Person Centred Care in NHS Wales 17th November 2014 Person Centred Care in NHS Wales Mike Spencer

Introduction and context

Achieving Excellence – Person Centred Care ....the whole improvement programme will ensure a person-centred focus which champions preservation of dignity and respect. Individuals will be encouraged to take responsibility for their own health and management of conditions, supported with clear and consistent information on how to achieve this.

Achieving Excellence – Person Centred Care ...concerns about NHS services. The principles of Putting Things Right are there to deliver: an approach centred on personal experiences rather than processes a focus on learning which drives quality improvement and reduces adverse events, and avoidable harm to those using services

NHS Wales Planning Framework

Pathways

Planned Care - GRYMUSO CLEIFION

Key Components of Integrated Care For many patients, the key point in their illness is when consideration is being given to referral for treatment. At this time patients require: access to information about their illness and the treatment options; methods to enable optimum decision making; the best environment in which they can openly discuss and make decisions about the important and sometimes life changing decisions about their treatment requirements; and “activation” to engage confidently with healthcare providers

NHS Wales Outcome Framework Staying healthy People in Wales are well supported to manage their own physical health Safe Care People in Wales are protected from harm and protect themselves from known harm Effective Care People in Wales receive the right care and support as locally as possible and are enabled to making that care successful Dignified care People in NHS Wales are treated with dignity and respect and teat others the same Timely Care People in Wales have timely access to services based on clinical need and are actively involved in decisions about their care Individual Care People in Wales are treated as individuals with their own needs and responsibilities Our Staff and Resources People in Wales can find information about how their NHS is resourced and make careful use of them

Prudent Healthcare Dec 2013: ‘Simply Prudent Healthcare’ Bevan Commission Jan 2014: Prudent healthcare in a time of austerity – the Minister’s speech April 2014: Prudent healthcare workshops (to test principles)

Prudent Healthcare Principles Five principles have emerged: Do no harm Carry out the minimum appropriate intervention Organize the workforce around the ‘only do what you can do’ principle Promote equity Remodel the relationship between user and provider on the basis of co-production These are the principles put forward in the paper ‘Achieving prudent healthcare in NHS Wales.’ They are based on the principles set out by the Minister and Welsh Government, and result from the workshops held by four health boards in April 2014. This session will focus on [Session name], which showcases work underway that supports the principle [select principle and expand on links].

Co-production an approach to public services based on equal and reciprocal relationships between professionals, people using services, their families and their communities.

Levels of Co-production basic acknowledges people's action is essential to the desired outcome intermediate recognises what service users can offer power imbalance between citizens and professionals remains Needham and Carr for SCIE Co-production is informed by The presence of the six principles How power is balanced between people getting support and the people who deliver it transformative service users involved in all aspects of design & delivery transforms power and control

Reviewing the Current Position

Trusted to care and Review of Concerns 2014

How do we Know What Our Users Really Experience?

Prudent=People centred=Co-produced Co-commissioned People centred services Co-designed Co-delivered Co-evaluated People Centred Care First and lasting impressions People’s Experience Safe, supportive environment Understanding and involvement in care

Framework for Assuring Service User Experience Three domains First and lasting impressions Safe, supportive environment Understanding of and involvement in care Four broad sources of feedback Real time Retrospective Proactive Balancing A national set of core questions

All Aspects of Experience Satisfaction Experience Concerns Complaints Serious Incidents Surveys Complaints Stories Incidents Tweets Plus, plus………………….

Enablers to Person Centred Care A wide range of expertise in NHS Wales

Co-creating Health This programme aimed to embed self management support within mainstream health services by equipping individuals and clinicians to work in partnership to achieve better outcomes. The programme focused on developing the skills and attitudes of both people with long term conditions and their clinicians, while also ensuring systems and services are designed to support and facilitate self management. Clinicians in ABMU are being supported to take this approach into clinical practice

Shared Decision Making The MAGIC (Making Good Decisions in Collaboration) programme worked with frontline health professionals in Cardiff and Newcastle to test how to embed shared decision making in clinical practice and overcome the barriers to change. The aim was to make healthcare more patient-centred and influence more healthcare professionals to give patients the choice and involvement they are asking for.

Evaluation

Bringing it Together

1000 Lives Pilot Collaborative “Prudent Interactions” Brings together learning from co-creating health, Magic and the EPP programme Will give clinical teams the skills and tools to take the learning into clinical practice Started October 2014 ends March 2015 Will be used to develop a programme that will be offered to NHS Wales from April 2015

So, why are we here? Policy and strategic drive towards person centred care Principles embedded in NHS Wales Outcomes framework National approach to assuring patient experience Sound evidence base about benefits and implementation of enablers 1000 lives working to give clinicians and patients the skills to move theory into practice