People and communitiesin the 5YFV Vanguards

Jeremy Taylor, CEO, National VoicesChair, People & Communities Board

22 April 2015

National Voices

• Coalition of 160+ charities

• Founded 2008

• Our mission: person centred care.

• “Few bodies have done more than National Voices to promote person centred care” Health Service Journal June 2014

What makes care person centred?

It focuses on what matters to me:

• Caring – compassion, dignity, respect

• Coordinated

• Personalised

• Enabling – information, support, voice, choice, control, independence

Person centred care made simple, Health Foundation, 2014

Person centred care 2020: National Voices position statement 2015

People & communities boardChair – Jeremy Taylor, National Voices

Caroline Abrahams, Age UK

Juliet Bouverie, MacMillan

Neil Cleeveley, NAVCA

Paul Farmer, MIND

Moira Fraser, Carers’ Trust

Emily Holzhausen, Carers UK

Sarah Hurcombe, Cabinet Office

Jo Lenaghan, Public Health England

David McCullough, RVS

Juliet Mountford, British Red Cross

Beverley Taylor, Regional Voices

Duncan Tree, CSV

Experts by experience – 2 being recruited

Our role1. Champion the vision of a “new relationship with

patients and communities”

2. Harness the expertise of patients, users of services, the voluntary sector etc to:

3. Support – and challenge – the Five Year Forward View programme

http://www.nationalvoices.org.uk/fyfv

What do people most

want?

What do they get?

Fast access Frequent problems with access; problems with

early diagnosis; rationing, especially social care;

Effective treatment Too much unwarranted variation; insufficient focus

on quality; access to therapies an issue for some

Involved in decisions, respect for

preference

50% inpatients not as involved as they want

Information & support for self

care

5% have care plan; info, education & support for

self care is not mainstream

Attention to physical &

environmental needs

Problems re dignity & nutrition,

Problems in home-care and care homes

Emotional support, empathy,

respect

Formal systems struggle with psychosocial aspects;

vital role for vol sector

Involvement of /support for

carers

Often insufficient

Continuity of care, smooth

transitions

Frequent fragmentation and poor transitions

Out-of-

Hours

Doctors

GP

District

Nurses

Social

Worker

Malcolm &

Barbara

ConsultantContinence

Adviser

Speech &

Language Adviser

Dietician

Community

Dentist

Occupational

Therapist

Equipment

Service

PhysiotherapistAlternating

Mattress technician

Wheelchair

Service

Oxygen

serviceDirect

Payments

Team;

Rowan

Org.

Alzheimer’s

Soc outreach

worker

Care team

2 live-in carers

(alternating weekly)

Replacement carer

[Some night nursing

– Health]

Emergency carers

& Barbara

The Web of

Care

(Last 7 yrs)

Dementia

Advisory

Nurse?

Person centred coordinated care

“I can plan my care with people who

work together to understand me and my

carer(s), give me control,

and bring together services

to achieve the outcomes important to

me.”

I have the Information

I need…

I am supported to achieve my

goals….

The professionals work as a team.

I always know who is coordinating my care

I’m involved as I want to be in

decisions…

I work with my team to agree a

care and support plan…

When I move between settings there is a plan in place….

Evidence based interventions• shared decisions about treatments, • care and support planning, using the principles and stages outlined

by National Voices and others.• information, education and support for self-management,

including peer support, for people living with long term conditions and disabilities

• coordinating care, following the narratives co-created by National Voices and partners

• access to personal records – proven to support self management, shared decisions and people’s commitment to courses of prevention and treatment

• personal budgets to give people greater control over the way they maintain their health and wellbeing

• training and development in the skills required for person centred care for large cohorts of practitioners – such as health coaching, motivational interviewing, risk communication and eliciting people’s values and preferences

www.nationalvoices.org.uk/evidence

People powered services• valuing and supporting carers and families• ‘social prescribing’, where statutory professionals have access to,

and refer people into, local community sector provision of health-supporting activities

• use of the Social Value Act 2012, which makes building social capital a key criterion in contracts and tenders, and which was intended to open up more opportunities for social enterprises

• community development approaches, such as those piloted in Croydon and Halton, which involve the community in identifying their needs and demands, and determining how these can be met

• investment in voluntary and community sector (VCS) infrastructure capacity to ensure that a full range of groups and organisations can play their part in developing and providing care and support locally

• investment in patient and lay leadership to help coproduce local strategies, plans and services and ensure a more powerful citizen voice in the governance of provider trusts, clinical commissioning groups, health and wellbeing boards and Healthwatch.

• encouraging volunteering

New models of care

Traditional New

Condition Person (in context of family &

community)

Care episode Pathway/journey

Hospitals communities

Organisations systems & networks

Clinical focus Quality of life focus

Formal workforce Formal and informal workforce

Doing to Working with

Final thoughts….“A new relationship with patients and

communities” means:

1. Person centred care, not just better communications

2. Different ways of working, not just integrated structures

3. We are here to help!

Thanks for listening!

• www.nationalvoices.org.uk– @NVTweeting

– @JeremyTaylorNV

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