What’s the problem?

Everyone aims to do a good job, but......

The subliminal message?

More, more, more.......

Faster, faster, faster......

And do it with less.......

Current State

Staff Experience

Teamvitality

Pulse surveys

ComplaintsBi-annual

survey

SystemOutcomes

People FocusedOutcomes

PatientGroups

BetterTogether

Local surveys

4 hours 18 wks

FinancialPerformanceAccess

Targets

Comprehensive systematic measurement infrastructure

NHS BoardNHS

Board

18 wks RTT

18 wks RTT HSMRHSMR 4 hour

A&E4 hour

A&E

NHS BoardNHS

BoardNHS

BoardNHS

BoardNHS

BoardNHS

BoardNHS

BoardNHS

BoardNHS

BoardNHS

BoardNHS

BoardNHS

Board

4 hour

4 hour

18 wks

18 wks

HSMRHSMR 4 hour

4 hour

18 wks

18 wks

HSMRHSMR 4 hour

4 hour

18 wks

18 wks

HSMRHSMR 4 hour

4 hour

18 wks

18 wks

HSMRHSMR

But, where is care experience? The voice of the service user?

Obs ofCare

System Performance

Staff Experience

Real-timeFeedback

Teamvitality

Pulse surveys

SystemMeasures

PersonalgoalsStaff

wellbeing

Care Experience

Real-time feedback

LovedOnes

Comp-liments

Must doWith Me

Measurement for Improvement

Values basedReflect.

Nothing about

me

SystemMeasures

SystemOutcomes

Systemoutcomes

Systemoutcome

Systemoutcomes

Future State

The feelings and emotions of the patients, under critical circumstances,

require to be known and to be attended to, no less than the symptoms of their

diseases.

Medical Ethics, Thomas Percival, 1740-1804, English physician and author

Focus on the people......

NHS Scotland - The 6 Cs• Caring & Compassionate staff & services• Clear Communication & explanation• Effective Collaboration between clinicians,

patients & others• Clean and safe care environment• Clinical excellence

What do the people want & need?

All health and careservices are centred around people

Aim Primary Drivers Secondary Drivers

Improved Care Experience

Improved Staff Experience

Co-Production

Leadership

Focus on......

•Culture, culture, culture•Values & behaviours

•High impact leverage points that will make a difference to the lived experience

•Reliable opportunities to personalise care •“Must do with Me” elements

•Breakthrough series model•Accelerate & share learning•Spread •Scale•Momentum

By December 2015 people using

services will have a positive experience

and get the outcomes they

expect

Services are delivered in active,

collaborative partnership with

people

Technical care is delivered reliably

and based on person-centred

principles

Physical & cultural environments

support the delivery of person-centred

care

Aim Primary Drivers Secondary Drivers

•Reliable application of the five “Must do with Me” elements:1. What matters to you? – Personal outcome goals agreed 2.Who matters to you? – Involvement of personal support network3.What information do you need? - information is timely, full and understandable4.Personalised contact – timing & method of contact with services is flexible5.Nothing about me without me!- involved with communication, handovers and transitions at the level they choose

•Dignity and respect frame all communication and interaction with people who use our services.

•Teams test and adapt tools to measure and improve communication

•Technical care is delivered in alignment with “Person-Centred Principles” 1) Active, equal partnership 2) Information sharing is timely, open and complete 3) Participation in decisions 4) Collaboration in design & delivery of services

•Reliable application of the 5 “Must do with Me” elements

•Weekly environmental walk rounds & Observations of Care by: a) Leaders; b) facilities teams; c)Clinical teams d)Service user / volunteer groups using person-centredness checklist•Walk-rounds & Observations focus on:

1. People & interactions (conversations with people using & delivering service, observations of care, etc)

2. Environment of care (signage, way-finding, etc)

Person-Centred Health & Care: Care Experience

Person-centred care is everyone’s

business

•Distributed, values based leadership culture from the point of service delivery through to support staff, middle management and senior executives•Values & behaviours form basis of recruitment , development & management of staff•Reliable use of recognised tools to promote optimal team functioning•Person-centred values & behaviours are evident in words & actions at all levels of leadership•See also “Leadership” change package for key interventions & structures

By December 2015 people using

services will have a positive experience

and get the outcomes they

expect

Services are delivered in active,

collaborative partnership with

people

Technical care is delivered reliably

and based on person-centred

principles

Physical & cultural environments

support the delivery of person-centred

care

Aim Primary Drivers Secondary Drivers

•Technical care is delivered in alignment with “Person-Centred Principles” 1) Active, equal partnership 2) Information sharing is timely, open and complete 3) Participation in decisions 4) Collaboration in design & delivery of services

•Reliable application of the 5 “Must do with Me” elements

•Weekly environmental walk rounds & Observations of Care by: a) Leaders; b) facilities teams; c)Clinical teams d)Service user / volunteer groups using person-centredness checklist•Walk-rounds & Observations focus on:

1. People & interactions (conversations with people using & delivering service, observations of care, etc)

2. Environment of care (signage, way-finding, etc)

Person-Centred Health & Care: Care Experience

Person-centred care is everyone’s

business

•Distributed, values based leadership culture from the point of service delivery through to support staff, middle management and senior executives•Values & behaviours form basis of recruitment , development & management of staff•Reliable use of recognised tools to promote optimal team functioning•Person-centred values & behaviours are evident in words & actions at all levels of leadership•See also “Leadership” change package for key interventions & structures

•Reliable application of the five “Must do with Me” elements:1. What matters to you? – finding out what’s important to people and using this info to collaboratively plan care2.Who matters to you? – making it easy & routine for people to involve their personal support network if they choose3.What information do you need? - information is timely, full and understandable & decisions are collaborative4.Personalised contact – as much as is possible timing & method of contact with services is flexible5.Nothing about me without me – people are involved with communications, handovers and transitions at the level they choose

•Dignity and respect frame all communication and interactions •Teams test and adapt tools to measure and improve communication

• Morally & ethically the right thing to do – its a basic human right!

• Reduces harm / provides early warning of harm

• We are under-utilising a valuable resource – people!