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  • The patient voice: What are the workforce implications of

    “putting patients at the heart of the NHS”

    Jeremy Taylor, CEO, National Voices

    At NHS Employers Autumn Workforce Summit 2015

  • National Voices

    • Coalition of 160+ charities

    • Founded 2008

    • We work for a strong patient and citizen voice, and services built around people

    • We stand up for voluntary organisations and their vital work for people’s health and care

  • What do people most want? http://www.nationalvoices.org.uk/evidence

    Where are the pinch points?

    Timely access Problems with waiting, access, eligibility for

    social care, access to particular therapies

    Effective treatment unwarranted variation in outcomes

    Involvement in decisions, respect

    for preference

    Significant minorities of patients not as involved

    as they want

    Information

    support for self care

    Information often insufficient; care planning &

    supported self management not mainstream

    Attention to physical &

    environmental needs

    Problems re dignity & nutrition,

    Problems in home-care and care homes

    Emotional support, empathy,

    respect

    Can be a struggle for busy staff; poor

    communication a frequent complaint

    Involvement of /support for carers Often insufficient

    Continuity of care, smooth

    transitions

    Frequent fragmentation and poor transitions.

    Problems with discharge; too many visitors to

    home; “telling story over and over” etc

  • 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?

  • 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….

  • Person centred coordinated care

    near the end of life

    “I can make the last stage of my life

    as good as possible

    because everyone works together

    confidently, honestly and consistently

    to help me and the people who are

    important to me, including my carer(s).”

    My goals and

    quality of life and

    death

    Honest

    discussion

    and

    planning

    The people who are

    important to me

    My physical,

    emotional, spiritual

    and practical needs

    Responsive

    and timely

    support

  • The Five Year Forward View

    “We have not fully harnessed the renewable energy represented by patients and communities”

  • The Five Year Forward View

    • People are fully engaged in their own health and care

    • Services are co-produced with communities

    • Inequalities are reduced

    • Carers are better identified, supported and involved

    • Health and care systems are fully realising the potential of volunteering and social action

    • Health and care systems are fully realising the potential of VCSE organisations

  • Why does this matter?

    People engaged and supported in health behaviours and their care & treatment are more likely to:

    • Have better health • Have better outcomes from care and treatment • Manage better • Make less use of high cost services

  • Why does this matter?

    Communities actively involved in decisions that affect health and services

    • Can help shape services that work for them (and therefore you)

    • Can solve many of their own problems • Are the source of people who help people

  • What works? • 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 for people living with

    long term conditions and disabilities • 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 • personal budgets to give people greater control • training and development in the skills required for person centred care – such as

    health coaching, motivational interviewing, risk communication and eliciting people’s values and preferences

    • ‘social prescribing’, where statutory professionals have access to, and refer people into, local community sector provision of health-supporting activities

    • 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

    www.nationalvoices.org.uk/evidence

    http://www.nationalvoices.org.uk/evidence

  • How do we engage? How do we hear patient voice?

    • prioritise clinical shared decision making and personalised care planning

    • use your feedback data

    • work with your Healthwatch & voluntary groups

    • continuing dialogue with the local community, not episodic consultation

    • work with service-users to co-design service improvements

    • Embrace and develop patient and lay leaders

  • and avoid tokenism…

  • Are you really listening?

  • What do staff need to “put patients at the heart”

    • a “working with” not “doing to” mindset

    • time

    • supportive, empowering management

    • multi-disciplinary team working, supported by IT

    • skills & capabilities in person centred approaches

    • skills & capabilities in engaging the “informal workforce”

    • leaders and managers who prioritise all the above

  • Thanks for listening!

    • www.nationalvoices.org.uk

    • You can follow us on Twitter – @NVTweeting

    – @JeremyTaylorNV

    • You can sign up for our newsletter: email info@nationalvoices.org.uk

    • You can become a member, partner or supporter: email info@nationalvoices.org.uk

    http://www.nationalvoices.org.uk/ mailto:info@nationalvoices.org.uk mailto:info@nationalvoices.org.uk