Public, patient and carer perspectives on productivity Neil Churchill Director of Experience, Participation & Equalities 2 October 2018

@WhoseShoes https://whoseshoes.wordpress.com/author/whoseshoes/

Sometimes the questions are complicated & the answers are simple

Always Event Co-Design an Always Event® Reliably Implement Standard Work Over Time Understand “What Matters to Patients?” in Pilot Unit or Program PLAN Communicate New SWork Processes to Clinicians and Staff Create an Aim Statement and Begin to Co-Design an Always Event® Event DO Always Teach, Coach and Support Implementation Test Specific Change Ideas for the Always Event® Understand “What Matters?” – themes from patient stories; themes from surveys, complaints and negative patient experiences; focus group Test the components and composite of the Always Event – give example (Teach Back) Standard Work: specify the process clearly -- who, what, when, where, how Observation: identify defects and redesign processes to mitigate failures STUDY/ACT Specify Details of Successful Changes for the Always Event® Observe, Reflect & Redesign Standard Work as Needed to Increase Reliability

Adapted from: Nesta: People Helping People: the future of public services

Helpforce vision

Profile of a Maternal Health Volunteer Name: Simran Seera Role: Ward Befriender - Maternity Ward Describe what you do: In Maternity, I aid the in nurses changing beds or attending to patients, be it for dinner if they have just given birth or emotional aid. I often help with sterilising bottles and provide care for both mothers and babies, by serving as a medium between patients and staff. I actively try to ensure the mums and little ones are warm and comfortable enough in the cold periods and ensure they always have enough water! Occasionally I help the mealtime workers in busy periods, or may be asked to visit the labs to drop off samples. Where: Queen’s Hospital

Questions Do we know enough about the volunteering resource currently supporting the NHS? Are we getting the most from the people who already give their time? - in terms of impact on outcomes; - in terms of ‘lifetime value;’ Are we engaging the people who stand to gain most from volunteering? - In terms of local populations? - including NHS staff? Are we maintaining and developing our collective investment in volunteering?

What are we doing? NHS England working in partnership with Helpforce – supported by a grant for £2.3 million over 2 years: to help health organisations to better align volunteering activity to strategic priorities; to create a wider range of opportunities for people who want to give back to the NHS and make a real difference to the care and experience of patients while in hospital and at home; currently around 78,000 people volunteering in hospitals across the country – HelpForce is working to double that number by 2021; Focus on high impact roles that can be developed into models that can be spread easily. Call for expressions of interest (by 8/10/2018) to work with Helpforce to test innovative ideas and increase the number of effective roles that can be more widely applied across the NHS. Since 2016, HelpForce has been working with five pilot sites to develop volunteering roles. Examples include 'therapeutic volunteer roles' being tested at Sandwell and Northumbria to assist patient mobility. These are high-impact roles directly addressing issues around bed rest, strength and de-conditioning and compliments NHS England’s work to end pyjama paralysis.   Other examples include volunteering programmes for 6th form students from the local community at Northumbria Healthcare NHS Foundation Trust and ‘Bleep Volunteers’ on hand to support ad-hoc tasks which have improved patient attendance to clinics up from 20 % to 100 % at Chelsea & Westminster Hospital NHS Foundation Trust . A further ten hospital sites can now apply for funding to develop strategic volunteering plans, supported by Helpforce. The aim is to test innovative ideas and  increase the number of effective roles that can be more widely applied across the NHS. More details:

International evidence ‘Modelling results indicate that approximately 5% more people with dementia would remain in the community from year 3 on and that 19.3% fewer people with dementia would die in institutions over fifteen years. During those years Minnesota could save $996 million in direct care costs.’ http://content.healthaffairs.org/content/33/4/596.abstract .

ARGUMENT 1: If we provide effective support to carers, then the carer’s health status will improve: they may require less health and social care; ARGUMENT 2: If we provide effective advice to carers and employers, then the carer will be more able to remain in work; ARGUMENT 3: If we provide effective support to carers, then the person with care needs will be better supported: they may require less health and social care. 12

The Strategy Unit and ICF. 13

Helping carers support patients Between 2013-2016 the number of carers identified and referred to Salford Carers Centre rose from 4790 to 6650 – a 39% increase, up to some 28% of the carer population; Excellent impact in identifying young carers through schools; GPs have to offer carers health check to 80% of list in year 1 and 100% in year 2; Third-wave of Salford vanguard will integrate carers’ support into integrated care; A new service will provide an intensive support package alongside discharge planning and following discharge.

@neilgchurchill neilchurchill@nhs.net