Transcript Document

Self-care and personalisation:
putting patients, service users and
carers in control
A London Health and Care
Integration Collaborative event
Monday 1 December 2014
Session 2.1
#bettercareLDN
Developing personalised approaches
Simon Galczynski
Sandy Marks
Clare Henderson
Making it Real – where it began
Islington Personal Budgets Network meeting June 2013
Workshop to agree what co-production means
in Islington
Islington Personal Budgets Network meeting June 2013
Investing in developing experts by experience
Islington Personal Budgets Network meeting June 2013
Encouraging others to lead
Working together as equals
Islington Personal Budgets Network meeting June 2013
Outcomes via co-production
 “I” statements adopted across health and social care
A joined up approach that recognises differences in approach and culture but
common aims. A single approach and policy for ‘personal budgets’
 PA register
Small working groups agreed a low cost way forward
 Links for Living website
Experts by experience input via mystery shopping
 Co-produced Easy Read documents
MIR Action Plan, MIR Co-production concordat, Benefits information, N19 Pilot
Evaluation, Personal Budgets, Direct Payments
 Training and learning
Co-produced training and e-learning programmes about personal budgets and
independent living
Wall of achievement
Why is person centred care important to us?
• Patient
activation
critical to
help people
stay well
longer, and
to get better
sooner after
acute illness
• Improved
patient and
clinician
satisfaction
•
Islington
CCG
5th
most deprived borough
in London
• Huge health and social
inequalities
• High prevalence of Long
Term Conditions
• Better use of resources
Providers
• Better outcomes
• patient activation
• quality of life
• patient experience
Patients Outcome &
Experience
The House of Care – our model for care
planning
Enhanced
Recovery
Pathway
Ethos embedded in
some services
Organisational
processes
DESMOND/
HeLP
Diabetes
Engaged,
informed patient
Expert
Patients
Programme
Co-Creating
Health SMP
& Reunions
Self Care
Working
Group
HCP committed to
partnership working
Personal
health
budgets
Care planning
in longer appts
& prior to MDT
teleconference
Commissioning – The
foundation
Navigator
Role- Age
UK
Islington
Programmes
to support
healthcare
professionals
and patients
Self Care
CQUIN/
LCS/VBC
Coproduction
workshops
Measuring
outcomes
Using PAM in Islington
•
Measure to assess the impact of initiatives across Islington (as a totality)
on patient activation
•
Before and after measure of patient education/support programmes
currently set up and running
•
Questionnaire to be sent to all patients with LTC on practice registers,
scored and number recorded on patients EHR.
•
To identify opportunities for providing tailored interventions based on an
individual’s level of activation
What’s working well
People
Over 20
personal health
budgets
82% COPD
have
management
plans
42% YOC
reviews for
people with
diabetes
Professionals
Staff
satisfaction
Recognition
with HENCL
award
Champions eg
PHB
Process
Commissioning
Longer appointments enabling better
conversations
Patient
involvement in
the process
Good
collaboration
across the
patch
Pathways with
care planning
have offers for
self care and
PHB
Move to
integrate
disease specific
approach
Challenges
People
Deprivation and
low levels of
activation
Reaching
people
Interest in
PHBs low
Professionals
Pressure of
time
“I’m already
doing this”
unknown
unknown
Reinforcing
new approach
Process
NHS E care
planning
template
Commissioning
Annual funding
cycle challenge
to providers
IT systems don’t support shared care
and support plan
Scaling
up/building
capacity
More than
disease specific
sils
What we have learnt
Takes time
Need flexibility of
delivery model
Ongoing
support –
patients and
clinicians in
new ways
One size
doesn’t fit
all
Senior leadership from
clinical community
Integrate with
concurrent
initiatives
Importance of
getting the
language right
Care planning
documentation
Teams rather than individuals
inter-professional learning
together
Thank you