Tag Archives: Better Conversations

The Q Improvement Lab – peer support access survey

The Q Improvement Lab – an initiative supported by the Health Foundation and NHS Improvement – brings together diverse groups of people to work and make progress on complex challenges in health and care (further details here).

Since April, the Q Lab has been working on the challenge ‘what would it take for peer support to be available to everyone that wants it, to help manage their long-term health and wellbeing needs?’.

As part of this work, we are excited to launch a survey on what matters to people when making decisions to do with peer support. We hope you will get involved in this piece of research.

About the survey

The survey will help us understand what factors different groups of people – people working in health and care, peer support workers and the public – consider important when referring to, recommending or accessing peer support.

The survey was co-designed with Q Lab participants (a diverse group of 170 people including health care professionals, those working in peer support, those who receive peer support, charities, universities and patients to name but a few) and colleagues at the Health Foundation. We are also working with YouGov to help share the survey and collect responses.

We think that the survey will give new insights into the drivers around decision making in peer support and could help facilitate better conversations between those working in health and care, those working in peer support and people who could benefit from using peer support.

To help us get as many people as possible fill in the survey, please:

·         Complete the survey (it will take less than 10 minutes)

·         Share the survey with 3 or more friends and colleagues (here’s a document with suggested text and tweets to help spread the word)

The survey is open until 19 January.

Even if you haven’t used, worked in or even heard of peer support before – your insights are still valuable.

Let’s spread the word

This is not a small survey; we’re aiming to get over 2,500 responses.

YouGov are helping with collating responses, however we need the help of the health and care community to help spread the word.

Together we can contribute to what we think is an exciting and practical piece of peer support research.

Get involved and further information

If you’d like to be involved in shaping the outputs of the survey, would like further information about our work or have any questions, do get in touch via QLab@health.org.uk.

Twitter: @theQcommunity    #QLabs

Hannah Patel, Insight and Evaluation Manager – Q Lab
The Health Foundation (Q Lab)

What now? Conversations after a terminal diagnosis

“We never expected the pain he experienced during the last week of his life… The reality was devastating for my husband and it subsequently had a huge and long-lasting effect on me… If we’d been given clear information about what to expect it could have been so different… No one sat me down and gave me information or explained what might happen.”

Pam, aged 60 from Cheshire, lost her husband Bill to heart failure in 2013. They had managed his heart disease and related illnesses fairly well for many years and were led to believe that Bill’s death, when it eventually came, would be peaceful, painless and at home. But when it did come, they were woefully unprepared and left unable to make the choices that were most important to them.

Pam was just one of the hundreds of people Compassion in Dying spoke to who are living with a terminal illness or caring for someone at the end of life. We wanted to understand what it is like to live with terminal illness, what are the challenges and how can they be overcome, and what advice people would give to others in similar circumstances.

People told us that they were often not given information about their prognosis or treatment options in ways they could understand. When they wanted more information, they didn’t always know the right questions to ask. They told us that opportunities for conversations about their care and treatment were missed.

 “The professionals involved waited for us to ask questions but we often didn’t know what questions to ask until it was too late. These were people who had watched many people die, and we needed them to offer more guidance.”

 In response we developed What now? Questions to ask after a terminal diagnosis to help people find the information they need and ask questions, so that they can make informed decisions about their treatment and care – helping them to live well in the time they have left.

What now_publication_1

What now? includes insights from people living with terminal illness, or caring for someone at the end of life. It shows the range of feelings, responses and questions that people can have, and how differently people experience receiving a terminal diagnosis.

People told us that having honest conversations with their families and healthcare teams helped them to understand what to expect, and to make the decisions that are right for them. They also told us that what they wanted to know could be forgotten in the moment, perhaps because the information is hard to take in, or because the conversation goes in a different direction.

What now? includes ‘tear out’ pages with questions people have told us they wanted to ask, so that others can ask them when having conversations with their health and care team. They span all aspects of living with terminal illness, and include questions like:

  • Can my family members be involved in decisions?
  • What kind of changes will I have to make in my work, family life, sex life, and leisure time?
  • What are the best things I can do to stay as healthy as possible?

We hope that What now? will encourage meaningful conversations between people living with terminal illness, their carers and their health and care teams.

Download or order a copy for yourself or the people you support.

 

Written by Natalie Koussa

Natalie is Director of Partnerships and Services at Compassion in Dying,  a charity that works nationally to support people to consider their wishes for the end of life, and to plan ahead to ensure what matters to them is known and can be followed.

C4CC welcomes new standards to be adopted for letters to outpatients

Hospital consultants will be encouraged to write clear, easy to understand and jargon-free letters directly to people and copied to their GPs, instead of the other way around, under proposals recently approved in principle by the Academy of Medical Royal Colleges (AoMRC) and championed by the Coalition for Collaborative Care (C4CC).

The AoMRC has been tasked with leading a programme of change to encourage and support clinicians across all disciplines to adopt this as good clinical practice and to incorporate it formally within the training curricula of both undergraduate and postgraduate doctors.

C4CC has long campaigned for this vital change, replacing the current practice of consultants writing to an outpatient’s GP, and referring to patients in the third person.

C4CC co-chair Nigel Mathers, the Honorary Secretary of the RCGP, said the plans had gained widespread support from doctors, including the Royal College of General Practitioners, and patient organisations.

“This will be a personal letter to you, with your GP copied in, who will also be supplied with more detailed technical information, which can also be discussed with you,” he said.

“It’s a big cultural change and naturally will take time to become standard practice because it requires training and a different way of thinking for all doctors, but the new policy framework is an important step in the right direction.”

Katie Clarke-Day, who works with NHS England and C4CC on projects to improve the lives of people, like her, with multiple long term conditions, said she had long advocated for more personalised communication between doctors and their patients.

“It may seem like a small change, but it is hugely important, particularly for people with long term conditions,” she said.

“It’s about relationship building with the people who are keeping you alive and trust is really important.

“From the start, from the very first letter that you receive, you should have all the information that you need, in plain English, so you can take ownership of your treatment and get the appropriate support,”

Making sure the right information is always included in outpatient letters is the first step.

New guidelines to help professionals do just that were published by the Professional Record Standards Body (PRSB) last summer.

Their new guidelines encourage professionals to produce consistently high quality letters.

“Many more people are treated in outpatient clinics including people with complex health and care needs so it is really important that outpatient letters are clearly written and contain the right information for hospital staff, GPs and teams looking after people in the community,” said Lorraine Foley, CEO of the PRSB.

“Our standards help professionals share information. We are right behind the proposals to ensure that letters to patients are written in plain English so that everyone has a good understanding of a person’s health needs and most importantly that patients can take greater control of their care.”

-End-

Future Hospital Programme – Better Conversations

The past few weeks have been busy for me, meeting lots of C4CC partners and community groups and learning how the principle of ‘better conversations’ is being played out and reaping rewards for people with care and support needs across the country.

A few weeks ago, I was invited as an outside expert to attend a seminar on the Future Hospitals Programme run by the Royal College of Physicians.

It highlighted the fantastic work which is being done at a number of sites around the country to create a much better deal for people using their services, in particular older people with frailty and multiple long-term conditions.

All the ground-breaking projects were to be commended, but two in particular caught my interest.

Betsi Cadwaladr University Health Board serves a largely rural community in North Wales, which brings its own obvious challenges. Their C@rtref project (meaning ‘home’ in Welsh) is pioneering the use of teleconferencing video technology in local community clinics to enable people to have a follow-up consultation with a doctor in the main hospital, without the need to travel.

It has proved a much more effective use of time for staff, with clear efficiency savings, while for the older people themselves it has meant having a single, holistic conversation with a geriatrician rather than several different conversations with different doctors, as well as much less wasted time in travelling. Seventy-two per cent of those seen were aged over 75, yet more than 80 per cent were satisfied with this new way of doing business.

I was also struck by the project in East Lancashire Hospitals NHS Trust, which aims to provide personalised care for people at, or as close to home as is safe and appropriate. One study showed that their multi-disciplinary and co-designed approach prevented 59 per cent of admissions. I was impressed they had trained a team of volunteers to carry out detailed interviews with people in their own homes about their experience of care. In their words, in-ward surveys, ‘only tell you about a part of the journey.’

The examples showed that better conversations can be about the way we conduct doctor-patient consultations or how we take the time to really listen to what matters to people, whether in hospital or the community. And what struck me was that the staff involved were genuinely committed to making a difference to people, sometimes under very difficult circumstances. We are very much looking forward to working with the Royal College of Physicians and others over the coming months, to see if we can grow these person-centred approaches far and wide.