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.”