A partnership between NHS England, NHS Health Education North Central and East London,

NHS Health Education North West London, and NHS Health Education South London.

Transforming community and general practice nursing in London – the art of the possible Inspiring nurses to rise to the challenge of improving quality and leadership in community and general practice settings in London Monday 9 February 2015 London

Delegate Guide #transformLDN

Sharing & Engaging: today, tomorrow & beyond

We are running this event because we want to inspire you to transform our community and general practice nursing services for Londoners, and we want to support you as much as we can in doing so. We think it is possible to transform services as there are innovative projects, great work and good ideas, and last but not least, fabulous, committed people working in London’s community and general practice services. We can tell you about these, and put mechanisms in place to join you up, but it is through you sharing your thoughts, comments and feedback, and engaging with others during and after today, that transformation will happen. We have designed the day so that there is time to think about what you would like to improve, and time to plan how you’re going to make that happen. By sharing and engaging, you can help us plan what we need to do next to support you. What can you do today to share & engage?

Share your project & learn about other’s projects We have created ‘Our Inspiration Landscape’ showing examples of how we are transforming community and general practice nursing services. It’s on the web, it’s interactive and it needs your project. The map will be on show at the event, and you can tell us about your project which we can upload onto the web later.

Make a pledge and complete your ‘Pledge Planning Tool’ Helen Bevan will present to us from her office in Coventry and will talk about the NHS pledge day she leads. After Helen’s talk we would like everyone to make a pledge on the one thing that they will try to improve in community and general practice services. At the back of this guide are two copied of the Pledge Planning Tool which you can use to help you plan your actions to deliver your pledge.

Listen and take part in today’s group sessions There are two group sessions, one in the morning and one in the afternoon. The morning session is an opportunity for you to meet new people on your table, share your reasons for coming to the event, and reflect on what you celebrate in community and general practice nursing. The afternoon session, after the workshops, will be when you return to the plenary room and sit with people who work in your borough. It’s a time to reflect on your pledges and how you’ve got on planning how you’re going to deliver your pledge using your pledge planning tool (see back page).

Visit the market place In the market place are innovative projects to hear about, university CPD courses to find out about, and Darzi Fellows, Queens Nurses and Care-Makers to meet. The Royal College of Nurses are there too and can tell you about their role in supporting networks and forums.

Engage with people There are about 200 people here today so there are plenty of people to engage with. There are opportunities at the breaks, at lunch time, and in the group sessions, as well as in the workshops.

Share your views on camera A film crew will have a corner in the market place, and will be around and about, during break times to record you talking about what you would like improved and your pledge to change it.

Join the live discussion on Twitter Join in the discussion on Twitter. A Twitter hashtag #transformLDN will be used for the event to help capture the conversation and encourage wider engagement.

Give us your feedback Your feedback is important to us, please complete the evaluation form and hand it in after the event.

What can you do tomorrow & beyond?

Join a network, or a few There are lots of networks and forums covering all sorts of themes; some are face to face others are web-based. Our Integration Landscape will eventually include them, in the meantime, you can get in touch with your local Community Education Provider Network (CEPN) via your local Health Education team, or go to the community hub in Action Area 4 of the 6Cs Live! website to join up with people. Also, the Royal College of Nursing, the Londonwide Medical Committee, and the Queens Nursing Institute all have networks too. There is one or more that will be great for you.

Share your project & learn about other’s projects After the event you will have further opportunities to share your project and join up with people. Go to www.transformLDN.org.

Contact us For more information on the transforming London programme, please visit www.transformLDN.org where you can find contact details for how to get in touch with this work.

General Information Photography, film crew and media Please be advised that there will be photographers, film crew and some media present. The event will not be taking place under Chatham House Rules. Assistance If you have any queries during the conference, please visit the registration desk. Refreshments All refreshments, including a light lunch will be served in the exhibition area. If you have arranged a special dietary meal then please make yourself known to the catering staff. Cloakroom facilities Coat rails are provided. Please note that these will not be staffed and, in the interests of security, we advise you to keep items of value with you at all times. NHS England and the venue do not accept liability for delegates’ personal belongings. Seating plan All delegates have been allocated a table number and this is indicated on your badge. Workshops Please see the agenda regarding the series of workshops that take place after lunch. Mobile phones As a courtesy to the speakers and other delegates please switch your mobile phones to SILENT whilst the conference is in progress. Wi-Fi Details regarding how to access the free venue wi-fi can be obtained from the conference registration desk.

Agenda (Subject to change)

08:30

Opening of the market place Meet Darzi Fellows, Queens Nurses, Care-Makers and others rising to the challenge of transforming community and general practice nursing services. Registration and refreshments

08:45 Our inspiration landscape Launch of ‘Our Inspiration Landscape’ showing examples of how we are transforming community and general practice nursing services.

SESSION ONE: The time is right Why transforming quality and leadership in community and general practice nursing services is important to us all.

09:30 Welcome and my story Caroline Alexander, Chief Nurse for London for NHS England, shares her reasons for caring about the transformation of community and general practice nursing services in the capital.

09:50 Sharing your story An opportunity for you to share (in groups) your story, discussing what motivates you and what you celebrate in community and general practice nursing.

10:15

Leading the revolution Jonathan Lewis, Chief Executive for Bromley Healthcare Community Interest Company, and Dr Pete Thomond, Managing Director for Clever Together, discuss why the time is right and why we need to improve community and general practice nursing services now.

10:45

Panel Q&A chaired by Jane Clegg, Director of Nursing South London for NHS England Caroline Alexander, Chief Nurse for London, NHS England Jonathan Lewis, Chief Executive Officer at Bromley Healthcare Community Interest

Company Dr Pete Thomond, Managing Director for Clever Together

11:00

Break

SESSION TWO: Making and leading improvements Caroline Alexander hears about the improvements that people have made and are doing, and Helen Bevan talks about her experiences of transformation.

11:30 Hearing your stories An opportunity to tell the audience your story of improving community and general practice nursing services.

12:00 The change hour Dr Helen Bevan, Chief Transformation Officer for NHS Improving Quality, describes how to move from an idea you care about to practical action and then delivering outcomes.

Make your pledge An opportunity to make your pledge and begin to plan how to deliver your improvement idea.

13:00 Lunch (45 mins)

SESSION THREE: Inspiration through Innovation An opportunity to attend three out of eight workshops (see list below) to hear examples of innovative and new models of working in the community and general practice, and ask ‘how’ questions to the presenters to build your improvement plan.

13:45 Workshop session A See list below

14:30 Workshop session B See list below

15:15 Break (15 mins)

15:30 Workshop session C See list below

SESSION FOUR: Your commitment and our commitment The end of the conference but not the end of the journey.

16:15 Next steps and closing remarks Caroline Alexander enables improvement plans to be completed, gives her tips on how to lead with compassion and describes the support available to you.

17:00 End Workshops There will be eight workshops in the afternoon which will look at examples of innovative and new models of working in the community and general practice. There will be an opportunity to ask the presenters questions on how they have made their improvements, and to reflect on how they would approach delivering their improvement pledges. Each workshop session will last 40 minutes and there will be three sessions, providing all delegates the opportunity to attend a total of three workshops.

Workshop titles

1. The future with IT 2. Implementing Buurtzorg principles in the NHS 3. Designing differently – how to truly design with people 4. Integrating & the levers for integration 5. Building and strengthening leadership 6. Innovative approaches to education 7. Working better with the London Ambulance Service 8. Community Education Provider Networks – using education to support service transformation

Overviews of the workshops

1. The future with IT Chaired by Anne Cooper, Lead Nurse for Informatics, NHS England Implementing IT-enabled mobile working in the mental health service.

Hear about how we use digital pens to complete standardised clinical records and improve clinical engagement, and how we got funding from the Nursing Technology Fund. Guy Powell, CPA Compliance and Development Manager, and Andrew Dickers, Lead Nurse for Community Recovery Services, Kent and Medway NHS and Social Partnership Trust

Using tablets in the district nursing service

Our district nurses, and some of our children and young people’s nursing staff, use tablets on their home visits. It means that we can access all the information we need for our pre-booked appointments, upload photos, access emails and write our notes in the person’s home, and we can share information across professionals easily. Sue Horbury, Programme Manager Telehealth and Remote Working, Oxleas NHS Foundation Trust

2. Implementing Buurtzorg principles in the NHS

Chaired by Crystal Oldman, Chief Executive, Queens Nursing Institute What are the Buurtzorg principles?

The Buurtzorg or “Neighbourhood” model is an innovative example of how Health and Social Care have been effectively integrated in the Netherlands and reduced acute hospital admissions. But what are its principles? Alieke Scholten, Buurtzorg nurse, and Gertje van Roessel, Buurtzorg nurse, Utrecht Overvecht, Holland

Implementing some Buurtzorg principles in our social enterprise We have implemented some of the Buurtzorg principles in our social enterprise and we are seeing some great results, including empowered, happy staff. We would like to tell you about how we’ve grown our organisation through independently-led teams and our achievements on the way. Moira Ford, Board Lead Foundation Services, Your Healthcare Community Interest Company

Improving access to dysphagia care: Upskilling the Multidisciplinary Team By training professionals from different backgrounds to meet the Foundation Dysphagia Practitioner

standard, we saw a reduction in referrals, in breaches of waiting times, and in the number of professionals working with each person. We can show you how the model is transferable across community services. Farah Moini, Lead Speech and Language Therapist, Hounslow Community Learning Disability Team, Hounslow and Richmond Community Healthcare NHS Trust

3. Designing differently – how to truly design with people Chaired by Pete Thomond, Managing Director, Clever Together Explore with us the ‘Phases of Innovation’, from understanding people and what they really want, to

trying out new ideas and discovering what works best. You can also find out what happened when the nurse met the Mr Men.

Heather Henry, Queens Nurse, vice-chair of the NHS Alliance, and founder & managing director of Brightness Management Limited, and Mat Hunter, Chief Design Officer, Design Council

4. Integrating & the levers for integration

Chaired by Eileen Bryant, Primary Care Nurse Advisor, NHS England London Region

Integrating caseloads Hear about how we have integrated the caseloads for practice nurses, community nurses and community matrons, and how we’ve assigned case managers to people receiving care. Marina Macey, Consortium Community Matron, Well Consortium in Hackney CCG

Integration across a system Integrating care across a NW London requires whole system thinking (and doing). Hear about what we’ve achieved so far and what is really challenging us.

Sue Pascoe, Deputy Director Quality, Nursing and Safeguarding, CWHHE CCGs Commissioning Collaborative

5. Building and strengthening leadership

Chaired by Bronagh Scott, Deputy Chief Nurse, NHS England London Region Motivational leadership in action

How we have supported our nurse leaders and the difference it has made. Dr Shelley Dolan, Chief Nurse, The Royal Marsden NHS Foundation Trust, and Clinical Director, London Cancer Alliance

Leading integrated community teams

How to move to and manage integrated teams through ongoing motivational leadership Rachel Street, Assistant Director; Amanda Mayo, Head of Nursing, and Tracy Stocker, Operations Manager for the Integrated Teams, Bromley Healthcare Community Interest Company

6. Innovative approaches to education

Chaired by Dr Catherine O’Keeffe, Head of Professional Development, Health Education North West London (HENWL) Our experiences of promoting a ‘whole systems approach’ to education. Hear from David about the community and general practice nursing aspects of Shaping a Healthier

Future (SaHF) initiative, and from Sally about her work on developing the nursing workforce to support the move of care from acute to community settings, and about Cuckoo Lane Health Centre in Ealing, a nurse practitioner-led practice.

Sally Armstrong, Practice Nurse and Ealing CCG Practice Nursing Lead, and David Sines, Emeritus Professor of Community Healthcare, Health Education North West London

Improving student nurse placements in community settings Hear about how we are trialling being the host trust for student nurses in order for them to have a fuller exposure to community nursing services. Darren Jones, Associate Director of Quality, Networked Community Nursing & Rehabilitation, and Tracy Stevenson, Head of Clinical and Professional Education, Quality and Learning Directorate, Central London Community Healthcare Trust

7. Working better with the London Ambulance Service

Chaired by Jane Clegg, Director of Nursing for South London, NHS England London Region What can we do to have the best relationship with the London Ambulance Service for Londoners? By

individually commissioning services in your area there is scope to commission services to meet local needs. Hear about what the LAS does for Londoners, and about its pilots and locally commissioned services that work with community and/or general practice services.

Zoe Packman, Director of Nursing, and Briony Sloper, Deputy Director of Nursing, the London Ambulance Service NHS Trust

8. Community Education Provider Networks – using education to support service transformation

Chaired by Sean Farran, Associate Director of Education and Quality, Health Education South London (HESL) HESL: Dr John Spicer, Head of Primary Care Education, will talk about developments in South London. HENCEL: Paula and Vicky will share how they have been able to ramp up their work using the CEPN as

a supporting and enabling network. Paula McLaren, Practice Nurse, Watling Medical Centre; Research Lead, Burnt Oak & Colindale Clinical Network, and Nurse Lead, Barnet Community Education Provider Network Vicky Souster, Education and Development Manager (Open Doors Project), Tower Hamlets CCG

HENWL: Dr Tony Burch, GP Advisor at HENWL, will talk about the pathway approach to CEPNs in North West London.

SCHEDULE OF WORKSHOPS Session A

13:45 Session B 14:30

Session C 15:30

1 The future with IT Red Room Filmed

2 Implementing Buurtzorg principles in the NHS

Green Room Green Room Filmed

3 Designing differently – how to truly design with people

Plenary Room Filmed

4 Integrating & the Better Care Fund

Red Room

Red Room Filmed

5 Building and strengthening leadership

Plenary Room Filmed

6 Innovative approaches to education

Plenary Room Filmed

7 Working better with the London Ambulance Service

Green Room Filmed

8 Community Education Provider Networks – using education to support service transformation

Blue Room Filmed

Blue Room

Plenary Speaker Biographies Biographies are shown in alphabetical order by surname

Caroline Alexander graduated as a nurse in 1987 from Edinburgh University and has an MSc in Nursing Studies from South Bank University (2001). From 1987 to 1993 she specialised in nursing older people in Edinburgh and then London at Guy’s Hospital as a ward sister. Caroline then worked for the Foundation of Nursing Studies for three years supporting nurses to use research in practice. In 1998 Caroline returned to the NHS and worked in Tower Hamlets in a range of roles within older people’s services. In 2005, Caroline took up her first Director post, as Director of Nursing and Therapies within Tower Hamlets PCT. With the clustering of PCTs in London in 2011, she took on the Director of Nursing and Quality within NHS East London and the City initially and then within NHS North East London when the clusters merged in 2012. Caroline was the Chief Nurse for NHS

London for 6 months until she joined NHS England in her current role. Caroline was a 2008 Florence Nightingale Leadership Scholar. She was a Visiting Professor at City University until 2012 and is now a Visiting Professor at Bucks New University.

Helen Bevan has been a leader of large scale change in the English National Health Service for more than 20 years. She led the groundbreaking “Business Process Reengineering” transformation programme at The Leicester Royal Infirmary in the 1990s. As a result, she was asked to become a national leader of initiatives to improve patient access to NHS care for which she was made an Officer of the Order of the British Empire in 2001. Helen has been at the forefront of NHS improvement initiatives that have made a difference for thousands of patients ever since. She introduced the first nationwide collaborative programmes to improve the delivery of cancer care across England in 2000. She designed the highly influential “Ten High Impact Changes for Service Improvement and Delivery” in 2004 and conceived the impactful “Productive Series”, starting with “The Productive Ward” in 2007. In 2010, Helen’s team launched a call to

action, utilising social movement leadership principles, which contributed to a 51% reduction in prescribing of antipsychotic drugs to people with dementia across the country. Helen initiated NHS Change Day, in partnership with a group of young clinical and managerial leaders in 2012. NHS Change Day 2014 was the largest ever voluntary collective action for improvement in the history of the NHS with more than 700,000 pledges made to take action to improve experience and outcomes for patients. NHS Change Day also won the global “Leaders Everywhere” challenge run by Harvard Business Review and McKinsey. NHS Change Day and another initiative Helen conceived, The School for Health and Care Radicals, are currently included in “Britain’s 50 new radicals” list sponsored by The Observer. Helen Bevan is acknowledged globally for her expertise in large scale change and ability to translate it into practical actio n and deliver outcomes. She provides advice, guidance and training on transformational change to leaders of health and care systems across the world. In 2008, the 60th anniversary of the National Health Service, Helen was recognised as one of the 60 most influential people in the history of the NHS.

Jonathan Lewis is Chief Executive of Bromley Healthcare Community Interest Company. He has had a wide-ranging career spanning advertising, broadcasting (ITV), social investment and health. He has also held a number of non-executive positions across private, public and voluntary organisations (ranging from TV channels to hospitals). He is now an experienced chief executive who has run a number of successful and rapidly growing businesses in very different markets. Dr Peter Thomond is recognised for helping leaders to transform their businesses and communities fast, cost effectively and in ways that deeply engage staff and stakeholders. Pete holds a PhD in Disruptive Innovation from Cranfield and has advised 60+ organisations across the world. He’s passionate about people having the licence to innovate and to lead at all levels.Pete’s work with healthcare leaders saw him rated as a top 50 innovator within the sector by the Health Services Journal (2014). The Prime Minister recognised Pete’s methods in community and youth development in 2013 with a social enterprise award.

Market Place Care Makers The Care Makers programme was setup in 2012 at the time of the Chief Nursing Officer's Conference. Care Makers are volunteers who act as ambassadors for the 6C's and are made up of colleagues from the health and social care sector, from care assistants, student nurses, midwives, physiotherapists through to HR directors, medical staff and board member Health Education organisations and the Darzi Fellowship Programme Health Education England (HEE) has responsibility for ensuring high quality education and training is provided to all health professionals including the next generation of doctors, dentists and nurses across England. To do this effectively and to ensure the best possible outcomes and experience for patients and people, HEE works closely with key stakeholders to ensure everything is driven by patient needs and by local healthcare providers. HEE in London is covered by three regions: Health Education North Central and East London (HENCEL); Health Education North West London (HENWL), and Health Education South London (HESL). They each have well-established programmes of work to increase capacity and capability in community and primary care including a range of opportunities for nurses and health care assistants including:

funded CPPD for nurses and HCAs salary supported training for nurses to obtain degree and postgraduate qualifications in primary care

nursing programmes to increase the numbers of student nurses who are able to have learning placement in GP

practices and primary care In addition to these programmes, there is a well-established clinical leadership development programme, called the Darzi Fellowship run by the London Leadership Academy on behalf of the London Health Education organisations. This innovative programme provides a cohort of clinicians, who are typically in the early stages of their career, with a unique opportunity to develop the capability necessary for their future roles as clinical leaders. There will be the opportunity to meet some of this year's cohort of Darzi Fellows in the market place, and to talk to them about the fellowship and their projects, which all relate to community and/or general practice services. Hounslow Wheelchair and Special Seating Service Hounslow Wheelchair and Special Seating Service provides wheelchairs to some of the most vulnerable clients in HRCH, many of whom cannot communicate or represent their needs. The service is instrumental in enabling families to maintain an independent and active lifestyle. In 2013 the wheelchair service won funding from HRCH in a Dragons Den style bid for their Sleep System pilot. They went on to be shortlisted for a prestigious HSJ Award 2014 for the category Compassion in Care for this project. The stall will showcase this project and some of their other innovative projects Interactive School Nurse App for Local Young People

In Hounslow and Richmond Community Healthcare NHS Trust our school nurse team have been actively developing their services, as part of this they presented a business plan to the annual ‘HRCH Dragons Den competition’ September 2014 and secured a substantial pot of money to build an interactive App for Young people of secondary school age. As part of the ‘competition’ as nurses we have been fully charged with the planning and decision mak ing through to the end of its development. Local young people are actively being involved in its development.

Public World Our goal is to improve the wellbeing of older and disabled people at home through co-design of relationship-based care delivered by resilient, self-supporting teams of home care workers. We draw on our expertise in co-design, service design, change and innovation and apply our learning from our Swedish partner Alamanco and the Buurtzorg model. The Queen’s Nursing Institute The QNI is committed to supporting excellent nursing care in the home and community. We do this by developing our community of Queen's Nurses to champion high standards of care, supporting and funding local projects and working behind the scenes to influence policy.

The University of West London We understand how complex, challenging and rapidly changing healthcare services are, and how important it is for community and general practice nurses to be able to access exciting, relevant and flexible CPD opportunities which meet their personal and professional needs. This, in turn, promotes the delivery of high quality, safe and compassionate care, resulting in improved health outcomes and an enhanced patient experience. UWL are delivering the following innovative HENWL funded projects in 2014-2015:

Annual Update programme for Practice Nurses Pilot preparing staff from the acute sector, to transition to practice nursing Nurse led management of leg ulcers pilot

The Royal College of Nursing The Royal College of Nursing represents nurses and nursing, promotes excellence in practice and shapes health policies. We are the voice of nurses and nursing locally, nationally and internationally. We Influence and lobby governments and others to develop and implement policy that improves the quality of patient care. We support and protect the value of nurses and nursing staff in all their diversity by building a sustainable, member led, organisation with the capacity to deliver our mission effectively, efficiently and in accordance with our values

Integrated Care and Acute Medicine, Whittington Health

FIND OUT HOW YOU CAN USE OUR DECLARATION AND JOIN THE COMMUNITY REVOLUTION TODAY,

transforming London’s community services#TRANSFORMLDN

GET PERSONAL

We must place LONDONERS at

THE HEART

EVERYTHING DESIGNED & DELIVERED AROUND THEIR PERSONAL NEEDS

OF CARE

*1,000+ health and social care staff from 100+ organisations, representing all 32 London boroughs have co-created this declaration.

REAL LEADERS, HAPPY WORKERS

INSPIRING LEADERS

OUR LEADERS INSPIRE AND COACH their people, this nurtures the right skills and talent for London's complex needs.

STAFF HAVE CLEAR CAREER DEVELOPMENT PLANS that value and nurture their talent, this makes the community an attractive place to work.

LEADERS of different organisations WORK TOGETHER WITH PATIENT LEADERS to bridge boundaries and share knowledge.

LOCAL TEAMS ARE EMPOWERED with autonomy to flexibly meet local needs.

FULFILLED AND

TO COORDINATE CARE

AND A SKILLED,

MOTIVATED

We must have

WORKFORCE

WE DECLARE THAT A COMMUNITY-LED REVOLUTION IN

WILL TRANSFORM THE HEALTH AND WELL-BEING OF LONDONHEALTH AND SOCIAL CARE

PERSONALISED CARE PLANS use simple language to help people decidetheir own goals and manage their own health.CARE is provided in PLACES THAT ARE CONVENIENT for those that need it.One point of contact makes ACCESS SIMPLE.Londoners have a POSITIVE EXPERIENCE of services in the community.ALL SERVICES are designed around the NEEDS OF LONDONERS and the resources available.PERSONALISED CARE PLANS are developed in partnership between those who use and provide services and they support partnerships between the community, primary and secondary care and the voluntary sector.People who commission, provide and use services services DEVELOP AND ASSESS

SERVICES TOGETHER.

London’s community health and social care services touch our lives at times of basic human need, when care and compassion are what matter most. They support us to keep mentally and physically well, to get better when

we are ill and when we cannot fully recover, to stay as well and independent as we can till the end of our lives.

They are here to improve the health and well-being in our city.

London’s growing population with more complex needs is creating unsustainable pressure for our partners in

hospital, social and primary care. Something needs to change and the solution lies close to home.

MAKE BOUNDARIES

INVISIBLE

WE MUST ENSURE THE

ORGANISATIONAL BOUNDARIES ARE IRRELEVANT to Londoners.

We have SEAMLESS TRANSITIONS between services and organisations because communication and trust are actively developed between everyone involved in providing care.

INVISIBLE TO OUR SERVICE USERS

Teams of health and social care staff, with different and complementary skills, WORK TOGETHER.

We help people access SERVICES FROM THEIR OWN HOME and community - THIS IS OUR COMMUNITY FIRST APPROACH.

SERVICE USERS can access their OWN CARE RECORDS, as can the teams involved in their care and these records are shared across all professionals providing care.

THE FOUNDATION OF OUR REVOLUTION HAS FOUR PARTS…

FOCUS ONOUTCOMES

focus on improving WE MUST ALWAYS

OUTCOMES FOR LONDONERS

THE HEALTH ANDWELL-BEING

BOUNDARIESOF ORGANISATIONS & SERVICES ARE

We understand the desired HEALTH AND WELL-BEING OUTCOMES of individuals, groups and the population we serve.

ALL HEALTH AND SOCIAL CARE organisations SHARE RESPONSIBILITY and incentives for improving health and well-being outcomes.

Those at RISK ARE IDENTIFIED to enable early intervention and PROMOTE WELL-BEING, rather than reacting to crises.

RESOURCES, INVESTMENT AND RISK ARE SHARED between all organisations involved in delivering care.

The amount of time people spend in acute and residential care is reduced as health and well-being are improved and more people are supported to MANAGE THEIR OWN CARE NEEDS AND HEALTH CONDITIONS IN THE COMMUNITY.

VISIT WWW.. TRANSFORMLDN.ORG

Your Notes

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