with LTCs Conference
What can the voluntary sector contribute?
November 14th 2012
Sue Roberts: Year of Care Partnerships
Linsley Charlton: HealthWORKS Newcastle
4. Each person finds the green piece of paper with the
scale on it on your table.
1 2 3 4 5 6 7 8 9 10
Agree Disagree
Mark with a line the point that indicates how much
you agree or disagree with the following statement
‘The voluntary sector needs to understand
how they are part of the solution to the
challenge of LTCs’
5. Each person finds the white piece of paper with the scale
on it on your table.
1 2 3 4 5 6 7 8 9 10
Agree Disagree
Mark with a line the point that indicates how much you
agree or disagree with the following statement
‘It is critical that health services learn more
about the role of the voluntary sector in
managing Long Term Conditions’
6. Introduction:
• How we got involved
• ‘Thanks for the Petunias’
• ‘answers?’ or ‘questions?’
The Lead Provider Model
Clinical and community worlds: Managing the
interface
7. The individual's perspective
…….Linking clinical and community support
Self care / management
Hours with NHS = 8757 in a year
professional = 3 in a year
8. PCTs had no:
Fragmented and Identified person
ad hoc schemes No development strategy
No identified work
programme
2008: Year of Care
Survey of
community support
for self management
‘Public Health ‘Not sure PCT
does that!’ knows what to do’
9. • Top Tips for Commissioning
• Commissioning for
sustainability
• The on line Health Directory
• Case Studies
• Tools including metrics
• Food for thought!
10. Care pathways, single or co morbidities
e.g. COPD, Diabetes, Obesity, Mental Illness
Initial assessment/stabilisation
Lead Non Traditional Annual care planning
Provider
Menu of activities related to needs/dependency
Self care Minimal support Moderate support High support
Own Direct access to services Health link worker
programme with initial induction and personalised
regular review programme and
intensive review
13. What next?
• Your initial thoughts?
• The Lead Provider Model : Pros and cons
• Clinical and Community worlds: managing the
interface
14. Towards Long Term Condition
Management
Our story so far…..(whistle stop tour!)
Linz Charlton
Senior Manager
HealthWORKS Newcastle
15.
16. Lead Provider
Advantages
Asset based approach (not reinventing the wheel!)
Using a range of organisations to work towards the aims
of the intervention
Supporting smaller local third sector organisations
Valued by local people
Lead provider is a single point of contact for the
commissioner
Lead provider takes the ‘risk’ of using smaller third
sector organisations by collecting and reporting
outcome data
21. Possible Implications
for the lead provider
• Robust data collection systems
• Build in administration and data entry
costs
• Outcomes
• Sustainability
24. Staying Steady
Community Fall’s prevention exercise programme
Hospital Fall’s services
Fall’s pathway
First Community
Contact Rehabilitation
Staying Steady Team
Community
Self referral
We will be collecting this up and feeding them back to you – but we think that these two statements illustrate a key issue for the voluntary sector – and that is how better links , but better working practices can be developed with the traditional services – and consequently the challenges for commissioner that arise from this.
The previous two questions highlight what we believe is the core to voluntary sector involvement in LTCs – a completely new way of thinking about roles , links and what these means in practice
This slide looks at things from the individual's perspective . The green wavy line in this diagram which was drawn on a table cloth by people with LTCs at a workshop, shows the ups and downs of living with a LTC like diabetes. The orange vertical bars indicate the contact with the health services which occurs at regular intervals , for a relatively short period of time in the life of the individual and currently bears little relation ship to their particular needs in the intervening period. Less than 50% of people discuss there self management needs when they attend clinical appointments which is a poor use of time and an enormously wasted opportunity. The YOC programme set about addressing this firstly by looking at how this time could making much better use of that contact time and in particular supporting the person so that they have the knowledge, skills and confidence to manage when they are making day to day decisions on their own. We call this care planning– a systematic approach to collaborative . The second aspect of the YOCP was ensure that the services that people needed to support them in achieving their goals were available in the community via commissioning ….and this is the aspect we are going to talk about today.
We surveyed some PCTs in 2008 to get an idea of what was going on already.
With Support of NHS Northeast Innovation funds we carried out a piece of work to look at what would be needed to enable commissioners (PCTs at that point ) to be able to commissioner more effectively for their local populations. The resulting publication we called ………We used the term NTP because when trying to engage the NHS in the value and benefit of this for people with LTCs we found that …….The document – and you have a summary on your table includes………. (remember stakeholder group)The pictures on the front are meant o encourage you to be imaginative ….its more than just eh gym and the swimming pool – important though those are. here you have…….
The document is centred around a systematic approach to linking clinical and community involvement which works like this:
Some key aspects areMedical to socialDirection of travel – green arrowWho could not think this was a great idea! But how to design and commission it in practiceOld text interventions in orange are more traditional and fit with the medical model of healthinterventions in green are non-traditional and are more aligned to the social model of healthgreen arrow shows the direction of individual travel, aiming for everyone to move towards the left hand side of the diagram (self care) with the associated reductions in cost of care orange arrow indicates that those newly diagnosed (who may require specialist assessment and stabilisation) will have higher costs than those at the bottom who are largely managing their LTCs with support from non-traditional providers
Old textA central feature of this model is simplified contracting arrangements: Commissioners have one contract with a small number of lead NTPs – one per locality Lead NTPs take on the role of developing relationships with other local NTPs to meet identified patient needs, allowing for variability in each locality A much wider range of non-traditional services can be made available to people with LTCs without the commissioner having to enter into multiple contracting agreementsThe Guide provides detailed information on the role of each of the agencies and the relationships between them. The model was developed to address many barriers that the Year of Care pilot sites had identified, and is based on pockets of good practice around the country.
Take a moment to talk to your neighbour about what you’ve just heard. We just have a few moments and will be going into the detail in the rest of the session. What are your first thoughts? Anything about the overall approach you would like to clarify. You have three minutes and then we’ll have a couple of pieces of feedback. Now to some of the detail …Handover to Linz…