Transcript Document

Living well with Multiple Conditions
Shifting the Paradigm
Dr Anne Hendry
National Clinical Lead for Integrated Care
Joint Improvement Team
What Matters to Me
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Coordination and continuity of care
Trusted relationships
Accessible information and advice
Good communication with, and between, staff
Number of people in Scotland with
two or more long term conditions
People living in more deprived areas in Scotland develop multiple conditions
around 10 years before those living in the most affluent areas
Mental health problems are strongly associated with the number of physical conditions,
particularly in deprived areas in Scotland
Current paradigm
Future paradigm
System geared towards acute
/ single condition
System designed around people with multiple
conditions
Hospital centred
Embedded in communities and their assets
Doctor dependent
Multi-professional and team based care
Episodic care
Continual care and support when needed
Disjointed care
Well coordinated integrated health and social care
Reactive care
Preventive and anticipatory care
Patient as passive recipient
Informed empowered patients and clients
Self-care infrequent
Self management / self directed support enabled
Carers undervalued
Carers supported as equal partners
Low-tech
Technology enables greater choice and control
Locality: the Engine Room of Integration
> Where we will best engage and empower those who
deliver and receive health and social care
> Where service changes can have a real and quick
impact on outcomes
> Where we will build effective relationships and
create local integrated networks of care and support
Creating conversation and space
that enables people to
understand, reflect upon and
reconsider their purpose,
attitudes, roles and relationships
9 Health & Wellbeing Outcomes (proposed)
People are able to look after
and improve their own health
and wellbeing and live in good
health for longer.
People, including those with
disabilities, long term
conditions, or who are frail, are
able to live, as far as reasonably
practicable, independently and
at home or in a homely setting
in their community.
People who use health and
social care services have
positive experiences of those
services, and have their dignity
respected.
Health and social care services
are centred on helping to
maintain or improve the
quality of life of service users.
People who provide unpaid
care are supported to reduce
the impact that their caring role
has on their health and
wellbeing.
People who use health and
social care services are safe
from harm.
People who work in health and
social care services are
supported to continuously
improve the information,
support, care and treatment
they provide and feel engaged
with the work they do.
Health and social care services
contribute to reducing health
inequalities
Resources are used effectively
in the provision of health and
social care services, without
waste.
Considering inequalities:
what are the implications for
health and social care services?
Dr Pauline Craig
Health Scotland
Deprived areas
• Area planning versus services for people
• More of the same in areas with greater need?
• How much more?
• Or different services?
Impact of social inequalities on
health
• Poverty, discrimination, family breakdown, domestic
and community violence, addiction, fear of crime,
dangerous environments, support networks
• Who are the poor? Hard to reach, easy to ignore etc
(recent reports)
• Single parents, people with disabilities, some ethnic
minorities, people with mental health problems,
people with addictions
Service planning: right to health
and AAAQ
• Available: location, opening hours etc?
• Accessible: physically, geographically, nondiscriminatory?
• Acceptable: culturally and ethnically, person
centered?
• Good Quality: environment, premises, safe and
effective, as good as they can be?
Health Inequalities Impact
Assessment
• Combined approach covers equality, human rights
and social inequalities
• Impact on different population groups, consider
diversity and complexity, voice of the voiceless,
literacy etc
• How do services need to adapt?
Discussion
• 1. Who can help you and your team to improve
outcomes for people with multiple conditions ?
• 2. How will you build effective relationships with
partners across all sectors ?
• 3. What actions will you and your team take to
help reduce inequalities within localities ?