Towards person centred, community-led health and care

How do we get the change we want to see?

Last week I attended my first meeting of the Realising the Value (RTV) Advisory Board. RTV is the programme bringing together the evidence base for person centred and community focused solutions to the challenges of health and care and to develop tools and approaches to get that evidence effectively used to drive change. I was struck in the conversations amongst those attending by a kind of “concerned optimism”. Elements of this were:

• Concern about resources and the implications of massive pressures
• A sense that perhaps for the first time person centred and community led approaches might be coming seriously onto the agenda in health
• Thinking about best strategy and tactics to take the opportunity and avoid re-freezing the system with only structural changes for another generation post Five Year Forward View

There was some self-criticism – why have we not managed to get traction for approaches that have been around for quite some time now. Why do eyes sometimes glaze over when we are pitching how person centred care and support planning and people powered health approaches can be powerful solutions to major problems, rather than cake icing or nice to have when the money is available?

The “concerned optimism” came in strongly when we listed the possible drivers for radical change, We have a resource crisis not solvable through existing approaches, chapter two of the 5YFV, the New Care Models Vanguards, Integrated Personal Commissioning and other demonstrator programmes, a sector starting to come together around person centred care – including via C4CC and Think Local Act Personal (TLAP). These are all present or coming into place, but what should be our best strategy and tactics to really take the opportunity when existing cultures, behaviours and interests are resilient. How do we persuasively demonstrate that person centred approaches and community led solutions must complement system re-configuration to achieve the win-win of sustainability and better outcomes?

We were agreed that the approach of RTV – not just gathering evidence of what works, but also looking at how to get it to work in the real world, is vital – including working with some local systems to see how approaches and tools make a practical difference.

In the same week two of C4CC’s partners – Nesta and the Health Foundation in collaboration and synergy with the Kings Fund and IPPR made their latest attempts to paint the picture of a possible future and offer key means to achieve it.

Three reports were published:
Nesta: The NHS in 2030 – a vision of a better future
Making Change Possible, A Transformation Fund for the NHS: King’s Fund and Health Foundation
Powerful People: Reinforcing the power of citizens and communities in health and care: IPPR

The three reports make quite strongly consistent pitches for the change they want to see – with person centred care and support at their heart – and two of them propose the specific mechanism of a Transformation Fund. The argument for the Fund is that even if £8bn extra funding is found by the Government, unless some is targeted at supporting radical new approaches, the risk is the impact will be limited to temporarily maintaining a system that is not long term sustainable and will not deliver the shifts called for in the 5YFV.

Take a look and see what you think. In the meantime – if you want to join us in turning our “concerned optimism” into an increasingly smart and powerful drive for the change we want to see – join C4CC and share your ideas and energy with a growing movement.

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