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Working together for change:
using person-centred information
for commissioning
Dr Fay Haffenden, National JSNA lead
National JSNA Dataset project 24 Feb 2010
Author: Sam Bennett, Department of Health
Working together for change
Putting People First
“It seeks to be the first public
service reform programme
which is co-produced, codeveloped, co-evaluated and
recognises that real change will
only be achieved through the
participation of users and
carers at every stage. It
recognises that sustainable and
meaningful change depends
significantly on our capacity to
empower people who use
services…”
Co-production
“This is not about consultation or participation –
except in the broadest sense…it is about
broadening and deepening public services so
that they are no longer the preserve of
professionals or commissioners, but a shared
responsibility…”
New Economics Foundation, Co-production: A manifesto
for growing the core economy
The WTfC project 2008-09
• Objective: To listen to what people said about their lives
and about services so that we can commission with
people to ensure they get more of what’s working in their
lives, less of what isn’t working and can achieve their
aspirations for the future;
• Approach: Worked with 4 councils to further develop
and test an approach for feeding person-centred
information from reviews and support plans into the
commissioning process;
• Outputs:
- A fully tested, written-up approach to co-producing
commissioning plans;
Why do this?
Understanding outcomes for people:
“Outcomes focused
reviews provide data about
individual outcomes…
…Using the same information in aggregate form provides the
opportunity to draw wider conclusions about outcomes for groups of
people, or populations”
Why do this?
The commissioning dataset:
•
•
•
•
•
•
•
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Strategic needs assessment – JSNA.
Socio-demographic data
Market intelligence
Performance and regulatory information
Historical commissioning patterns
Input from frontline staff
Consultation
Customer satisfaction surveys/complaints
JSNA
• DH guidance states that other data
sources “should be supplemented by
information gained through active
dialogue with local people, service
users and their carers”
BUT - Ensuring meaningful community
engagement in the JSNA process has
proved difficult…
Possible limitations
Data source
Limitation
Sociodemographic
data
Highlights
needs rather
than aspirations
Consultation
Often occurs
after
development of
the strategy
Satisfaction
surveys
Often use
closed
questions
Market
intelligence
Imaginative
constraints
JSNA
DH guidance states that
other data sources
“should be
supplemented by
information gained
through active dialogue
with local people,
service users and their
carers”
This has proved
difficult
The raw data for WTfC:
person-centred reviews
• The review of a person’s individual support plan or
personal health plan;
• Includes three key questions:
“what’s working?”
“what isn’t working?”
“What’s important to you for the future?”
• You can’t use ‘working together for change’ without
doing person-centred reviews!
The six stages of WTfC
1. Collect raw data from care plans/person-centred
reviews;
2. Organise information: top 3 “working” “not working”
and “important for the future”
3. Cluster the information with a diverse group of local
people;
4. Analyse – what are the root causes? what would
success look like?
5. Action plan – what will we do differently?
6. Share and communicate.
E.g. Step 3: Clustering
“I have only one
friend”
“I only have staff in
my life”
“I don’t see many
people during the
day”
“I am lonely”
E.g. Step 4: Analysis
“I feel lonely”
• We don’t put enough emphasis on relationships when we
commission services;
• Staff don’t know how to connect people and don’t see it is part of
their job;
• Providers don’t see this as a priority;
• CQC does not inspect on this so we don’t see it as important;
• This isn’t part of staff training;
• Care managers don’t see this as important when looking at
placements…etc
E.g. Step 5: Action plan
Individual change
“working”
Plan what it
would take to
spread this
practice
“not working” Plan what it
would take to
change this –
action at
operational
and strategic
level
“important
for the
future”
Inform market
development
and
commissioning
Strategic change
Presenting the data
Outcomes of WTfC implementation
• People using services and their families are put at the
heart of the process so that commissioning is
transparent and readily understood;
• Data generated routinely from person-centred reviews
can be used alongside (or as part of) JSNA to inform
strategic commissioning;
• Strengthened thread of robust qualitative data adds
‘colour’ and individual voice;
• That there is a clear and demonstrable link between
‘what people said’ and ‘what commissioners did’ – the
golden thread;