Presentation to Foundation Trust governors in April 2015 explaining National Voices' take on person centred and community focussed care and inviting governors to reflect on their role in making it happen

1. FT governors and person
centred care
a National Voices perspective
Jeremy Taylor, CEO, National Voices
At Governor Focus
8 April 2015

2. National Voices
• Coalition of 160+ charities
• Founded 2008
• Our mission: person-centred care.
• “Few bodies have done more than National
Voices to promote person centred care” Health
Service Journal June 2014

3. What makes care good?
• Safe
• Effective
• Person-centred
• Timely
• Efficient
• Equitable
From Institute of Medicine six domains of quality

4. What makes care person centred?
It focuses on what matters to me:
• Caring – compassion, dignity, respect
• Coordinated
• Personalised
• Enabling – information, support, voice, choice,
control, independence
Person centred care made simple, Health Foundation, 2014
Person centred care 2020: National Voices position statement
2015

5. What do people most want? What do they get?
Fast access to advice & help Frequent problems with access; problems with
early diagnosis; rationing, especially social care;
Effective treatment Too much unwarranted variation; insufficient
focus on quality; access to therapies an issue for
some
Involved in decisions, respect for
preference
50% inpatients not as involved as they want
Information and support for self
care
5% have care plan; info, education & support for
self care is not mainstream
Attention to physical and
environmental needs
Generally good in formal settings –but real
problems re dignity & nutrition
Emotional support, empathy,
respect
Formal systems struggle with psychosocial
aspects; vital role for vol sector
Involvement of /support for carers Often insufficient
Continuity of care, smooth
transitions
Frequent fragmentation and poor transitions

6. Why “enabling” matters

7. Why “coordinated” matters

8. Out-of-
Hours
Doctors
GP
District
Nurses
Social
Worker
Malcolm &
Barbara
Consultant
Continence
Adviser
Speech &
Language Adviser
Dietician
Community
Dentist
Occupational
Therapist
Equipment
Service
Physiotherapist
Alternating
Mattress technician
Wheelchair
Service
Oxygen
serviceDirect
Payments
Team;
Rowan
Org.
Alzheimer’s
Soc outreach
worker
Care team
2 live-in carers
(alternating weekly)
Replacement carer
[Some night nursing
– Health]
Emergency carers
& Barbara
The Web of
Care
(Last 7 yrs)
Dementia
Advisory
Nurse?

9. Person centred coordinated care
“I can plan my care with people who
work together to understand me and my
carer(s), give me control,
and bring together services
to achieve the outcomes important to
me.”
I have the
Information
I need…
I am supported
to achieve my
goals….
The professionals work as a
team.
I always know who is
coordinating my care
I’m involved as
I want to be in
decisions…
I work with my
team to agree a
care and support
plan…
When I move between settings
there is a plan in place….

12. Evidence based interventions
• shared decisions about treatments,
• care and support planning, using the principles and stages outlined
by National Voices and others.
• information, education and support for self-management,
including peer support, for people living with long term conditions
and disabilities
• coordinating care, following the narratives co-created by National
Voices and partners
• access to personal records – proven to support self management,
shared decisions and people’s commitment to courses of
prevention and treatment
• personal budgets to give people greater control over the way they
maintain their health and wellbeing
• training and development in the skills required for person centred
care for large cohorts of practitioners – such as health coaching,
motivational interviewing, risk communication and eliciting people’s
values and preferences
www.nationalvoices.org.uk/evidence

13. People powered services
• valuing and supporting carers and families
• ‘social prescribing’, where statutory professionals have access to,
and refer people into, local community sector provision of health-
supporting activities
• use of the Social Value Act 2012, which makes building social
capital a key criterion in contracts and tenders, and which was
intended to open up more opportunities for social enterprises
• community development approaches, such as those piloted in
Croydon and Halton, which involve the community in identifying
their needs and demands, and determining how these can be met
• investment in voluntary and community sector (VCS)
infrastructure capacity to ensure that a full range of groups and
organisations can play their part in developing and providing care
and support locally
• investment in patient and lay leadership to help coproduce local
strategies, plans and services and ensure a more powerful citizen
voice in the governance of provider trusts, clinical commissioning
groups, health and wellbeing boards and Healthwatch.
• encouraging volunteering

15. New care system (cont)
Traditional New
Condition Person (in context of family &
community)
Care episode Pathway/journey
Hospitals communities
Organisations systems & networks
Clinical focus Quality of life focus
Formal workforce Formal and informal workforce
Doing to Working with

16. Questions governors can ask
• Is our trust good enough? (safe, effective, person-
centred, timely, efficient, equitable)
• Are we focussing on what really matters?
• How do we know?
• How does the trust use data and intelligence? What
changes?
• Are we governors sufficiently involved?
• Are we demanding that patients are sufficiently
involved?
• Are we sufficiently connected?

17. Making connections
• Patients
• Carers and families
• Staff
• Volunteers
• Voluntary & community organisations
• Healthwatch
• Patient and lay leaders

18. Involving people
http://engagementcycle.org/

19. Involvement standards
Principles – shared, inclusive, listening, respectful
Purpose – clarity and transparency
Presence – diversity of people involved at all levels
Process – carefully planned to maximise
involvement
Impact – did involvement make a difference?
4PI National Involvement Standards

20. Thanks for listening!
• www.nationalvoices.org.uk
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