Supporting the Shift to Person Centred Care Martin Routledge: Director, Coalition for Collaborative Care

Personalisation and Integration – A Moment of Opportunity? NHS “Five Year Forward View” 2014 emphasised integration, personalisation & empowerment “There is broad consensus on what the future needs to be. It is a future that empowers patients to take much more control over their own care and treatment. It is a future that dissolves the classic divide, set almost in stone since 1948, between family doctors and hospitals, between physical and mental health, between health and social care, between prevention and treatment.”

There is building evidence for a “win-win” Reduced service use Meds use improves Able to work more Active and empowered person Engage with clinician more Better disease management Lifestyle improvements e.g. diet Info seeking Patient Activation = confidence, skills & knowledge

Interventions that build people’s knowledge, skills, confidence… Personal Health Budgets Evaluation: cost effective, improved Quality of Life, best for high needs. POET survey show impact on carer well-being Personalised care and support planning Cochrane review 2015:  ”personalised care planning is a promising approach that offers the potential to provide effective help to patients, leading to better health outcomes”. Shared Decision Making, including Patient Decision Aids Better experience of care, some reduction in use of services, less surgery. Self-Management Support, such as Expert Patient Impact of behaviours, Quality of life, symptoms and better use of resources. Not just technical information, but behaviour change

It’s more than medicine A Guide to Community Based Approaches for Health and Well-being: NHSE/PHE 2104

Integration and person centred care and support The Five Year Forward View and Care Act offer the opportunity to build the integrated health and care system of the future. A connected group of locally led, centrally supported initiatives provide the chance to test, learn and spread the best ways of getting there The Better Care Fund promotes integrating commissioning of health and social care. The Integration Pioneers started testing a range of innovative ways to deliver integrated health and social care Building on lessons from these and other initiatives, the Five Year Forward View proposed two new programmes: New Care Models Vanguards and Integrated Personal Commissioning Programme. These two programmes are closely linked and the support teams will work closely together to ensure that support and evaluation work is coordinated.

But… There is an increasing recognition of the great potential for new and better ways for people’s expertise to come together to ensure improved outcomes for people with long-term conditions. But also frustration that the promising practice that can be seen in patches around the country is not becoming mainstream practice quickly enough. We want to change this and work with those determined to move person-centred collaborative care from the margins, to the centre of practice and experience.

About C4CC – who are we? A partnership of organisations across health and social care, community and voluntary sector Hosted by NHS England Launched in November 2014 with about 20 national partners Now have 47 partners, 1800 members, 29 coproduction group members and a ‘hub’ team of 6 WTE staff

(Joined April 2015 - 24 partners) Wave 2 New Partners Founding Partners (14 partners)   Wave 1 New Partners (Joined April 2015 - 24 partners) Wave 2 New Partners (Now 47 partners) Royal College of General Practitioners ADASS (Association of Directors of Adult Social Services) British Heart Foundation College of Social Work Diabetes UK The Health Foundation Macmillan Cancer Support National Voices NESTA NHS England NHS IQ Royal College of Nursing Think Local Act Personal Year of Care Partnerships Age UK ARMA (Arthritis and Musculoskeletal Alliance) Arthritis Research UK British Geriatrics Society British Society for Rheumatology Change Chartered Society of Physiotherapists College of Occupational Therapists Community Development Foundation Health Education England In Control Mind National Council of Palliative Care NHS Alliance NICE The Picker Institute PCC (Primary Care Commissioning) Royal College of Anaesthetists Royal College of Physicians Royal Pharmaceutical Society Shared Lives Plus Skills for Health Spice Timebanking UK Alzheimer’s Society Carers UK Centre for Citizenship and Community Community Catalysts Faculty of Medical Leadership and Management Royal College of Psychiatrists Self-Care Forum Skills for Care Public Health England

What are we trying to do, how? Significantly improve health and well-being for people with long term conditions and their carers and build equal and effective partnerships between people and professionals Through gaining much greater traction for person centred care and support planning and “more than medicine/people powered ” approaches and the things that link and connect these with co-production central – Conversation, Community Co-production Via – the actions of a partnership of influential national groups and organisations working in powerful co-production with people with long–term conditions and carers and a growing membership of local people, practitioners and groups Using the levers and enablers within a developing context where prevention, personal and community capacity, integration and person centred approaches can be increasingly seen as part of the solution to challenges

What is our approach to change? Action in four connected areas which builds the case for the incorporation of person centred approaches into core health and care activity and levers change by: supporting action and creating conditions: 1. Supporting Practice, People and Communities: “Depth” activity, directly influencing and supporting significant exemplar initiatives to incorporate and demonstrate the case for person centred approaches “Breadth” activity, supporting and building networks of people, organisations and champions – providing information, links and connections to enable them to implement person centred approaches in their communities of geography and interest Direct support to pioneering programmes e.g. IPC, the Vanguards Advice to places wanting to make change – where there is mutual benefit Regional work to spread the word and spread good practice – like this; more to follow Specific work – e.g. a regional leadership programme Connecting people and initiatives – encouraging partnership, helping to align agendas of our partners, creating a movement through mass membership Direct support to pioneering programmes e.g. IPC, the Vanguards Advice to places wanting to make change – where there is mutual benefit Regional work to spread the word and spread good practice – like this; more to follow Specific work – e.g. a regional leadership programme Connecting people and initiatives – encouraging partnership, helping to align agendas of our partners, creating a movement through mass membership

Supporting people and practice Direct support to pioneering programmes e.g. IPC, the Vanguards Advice to places wanting to make change – where there is mutual benefit Regional work to spread the word and spread good practice – activity being planned with partners Specific local initiatives – e.g. a regional leadership programme Connecting people and initiatives – encouraging partnership, helping to align agendas of our partners, creating a movement through mass membership We will support staff, people living with long-term conditions, their family carers and the wider community to bring about the change We will do this by ensuring this ‘movement’ has the tools, connections and support it needs. We are working in depth in some places and are working to connect people in networks and to others who can help.

Creating the conditions Workforce development – bringing partners together to think about role of workforce, training needs et around person-centred care, community capacity bulding, co- production and commissioning Providing powerful evidence – bringing together, influencing research, promoting, building stories or what’s possible Identifying and pulling system levers to drive positive change in practice – national incentives, targets, barriers.

What is our approach to change? 2. Knowledge and evidence: Sharing existing knowledge, resources and evidence with our partners, members and the wider public so that C4CC is educating informing and positively influencing people, organisations and policy related to person- centred care Supporting development of evidence and knowledge which further builds and supports the case for person centred care and ensuring its effective deployment

What is our approach to change? 3. Workforce: Supporting and influencing culture change across networks of professionals and disciplines Inform and influence policy and developments in the area of professional training to ensure the incorporation of person centred care Identify and communicate training and development needs for local level change to support action

What is our approach to change? System levers: Identify key levers including metrics and commissioning likely to drive person centred care into systems and practices and action that can be taken by partners and others Support and influence DH and NHSE policy development work to ensure person centred approaches are a core part of developing models along with other key bodies and organisations holding key levers

To find out how you can join us and help make person-centred care a reality for people with long-term conditions, visit our website at: www.coalitionforcollaborativecare.org.uk