All posts by Kirsty

Achieving Personalisation for People Affected by Dementia

With the NHS Five-Year Forward View and the Care Act driving the personalisation agenda into the mainstream, there is an increased need to focus on how to achieve this meaningfully and consistently in the context of budget cuts and other pressures.

Whilst many recognise the benefits of personalisation, there is still work to be done in making it real for people and we hope that this tool can help provide consistency in the approach used by professionals involved in care and support planning for people affected by dementia.

Progress front coverThis tool can be used by anyone organising individual support packages. It highlights good practice and shows areas where possible improvements are needed, while acknowledging that people and organisations won’t all be starting from the same place.

By adopting a ‘no blame-no excuse’ approach, the tool can be an unthreatening way for staff and teams to explore their current practice against practical benchmarks and find ways to improve their performance incrementally.

People with dementia consistently tell us that they want choice and control over decisions about them, for services to be designed around them and to feel valued as part of a community. We know that person-centred conversations lead to better individual outcomes and we hope the practicability of this tool can lead to transformational change across the dementia landscape.

Personalisation is at the heart of what Alzheimer’s Society do and within my team in particular, we are working to achieve this for people affected by dementia.  We are committed to modeling our own practice around the approaches detailed here. Through our partnerships with local authorities, CCGs and other organisations we will seek to ensure all people affected by dementia get the best care and support available to deliver what is most important to them.

C4CC Launches New Care and Support Planning Tool

One of the core aims of the Coalition for Collaborative Care (C4CC) is to ensure care and support planning is a mainstream activity and I hope that the launch of our new planning tool will make a real contribution to making that happen on the ground.

Progress front coverIt is vital that people with long-term conditions have the opportunity to have a conversation about what matters to them and to be seen as an equal partner in their care by those supporting them, in health and social care.  Many of our partners and co-production team have evidence and stories about the positive difference the right conversations can have on people’s wellbeing, in achieving the outcomes that are important to them and on their confidence in taking control of their own health.

C4CC wants care and support planning to be available to everyone with a long-term condition and not just the “lucky few.” This tool has the potential to ingrain this best practice across the entire health and social care sector, providing organisations with a baseline starting point and the ability to continually assess their progress.

The toolkit has come about as a result of extensive work with C4CC partners such as the Alzheimer’s Society and Royal College of GPs, because they recognise the value of those conversations in achieving a better deal for people with long-term conditions.  This partnership approach will also be vital as we look to make its use widespread and bring about the system change we are all so passionate about.

In the coming year we will be continuing to deliver training, development and awareness raising sessions around better conversations, using the strength and breadth of our networks to build this movement for change.  Please get in touch by emailing info@coalitionforcollaborativecare.org.uk if you want to collaborate with us to help us keep up the momentum.

Encouraging Personalised Care and Support Planning in Mental Health Services

As we approach the end of Mental Health Awareness week 2017 it is important to think about not only those who have a mental health condition but also those people and organisations who work hard, often without recognition, to support them.

With two out of every three adults saying that they have suffered from mental ill-health, the tens of thousands of people in provider organisations across the country are working tirelessly to ensure that everyone has the best possible chance to recover and live the life that they want to.

We acknowledge that there are a wide range of service providers supporting people with mental health needs, from large NHS and statutory providers, to voluntary and community sector (VCS) providers of all sizes, down to small local groups and volunteers.

It is also important to remember that VCS and statutory providers need each other. Neither can exist independently of the other and both have a vital role to play in the support of people with mental health conditions over the course of their lives. The differences we identify as people working within the sector are of no importance to people who use our services and their friends and families who are seeking treatment for themselves or their loved ones. It is down to us all to make sure that we are working together to make the journey as seamless as possible.

Great strides have been made over the last few years towards this goal with initiatives to place staff from each sector within other services. This can be seen happening across care from GPs to housing support, employment support and the criminal justice system. But we need to do more. There is still too little understanding between the sectors about opportunities for collaboration.

Association of Mental Health Providers is here to help. As the only representative body for VCS providers of mental health services, we are well placed to encourage better conversations, that result in improved integrated personalised care and support planning. This will help to provide more effective joined-up care, tailored to a person’s needs. By working with members to ensure coordinated planning and provision, the Association champions services which will provide effective whole-person care.

There are an increasing number of people with health problems that require access to multiple health and social care services. The knowledge and experience that the voluntary mental health services have, plays an important role in bridging the gaps to achieve effective personalised care and support planning, alongside statutory services. The Association is focused on taking forward evidence of effective service provision in this area.

To find out more or to help us with stories or evidence of what is working well in your area around good, mental health care and support, visit www.amhp.org.uk or follow them on twitter @AssocMHP and LinkedIn AMHP

 

Accessible Information and Healthcare: Thoughts and advice from a person with a learning disability

Shaun Webster MBE is an International Project Worker at CHANGE and has delivered training worldwide. He is a role model for co-working and co-production.

In this blog Shaun shares his personal experience of accessible information in healthcare and how he is working with C4CC.

My personal experience

When I joined the local doctor’s, they used to send me appointment letters. I didn’t understand the letters and used to miss my appointments. The writing was in small lettering, on white paper, with no spacing between the lines. It would make me feel quite sick – it was like looking at ants on a page. This is because of my dyslexia and learning disability. I told the receptionist I would be able to read documents if they were printed on pale green paper, in bigger fonts and 1.5 gaps. They didn’t take this information seriously. They didn’t seem to understand the effects of my learning disability. I felt like it took my independence away.

This was very important information about my health and wellbeing which I could not understand and this could have affected my life in a very serious way. After two years of this situation, new management took over the surgery. They had a different approach and attitude to my disability. They started to think out of the box to find solutions. We talked about different options and finally decided to use text messages to remind me of my appointments and the reason for going. This worked very well for me – now they will even ring me to remind me of my appointment. This helps as I have short-term memory issues, so two reminders is better.

Here are some other ways health services can be more accessible:

  • To help me remember what medication I take, it would help to have access to Easy Read documents with pictures of the types of medication.
  • Having pictures of the doctors could help me recognize the doctor I have seen, as I am good with people’s faces.
  • A lot of people with learning disabilities find it difficult to get the information they need in a 5-10 minute appointment. Doctors should think about giving them longer appointments.
  • Prescriptions are written in small letters and doctors and chemists do not explain enough about the side effects of the medication and how often you should take them. Easy Read prescriptions would be better.

Important things to remember about accessible information

  1. Everybody is different

Find out when someone joins a surgery what type of support and communication they need. Ask them at the beginning rather than assuming what the solution is. You might want to invite a support worker, family member or advocate to the first meeting.

For people with learning disabilities Easy Read is often used for documents.

  1. Use jargon-free language

Professionals need to talk in plain English otherwise people with learning disabilities will find it hard to understand. It is important to always double check that the patient has understood the information correctly.

People with higher support needs might need an advocacy worker or support worker to help them understand their condition and their choices. However, it is important that professionals keep talking to the patient, and make eye contact with them, rather than exclude the patient from the conversation!

How is good accessible information made?

Always work with people with learning disabilities from the beginning rather than at the end of the process.

At CHANGE, we  make accessible information by combining the life experience of people with learning disabilities with the skills of designers. Everybody works together from the beginning to the end of the making of the document to decide if the words and pictures are understandable and fit together. This process means we don’t go in the wrong direction.

Why is it important to have accessible information in organisations and services?

If accessible information is not provided to people with learning disabilities, they will feel not included and not equal.

However, if accessible information is available, the person will feel more confident, empowered, and have a voice. This will allow organisations and services to break barriers and change attitudes.

If I had accessible information from the start, I would have made it to my appointments, been more independent, and it would have saved time and money spent on letters that were not useful to me.

On a bigger scale, accessible information can help anybody who finds reading and writing hard, not just people with learning disabilities e.g. people who do not have English as a first language.

I am looking forward to working with C4CC to break down barriers and change peoples’ attitudes by advising and delivering training on accessible information.

A note from C4CC:

The C4CC hub-team was recently given easy-read training by Shaun and his colleagues at Change. We found this invaluable in enabling us to create our own easy-read documents and reaffirmed our belief that organisations can always learn more by speaking with and working together with people who have lived experience.

If you are interested in creating easy-read documents of your publications, or would like to know more about the training offered, get in touch with Change on info@changepeople.org or click here.

Leadership for Empowered and Healthy Communities Programme – recruiting now!

Following the continued success of the Leadership for Empowered and Healthy Communities programme, new dates have been announced for the next cohort.

This innovative programme explores how leaders can grow and nurture capacity in local communities to improve health and wellbeing and ensure better outcomes for people living with long-term conditions, disabled and older people.

The programme is aimed at senior leaders and clinicians across health, social care and beyond who want to be part of a movement for change. Participants will be encouraged to think radically about the role of ‘social capital’ in health and social care and the role of public service leadership in shaping the communities that citizens need and want.

The programme involves a series of one-day workshops, action learning sets, one-to-one leadership coaching sessions, a Myers-Briggs (MBTI) analysis of personality style and a specialist 360 degree feedback diagnostic. Participants will have the opportunity to learn about best practice as well as developing the leadership skills required to embed co-production into organisations and enable strong and empowered communities to grow and flourish.

The programme, which kicks off in July 2017, is a joint venture between C4CC, Thames Valley and Wessex NHS Leadership Academy, Skills for Care, Think Local Act Personal, ADASS and the Local Government Association.

The New Economics Foundation’s evaluation of the 2012 programme found, “The leadership course was regarded in positive terms unanimously by those that attended. It was described as “excellent”, “inspirational” and perhaps most crucially, has already led to new leadership behaviours in those attending.” It also found the fact that, “…most of those who attended the course had already begun to transform their role or services is evidence of the extent to which the course inspired.”

The dates are:

6th July 2017
28th September 2017
9th and 10th November 2017 (residential)
24th January 2018
14th March 2018

To find out more, including dates for webinars / virtual learning, please click here.

To register your interest please email: Harmeet Bhatia at harmeet.bhatia@lehc.org.uk

Realising the Value: four months on

Last November, the Realising the Value programme launched its final reports. The programme aimed to enable people to take an active role in their own health and care, in support of the NHS Five Year Forward View vision to develop a new relationship with people and communities. This was an 18-month programme funded by NHS England and led by Nesta and the Health Foundation, working with Voluntary Voices (made up of National Voices, NAVCA, Regional Voices and Volunteering Matters), the Behavioural Insights Team, PPL and Newcastle University.

Over 18 months we strengthened the case for change and identified evidence-based approaches that engage people in their own health and care. We have:

● Drawn together and consolidated the evidence base
● Developed an economic tool for commissioners
● Created tools to support behaviour and culture change
● Explored the value of individuals and communities in their own health and care
● Pulled together a catalogue of practical lessons from local areas putting this into practice
● Assessed system change levers and drivers
● Set out ten actions to put people and communities at the heart of health and wellbeing.

We also worked with five local voluntary, community and social enterprise sector organisations that are exemplars in the field – Positively UK, Penny Brohn UK, Big Life Group and Being Well Salford, Creative Minds, and Unlimited Potential with Inspiring Communities Together. The understanding brought by our local partner sites has informed all aspects of the Realising the Value programme.

Now is a good opportunity to review the look back on the work we have done. There are some great numbers:
● Over 18 months we engaged more than 600 people directly through a series of programme events at key points, including our two final launch events in London and Manchester.
● We’ve had a lot of interest in our reports and publications. To date there have been more than 15,000 unique downloads of our reports.
● The online reach of our outputs has been significant. The Twitter hashtag #realisingthevalue had more than 4,000 mentions reaching over three million people. There have also been 26,000 views of more than 30 Realising the Value blogs

Behind these high level statistics there are some wonderful stories that have informed the way we think about what good health and care looks like.

Like Mark, who has lived with poor mental health over nearly 40 years and, through getting involved in a local football team, is now driven by an intense drive to make life better, for himself and others.

And Alex, a 41-year-old father of three, for whom a local project to promote the importance of fathers’ wellbeing and the impact it has on their kids has has brought clarity to his life.

We want these stories, and our work, to continue to inform and shape debate and action. And we are already seeing early signs that the tools developed through the programme are being picked up and used on the ground. We have spoken to a number of CCGs who are using the economic tool to inform their business planning, as well as voluntary organisations using it to inform their conversations with commissioners. And there have been more than 5,000 downloads of the two behavioural insight guides to date.

And we are seeing signs of Realising the Value informing broader policy-making. For example, the Director of Patient and Public Involvement and Insight at NHS England, Anu Singh, has said that,

“Realising the Value has formed the blueprint for NHS England’s new Supported Self Care programme”.

Dr. Alf Collins, clinical lead, person centred care, NHS England, has said,

“Thanks to the work of the Realising the Value programme, we can now see a structured approach to supported self-care that is based on evidence and practical examples. Given this evidence, NHS England is committed to providing leadership for the NHS to engineer Realising the Value principles and practice into the way it works. In short, putting in place Realising the Value will go a long way towards delivering the vision of Chapter 2 of the Five Year Forward View.”

Jon Rouse, Chief Officer at the Greater Manchester Health & Social Care Partnership, has said that he has, “taken learning from the programme directly into the development of our Population Health Plan and our work on integration of health and care services.”

A huge amount of work has gone into the programme, and it’s fantastic to see the impact the work is already having across the system. We hope this provides a solid foundation on which we all need to build. We are now in a much better place to understand what should be done and how people need to work differently to put people and communities at the heart of health and wellbeing.

C4CC’s Reflections on Realising the Value

When it comes to transforming health and care, there are countless toolkits, guidance documents, and resources that provide information about what should be done and what could be done. There are numerous legal duties that set out what must be done. There is a growing abundance of evidence generated from what has been done. And there are plans about what will be done.

This can be overwhelming at times, but the wealth of information and conversation over recent years has led to a level of consensus about the fundamental shifts we need to achieve, that suggests that now might just be the right time to pursue and realise the ambition.

“More stars are aligned to this agenda this time, let’s make it happen,” RtV presenter at regional event.

The Realising the Value (RtV) programme has made a significant contribution to this sense of alignment and possibility. In bringing together much of the outspread evidence, strengthening the case for change and pointing to the breadth of behavioural, cultural and systemic change that would be needed to achieve the transformation, the programme marks a watershed in our approach to health and wellbeing, validating the community and person-centred approaches that are being championed by C4CC and its partners.

C4CC is committed to working with its partners and other key stakeholders to ‘become clearer about the difference that these approaches make to people’s own health and wellbeing and to the wider system (page18 ten key actions doc)’ and bring about the fundamental changes that are needed to enshrine these ideas into the mainstream.

We know that it’s not about re-inventing the wheel, but making the best of assets that are already in place and utilising them in coherent and sustainable plans. Our coalition is a diverse and vibrant partnership that spans disciplines and sectors and reaches into the complex networks of changemakers at local, regional and national levels.

Together we have articulated the enablers to change as the ‘three Cs’; better conversations, coproduction and community development. Through collaboration at a local, regional and national level we will:

  • Support the ‘do-ers’: increasing their awareness and understanding of the ‘three Cs’; building consensus about what the ‘three Cs’ mean in a particular place and to different groups; and, improving the knowledge, skills and capacity to do or deliver the ‘three Cs’.
  • Create the conditions: supporting the development of behaviours, practices, systems and cultures that will sustain the transformation being sought.

Change can happen in many different ways. The implementation of person and community centred approaches will be configured differently, will be experienced differently and will produce different results in different areas and for different people. Our challenge will be in developing the adaptive capacity of people, communities and systems to ensure that the changes can be sustained long term and become the norm.

All the evidence and resources produced as part of the Realising the Value programme can be found here. If you would like to get in touch with the team, you can email health@nesta.org.uk

To follow the work of the Coalition for Collaborative Care, you can join us, free of charge, as a member here, subscribe to our newsletter here and follow us on Twitter here.

C4CC’s Perspective on the Five Year Forward View Delivery Plan

Catherine Wilton, Director and Fiona Carey, Co-Chair of the Coalition for Collaborative Care, offer the partnership’s perspective on the new Five Year Forward View Delivery Plan:

Since the Five Year Forward View (FYFV) was published two and a half years ago, the Coalition has been working together with our 50 national partners to effect change at pace and scale across the whole health and care system, to provide a better deal for people with long-term conditions and their carers.

At the heart of our approach has been the ‘Three Cs’ of better conversations, building community capacity and co-production.  For people with long-term conditions this means a new relationship with the NHS – in which people have the opportunity to have a conversation about what matters to them and what good looks like, to explore the assets and supports they have available to them – among their family, friends and local communities – and to plan and coordinate with healthcare professionals the services and treatments they might need to ensure they get the best possible outcomes.  It also means NHS organisations behaving differently – actively supporting and working with local people and communities to build community resilience and to co-design the supports that people want.

The original ‘Chapter Two’ of the FYFW championed the importance of empowering people and communities, and while it doesn’t have a separate chapter in the new Delivery Plan, many of our partners know that to make the plan become a reality, the NHS needs to fully embrace the power of people and communities.  ‘Health’ is not just created by health services – it happens when people are able to take control of their own lives and have a voice in what needs to happen locally to support them, on a one-to-one, and on a collective, level.  It is great therefore that the delivery plan has recognised the need for Sustainability and Transformation Partnerships to develop the concept of and collective action for ‘Health Creation’, as advocated by NHS Alliance. 

Having access to health and care services is vitally important but it is the quality of conversations between people and professionals that will ensure the best outcomes for people with long-term conditions.  The RCGP have stated that it is a ‘necessity’ for care and support planning to become core business for general practice, as it is an effective way to support people with multiple long-term conditions.  And they believe it is so important that they have made it part of the RCGP curriculum, meaning that to qualify as a GP, new recruits will have to know the principles and have the skills to do care and support planning.  Over the coming year we will be working very closely with the RCGP and other C4CC partners to roll out care and support planning – not only is it the right thing to do for people themselves, we believe that it can reduce the pressure on acute services for two reasons – because people are able to look after themselves better, and better coordinated care is more efficient.

There are huge challenges facing health and care over the coming years but we also share the optimism of the delivery plan that a better and more effective NHS can be delivered. We strongly believe that a people- and community-centred vision of collaborative care, delivering the ‘Three Cs’ is the best way to build an NHS fit for the 21st Century and one that will continue to sustain us all in the future.

C4CC’s Co-production Team View 

Sue Denmark from C4CC’s Co-production Team reflects on what this means for people.

“As someone with multiple long-term conditions, I was glad to see GPs getting the recognition they deserve as I all too aware of how important they are. The increase in their numbers is good to see, but I did feel there was something missing around the quality of the conversation between the professional and the person – more access is great, but we need to ensure care and support coming from the time together is person-centred.

“I was also pleased to see such a focus on mental health and the increase in talking therapies, but I did feel this could have gone a step further, looking at how community-based services could provide support, in a different way to medical treatment.

“I know from my own personal experience how community-based groups and activities can contribute to a person’s health and wellbeing. A few years ago, myself and others needing regular leg treatments worked together with our GP practice to create our own group and receive our care there instead of making appointments. The group, simply by its existence, began to tackle other wider issues such as isolation and loneliness – friendships made there led to walking groups and learning new skills. This has helped to improve people’s physical and mental health and reduced pressure on the GP practice.

“Reading this plan, I was unsure how I as a person fitted in to it, but having considered it, I think we can help by taking the lead on looking at our own communities and helping to fill in any gaps with local, tailored solutions. This, together with the work of NHS England, will start to deliver real change where it is needed.”

Job Opportunity – Head of Business Development with Spice Time Credits

There is an exciting opportunity to join the Spice Time Credits team as their Head of Business Development.

As part of Spice’s Senior Leadership Team (SLT), you will help drive Spice’s scaling strategy. Leading a motivated Business Development, Communications and Marketing Team, with a focus on securing funding from national initiatives, local authorities, CCGs, foundations, trusts and corporate partners, as well as leading Spice external communications and marketing initiatives. Working closely with the Chief Executive Officer, SLT, Trustees and wider organisation to drive the growth of Spice’s offer, you will also have an important role in visioning and designing the future of Spice working with existing and potential clients to ensure that they remain at the cutting edge of community development, public sector reform, preventative health and time banking.

Spice began as a start-up eight years ago and has now grown to a team of more than 40 people, with offices in Cardiff and London, and programmes in five regions of England and Wales – their turnover has grown more than five-fold, reaching over 33,000 participants.

The location of the role is flexible, with a starting salary of £43,000, with London weighting where applicable. Deadline for applications is 9am on Monday 3 April, with interviews taking place on Tuesday 11 April, in London.

You can find out more about Spice here, and to find out more about the role, and to apply, click here.

Timebanking, Good Gym and Social Prescribing

From social isolation to valued sports coach in one move…

I have recently signed up to Reading’s ‘Ready Friends’ befriending network on behalf of the timebank that I set up and continue to chair. NHS England allows staff to spend a week, fully paid, volunteering in their community or on other charitable projects, so I took advantage this by spending half a day at a workshop with about 10 different community organisations, all committed to combatting loneliness and social isolation in our town.

The groups at the meeting spanned from traditional-type befriending services, like those run by Age UK, to community transport schemes and one small group of neighbours who provide a home cooked meal for someone else in their street by just cooking a little more than they would normally.

Our timebank is providing social opportunities and links between people who share interests or who need help, and we have lots of success stories – someone who got a longed for job as a result of the skills and experience that running the timebank gave them, a person whose path to alcohol recovery has been helped by meeting people outside their usual circle, and one older person who used to go away every Christmas because it was too painful to be alone stayed in Reading last year, to meet up with friends made through the timebank.

There are examples like this from timebanks across the UK – where fantastic outcomes that improve people’s lives are the result of people and communities helping each other and not about the services they receive.

Another organisation at the meeting sparked some interest – Good Gym is doing fantastic work, particularly in the London area, but now expanding its reach. It encourages people to take up running and help their community at the same time.

Participants have three choices – join a group that runs somewhere to do a community-based activity like a gardening project; run to do a job to help someone, usually an older person, like putting a shelf up, then run back again; or be paired with an older person, with the aim of running to their house at a given time in the week. The twist is the older person is designated as the runner’s ‘coach’, providing a real reason to turn out on a dark and cold night.

I have pledged to sign up when Good Gym comes to Reading, as goodness knows I need the extra motivation to drag myself out to exercise on a wet Wednesday.

And lastly, we heard how the social prescribing project being run by Reading Voluntary Action has really demonstrated the power of person-centred conversations. Coupled with signposting to other support and helping people get connected to people and groups in their local community it has delivered improvements in all aspects of wellbeing for those involved.

The key to all this continuing to happen is of course the statutory sector recognising the huge contribution that community groups make to health, even though some of the schemes in the network do not look like traditional ‘services’ and have grown from the bottom up rather than as the result of a commissioning process. We are hoping that by working together we can build a network of supports across the town so that people are less likely to fall through the net. And my vision is also that those ‘befriended’ start to be seen for what they can do for their community, not what their community can do for them.