patient partnerships - new approaches in england
TRANSCRIPT
@robertvarnam
Dr Robert VarnamHead of general practice development, NHS EnglandGP, The Robert Darbishire Practice, Manchester
@robertvarnam
Patient partnershipAn international perspective
@robertvarnam
Patient partnershipAn international perspective
bit.ly/160728partnerships
@robertvarnam
Improving quality
Our successes: Data-driven approach Peer review Incentives for quality
Room for improvement: Culture of unease Focus on outcomes as well as inputs Focus on patient perspectives as well as professional Non-peer review Multi-morbidity, complex care & collaborative care
@robertvarnam
Massive shifts…
• Population needs (LTCs)
• Societal expectations
• Technology
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Population
Community
Care
Three arenasfor new partnerships
@robertvarnam
Population
Community
Care
Three arenasfor new partnerships
@robertvarnam
bit.ly/nhs5yfv
Shifts / rebalancing…
• From treatment to wellbeing• From professionals to people• From hospital to community
@robertvarnam
Shifts / rebalancing…
• From treatment to wellbeing• From professionals to people• From hospital to community
New Zealand Health Strategy 2016
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Population arena
• Shift of investment towards prevention
• Partnerships across society
• Coproduction of priorities with citizens
@robertvarnam
Population arena
• Shift of investment towards prevention
bit.ly/GPAF1voxpops1
@robertvarnam
Population arena
www.nhscitizen.org.uk
@robertvarnam
Population arena
startool.org
@robertvarnam
Population
Community
Care
Three arenasfor new partnerships
@robertvarnam
Population
Community
Care
Three arenasfor new partnerships
@robertvarnam
Community arena
• Coproduction of priorities with citizens
Wave one Wave two
57 schemes2,500 practices18m patients
bit.ly/PMCFresources1
Prime Minister’s GP Access Fund
@robertvarnam
Community arena
• Coproduction of priorities with citizens
• Asset-based community solutions
eg GP Access Fund in SloughOpen town meetings (lots of GP concerns) – almost instant benefits… different priorities local champions patient-run services
@robertvarnam
Community arenaOther resources…
How are practices engaging differently with the population
• bit.ly/GPAF1ppe1
The GP Access Fund• bit.ly/GPAFresources
Leading inter-practice change• vimeo.com/album/3133652
@robertvarnam
Population
Community
Care
Three arenasfor new partnerships
@robertvarnam
Population
Community
Care
Three arenasfor new partnerships
@robertvarnam
Care arena…
Patient-led transactions
Informing patients
Improving access
New consultation paradigms
Care planning & coordination
Personal budgets
Patient training
@robertvarnam
Care arena…Patient-led transactions• Patient Online: book appointments, request repeat
prescriptions
www.england.nhs.uk/ourwork/pe/patient-online/
@robertvarnam
Care arena…Informing patients• NHS Choices: information about symptoms, conditions and
treatments
• Patient Online: access to your medical record
www.nhs.uk
www.england.nhs.uk/ourwork/pe/patient-online/
www.dynamichealthsystems.co.uk
www.digitallifesciences.co.uk
@robertvarnam
Care arena…Improving access• Demand-led systems
• Phone consultations
• e-consultations
bit.ly/GPAFresources
@robertvarnam
Care arena…New consultation paradigms• Self monitoring
• Group consultations
• Assessing patient activation
• Coaching
bit.ly/GPcapacitynet2
www.getflorence.co.uk
bit.ly/NHSE-PAM1
youtu.be/p47H6kVF0IU
youtu.be/_uHFIJhWSxU?t=4m36s
www.dynamichealthsystems.co.uk
@robertvarnam
Care arena…Care planning & coordination• Incentives for practices
• Social prescribing
• Very multidisciplinary teams
bit.ly/GPcapacitynet8
waystowellness.org.uk altogetherbetter.org.uk
bit.ly/2ac6laU
www.coalitionforcollaborativecare.org.uk
@robertvarnam
Care arena…Personal budgets• For social +/- health care
www.nhs.uk/personalhealthbudgets
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Care arena…Patient training• Expert Patients Programme
• COPD
• Diabetes
• etc
selfmanagementuk.org
www.blf.org.uk
www.dafne.uk.com
@robertvarnam
eg GP Access Fund
@robertvarnam
Care arena…
Patient-led transactions
Informing patients
Improving access
New consultation paradigms
Care planning & coordination
Personal budgets
Patient training
@robertvarnam
Population
Community
Care
Three arenasfor new partnerships
@robertvarnam
How does it feel?
What next?
How?
So …
@robertvarnam
How does it feel?
Innovative+ Great … obviously− Threatening … obviously
Power shift+ Empowering− Abrogation of responsibility
Demedicalising+ Appropriate− Loss of role
We’ve begun
…
there are differing
perceptions
@robertvarnam
What next?• Sustain innovations• Spread innovations• Address inequity• Embed / normalise
How?• Grow evidence of benefit• Understand conditions for success • Inc training capacity• Change patient expectations• Align incentives & payment