Tag Archives: Community

‘Thank God for the NHS and Nye Bevan!’

Photo of C4CC co-chair Nigel MathersTo mark 70 years of the NHS, C4CC’s co-chair, Nigel Mathers, writes this blog post on why he owes so much to the NHS and what his hopes are for the future.

I owe so much to the NHS.

I had severe asthma as a child and without the NHS, back then in the early 1950s – in its infancy, it would have been very difficult to get a good quality of treatment.

After training at medical school, I spent my entire working life in general practice, a fulfilling and rewarding career.

And just last year it proved a life-saver after I suffered a major heart attack and collapsed in the street.

Fortunately, an ambulance crew arrived in only seven minutes and was able to resuscitate me at the roadside. I had just a five percent chance of survival and was rushed to the coronary care unit at our local hospital.

Thanks to the skill of the surgeons and the wonders of modern medical technology I pulled through and have made a great recovery with a good quality of life.

Of course, this is one of the major success stories of the NHS, survival rates from heart attacks, many forms of cancer, particularly breast cancer, and a host of other diseases have dramatically improved over the past 70 years.

Way back then, heart attack victims were prescribed prolonged bed rest, while my rehabilitation has been based around daily four to five mile walks – tough at first but necessary and now part of my daily routine.

So it is easy to see why I care so much about the service launched by good old Nye Bevan in 1948 and now having to adapt to the very different landscape of 21st Century Britain, with all the challenges that brings.

As a former Honorary Secretary of the Royal College of General Practitioners (RCGP) and as co-chair of the Coalition for Collaborative Care (C4CC), I have been campaigning to bring about the changes to the health system that I believe can help it thrive for the next 70 years and beyond.

The NHS and social care services are currently under immense pressure through a combination of an ageing population and over 15 million people living with complex long-term conditions.

C4CC believes that the answer to easing these pressures, and providing people with the high-quality care and treatment they deserve, lies in our Three Cs – Better Conversations, Co-production, and Stronger Communities and happily there is now general consensus that this is the way forward. This personalisation of care has captured the zeitgeist – ‘spirit of our times’

As I look back on my career in general practice, which spanned over half of the 70 years since the NHS started, many of us were already using or beginning to harness these key principles in our daily work.

When I started as a GP, consultations with patients lasted the grand total of five minutes, the relationship was much more formal, with nobody calling me by my first name, and conversation and interaction was strictly limited, not least because of time.

In my inner-city practice, we tried hard to break down these artificial barriers by dressing informally, having soft furnishings in the rooms and never sitting directly behind a big desk when talking to people we adopted a conversational style across the side of a desk for consultations.

It was innovative at the time, but is now seen as best practice and of course consultations can now last up to 15 minutes, giving the opportunity to get to the root of a problem, which may not require costly medical intervention.

Co-production as a notion has also been around for a long time, it was just not called it.

In the 1980s we talked about a meeting of experts, with people experts on themselves and what might work best for them, and doctors the experts because of their medical training.

This evolved into RCGP best practice around shared decision-making, designed to encourage the patient to be an equal partner in their own care, the basic principle of what is now called co-production.

I’m particularly proud that C4CC has developed a model for co-production that seems to work and which has been adopted by our partner NHS England in its planning in this key area.

Finally, we have always relied on community and the voluntary services to address the unmet needs of our patients and sometimes [sadly] to fill the gaps in health and wellbeing provision for our communities.

My practice and many others were prescribing exercise in the 1980s, organising bi-weekly walks from our surgery for those we felt might benefit.

We now call this social prescribing and whether it is running, walking, joining other community groups or simply volunteering it has been found that these non-medical referrals can relieve the burden on the NHS and tackle issues such as loneliness and social isolation, themselves major causes of illness.

So while our Three Cs may not be new, I believe they really have captured the spirit of our times and as the NHS looks to the next 70 years will play an increasingly important role in policy direction and strategy.

It’s about changing the culture – about helping people to become active participants in their own care rather than passive recipients of that care – to encourage them to be far more involved in their own care and treatment.

The staggering pace of scientific development will, I believe help play a major part to facilitate this.

Wearable technology such as Fitbits and other devices allow people to monitor their fitness and general health.

There will be far greater interaction with people and health professionals through the Internet and advances in genetic technology [eg individually tailored drug treatments] are another area that has such tremendous possibilities for everyone.

Despite the current challenges, I believe we can look forward to the future with optimism.

I know C4CC and our partners in the coalition have a key role to play in shaping that future and to lead this social movement for change in the way that we work with people to improve their care and deliver better health outcomes for all – ‘personalised care’ for all – right across our NHS.

Nigel Mathers, Co-Chair of C4CC

 

 

What can healthcare commissioners do to get everyone involved with health and care in their own communities?

The need for community-based approaches to give people a real and effective voice in their own health and wellbeing needs has been validated and given greater weight by the NHS Five Year Forward View and its recommendations under Next Steps to utilise those assets as a catalyst for change.

Realising the Value has drilled down to provide the evidence of the validity of these approaches and is a call to action to make it happen.

All well and good, but it’s our contention as authors of Commissioning for Community Development for Health that there are many decision-makers in the health system who want to strengthen community action, but have no model for how to start going about it.

We wanted to produce a research-based publication that addresses this need and provides a framework for action, starting in priority neighbourhoods.

It offers a systematic approach to increasing resident involvement in health-giving activity, mutual aid and community effectiveness across a CCG area, and provides the tools to get it going.

It offers:

  • a down-to-earth explanation of what community development is and does
  • where it fits in to current health policy
  • the kinds of health benefit that these methods can generate
  • a rationale for partnership with other local services to boost community activity
  • mobilising participation through all community groups and networks
  • addressing both health and care and the social determinants of health
  • making services more responsive to communities
  • designing a two to five year community strengthening strategy
  • phasing the work across the CCG, starting with priority neighbourhoods
  • what skills should be sought in recruiting project leader and staff
  • model contract for provision of the community development project
  • model baselines, milestones and key performance indicators
  • reconciling planned outcomes and objective evaluation with scope for flexible fieldwork method.

The Handbook closely reflects C4CC’s own 3Cs. So we are proud to help spread the message to a wider network.

It has also been endorsed by the Royal College of GPs and Think Local Act Personal (TLAP). support we obviously welcome.

But our work does not end with its publication and we are offering introductory seminars and practical workshops to commissioners and others keen to learn more.

As well as explaining the key concepts and instruments and looking at case studies, these can be tailored to particular audiences, priority local issues and participants’ needs.

Contact gabriel.chanan@talktalk.net or brianfisher36@btinternet.com for more details.

 

Leadership for Empowered & Healthy Communities Programme – recruiting now! 

Following the continued success of the Leadership for Empowered and Healthy Communities programme, Think Local Act Personal, one of the Coalition’s partners, have announced dates 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 open to 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.

Starting in June 2014, the programme is a joint venture between Thames Valley and Wessex NHS Leadership Academy, the National Skills Academy for Social Care, Skills for Care, Think Local Act Personal, the Association of Directors of Adult Social Services and the Local Government Association.  The programme was initiated in 2011 by Jo Cleary, chair of another Coalition partner – the College of Social Work, and has already run three times to much acclaim.

 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….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:

  • June 4th 2015
  • July 13th 2015
  • September 21st 2015
  • November 17th 2015
  • January 20th 2016
  • October 20th 2015
  • December 4th 2015
  • January 14th 2016

To find out more click here and to register your interest please email: cathy.timmis@lehc.org.uk .