Health Literacy and Self Directed Support: Improving outcomes for health and social care Wednesday 26th October 2016

Housekeeping Twitter - #healthlitsds

Aim The learning outcomes : Gain a better understanding of the links between health literacy and self-directed support Identify how current knowledge relating to health literacy can be shared and transferred to settings across health and social care Pledge to take health literacy action in their own area of work.   Health literacy is about people having enough knowledge, understanding, skills and confidence to use health information, to be active partners in their care, and to navigate health and social care systems. Health Literacy is being increasingly recognised as a significant public health concern around the world.

Outcomes Taking an outcomes approach means engaging with the person and significant others to find out what matters to them, what they hope for and what they want to be different in their lives. (IRISS Insights) Taking an outcomes approach means engaging with the person and significant others to find out what matters to them, what they hope for and what they want to be different in their lives. This approach involves thinking about what role the person themselves might play in achieving their outcomes, which can be a significant shift from more traditional services where the solutions are viewed as located on the service side. The practitioner adopts an asset based approach to wellbeing by focusing on the person‟s own knowledge, skills, personal resources and that of their families and local community, together with resources offered by services. This process may require managing the expectations of the individual and being honest about the limitations of services and supports available, while thinking creatively about possibilities. This provides the basis for working together to ensure the best quality of life possible and the greatest independence for the person.

Knowledge into Action Cycle Sharing in different settings Learning from others and preventing duplication Social learning Disseminating

Confidence ruler Not well at all-------------------------------------Extremely well How well do you do you understand the links between health literacy and social care in particularly self-directed support? How confident are you in applying health literacy principles in your work? How confident are you in sharing health literacy information and ideas with others?

Setting the scene Lindsey Murphy Senior Knowledge Manager – Health Literacy NHS Education for Scotland Des McCart National Lead on SDS and Commissioning Scottish Government

Health Literacy “Health literacy is about people having enough knowledge, understanding, skills and confidence to use health information, to be active partners in their care, and to navigate health and social care systems. Health Literacy is being increasingly recognised as a significant public health concern around the world.” (Scottish Government, 2014)

Making it Easy https://vimeo.com/98038490

Policy links Realistic Medicine (Scottish Government, 2016) Social Work in Scotland (Audit Scotland, 2016) Personal Outcomes: Learning from the Meaningful and Measurable project (2016) Making it Easy: a health literacy action plan for Scotland (Scottish Government, 2014) 2020 Vision (Scottish Government, 2011) Quality Strategy (Scottish Government, 2010)

Self-directed Support Des McCart National Lead on SDS and Commissioning

Being in the driving seat

Social Care (Self-directed Support) (Scotland) Act 2013 “Individuals will have greater choice and control over the services they use through self-directed support for social care and person-centred healthcare.” It gives people 4 options in terms of how their social care is delivered. Option 1 – they take a direct payment, and arrange their own support, either by employing their own Personal Assistants to deliver their care or buying care services from a care agency. Option 2 – they decide who they want to deliver their care and their local council arranges the support Option 3 – after talking to them, their council decides and arranges their support Option 4 – they use a combination of 2 or more of the other options to arrange their care and support

SDS Strategic policy objectives 2015-2016 Main objective: Engaged informed empowered individuals and carers who exercise choice and control Supported by: Appropriate services, systems and processes that support personal outcomes Skilled and valued workforce which works with others to empowered and support with a focus on prevention Responsive commissioning that supports choice and control

Health and wellbeing outcomes Outcome 1: People are able to look after and improve their own health and wellbeing and live in good health for longer Outcome 2: People, including those with disabilities or long term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community Outcome 3: People who use health and social care services have positive experiences of those services, and have their dignity respected Outcome 4: Health and social care services are centred on helping to maintain or improve the quality of life of people who use those services Outcome 5: Health and social care services contribute to reducing health inequalities Outcome 6: People who provide unpaid care are supported to look after their own health and wellbeing, including to reduce any negative impact of their caring role on their own health and well-being Outcome 7: People using health and social care services are safe from harm Outcome 8: People who work in health and social care services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide Outcome 9: Resources are used effectively and efficiently in the provision of health and social care services

Outcomes Based Approach The aim of an outcome based approach is to: "...shift the focus from activities to results, from how a programme operates to the good it accomplishes.“ Margaret Plantz, Martha Greenway & Michael Hendricks (1999) Outcome Measurement: Showing Results in the Non-profit Sector. United Way of America Online Resource Library Outcome Based Commissioning is about pushing the level of conversation between commissioners and providers up the scale – from processes and outputs to outcomes. Not the detail of how services or interventions operate but what they want to achieve. Too often conversations between commissioners and providers start at the wrong end and commissioners meddle in operational detail. There are many techniques to support outcome based decision making, including techniques developed from the work of Mark Friedman and his work on Results Base Accountability, known as Outcomes Based Accountability in the UK. You may have heard the term `turning the curve’ which comes from this work. Many local areas have begun to use this methodology as a way of ensuring that their commissioning processes focus on ends, rather than means…….and use data to inform practice and decision making. More information about this approach is given in the OBA handout. Note that there are other techniques to support outcome based commissioning, but OBA is widely used for strategic planning based on outcomes.

Things people like about an Outcomes Approach Based on the person’s desires, not service led. Holistic approach. Fits with person centred approaches; puts the individual at the centre. Empowers service users and promotes self advocacy. Emphasises evidence based practice. Focuses on needs and seeks positive interventions to provide better outcomes. It facilitates a co-productive approach using person’s assets as well as services or support. ASK; what do people DO NOT like about outcome based approach? Hard to measure – can be time consuming The more aggregated the personal outcome measures – the less meaningful they become Dichotomy between importance to individual and meeting national standards and other drivers

During the day Think about how health literacy principles and tools can be applied to social care and self-directed support How could health literacy approaches support your area of work? How could health literacy approaches help the people you work with? How can we work better together? What will be your ‘take aways’?

Break

Parallel sessions Table one – Health literacy and Realistic Medicine Table two – Health literacy research proposal Table three – Applying health literacy principles to self-directed support  Table four – Resources for minority ethnic groups Table five – Finding information to support health literacy Table six (upstairs Boardroom) – Health information seeking behaviours 

Lunch

Group activity Finding the right words Consider the words and phrases provided, what better words or phrases could be used to explain these terms? What words and phrases do you use in your work that could be explained more clearly? Discuss ideas with others at the table to ‘find the right words’

People Connect

Yammer

E-learning

Break

Group discussions How can learning from today be shared with others? How can people apply learning from today to own area of work? What are the next steps from today? Pledge making activity

Have a safe journey and thank you for all your contributions! Close Next steps Revisit confidence rulers Closing remarks Feedback Have a safe journey and thank you for all your contributions!