#bettercareLDN Self-care and personalisation: putting patients, service users and carers in control Self-care and personalisation: putting patients, service users and carers in control Monday 1 December 2014 Session 2.1 A London Health and Care Integration Collaborative event

Simon Galczynski Sandy Marks Clare Henderson Developing personalised approaches

Making it Real – where it began Islington Personal Budgets Network meeting June 2013

Workshop to agree what co-production means in Islington Islington Personal Budgets Network meeting June 2013

Investing in developing experts by experience Islington Personal Budgets Network meeting June 2013

Encouraging others to lead

Working together as equals Islington Personal Budgets Network meeting June 2013

 “I” statements adopted across health and social care A joined up approach that recognises differences in approach and culture but common aims. A single approach and policy for ‘personal budgets’  PA register Small working groups agreed a low cost way forward  Links for Living website Experts by experience input via mystery shopping  Co-produced Easy Read documents MIR Action Plan, MIR Co-production concordat, Benefits information, N19 Pilot Evaluation, Personal Budgets, Direct Payments  Training and learning Co-produced training and e-learning programmes about personal budgets and independent living Outcomes via co-production

Wall of achievement

Why is person centred care important to us? Patients - Outcome & Experience Better outcomes patient activation quality of life patient experience Providers Patient activation critical to help people stay well longer, and to get better sooner after acute illness Improved patient and clinician satisfaction Islington CCG 5th most deprived borough in London Huge health and social inequalities High prevalence of Long Term Conditions Better use of resources

The House of Care – our model for care planning

Year Of Care Co-Creating Health ADP Supporting Lifestyle Behaviour Change Coaching for Health Engaged, informed patient HCP committed to partnership working Organisational processes Commissioning – The foundation Self Care Working Group Navigator Role- Age UK Islington Self Care CQUIN/ LCS/VBC Co- production workshops Measuring outcomes Personal health budgets Expert Patients Programme Co-Creating Health SMP & Reunions DESMOND/ HeLP Diabetes Ethos embedded in some services Care planning in longer appts & prior to MDT teleconference Enhanced Recovery Pathway Programmes to support healthcare professionals and patients

Measure to assess the impact of initiatives across Islington (as a totality) on patient activation Before and after measure of patient education/support programmes currently set up and running Questionnaire to be sent to all patients with LTC on practice registers, scored and number recorded on patients EHR. To identify opportunities for providing tailored interventions based on an individual’s level of activation Using PAM in Islington

What’s working well People Over 20 personal health budgets 82% COPD have management plans 42% YOC reviews for people with diabetes Professionals Staff satisfaction Recognition with HENCL award Champions eg PHB Process Longer appointments enabling better conversations Pathways with care planning have offers for self care and PHB Commissioning Patient involvement in the process Good collaboration across the patch Move to integrate disease specific approach

Challenges People Deprivation and low levels of activation Reaching people Interest in PHBs low Professionals Pressure of time “I’m already doing this” unknown unknown Reinforcing new approach Process NHS E care planning template IT systems don’t support shared care and support plan Commissioning Annual funding cycle challenge to providers Scaling up/building capacity More than disease specific sils

What we have learnt Takes time One size doesn’t fit all Ongoing support – patients and clinicians in new ways Importance of getting the language right Care planning documentation Teams rather than individuals inter-professional learning together Integrate with concurrent initiatives Senior leadership from clinical community Need flexibility of delivery model

Thank you