What have we learned and do we have any agreed actions? Dewar 2013

Introduction These slides hope to capture the discussion held in the last plenary session of Dewar 2013 ….

The Dewar Process… Community enterprise and resilience in evidence demonstrated in the building The NHS integrated into the community: participation Grass roots and community building

What is the way forward? Break down the silos? Research-led process? Funding for innovative pilots? Cross-organisational funding? How do we achieve this?

Ideas: the communities Control of the land – an amazing example of success; must demonstrate success to inspire others If there are communities doing it well, we need to spread the word to take and spread the ideas We need to change the NHS to what we want it to be: fundamental change

Ideas …Context Part of the context is massive social and demographic change: ageing population – but this is a good problem to have Context: promotion of rural careers via social media Support networks for practitioners via Skype being piloted – need to embrace technology

More Ideas …Integration All medical professions are key – integration? Team approach = sustainability of services in R&R areas Skills sharing, competencies, portfolio careers Care in the home

Ideas … connections NHS Highland could work with local development officers? A joined-up approach We need to record processes and outcomes: we need to measure outcomes too Some of this is happening – a qualitative approach plus Action Learning

Ideas …Communities and patients Communities have to create their own solutions and models and then they can take ownership of it? Must capture the patient experience – in the planning, the execution To work with people and make sure they have an element of choice in their treatment and care

Ideas … Education Involvement of the patient in the learning process and education To mitigate the demographic time-bomb – to help people look after their own health better CCPs also key in facilitating this

Community well-being More research needed on Highlands and Islands society? What is community well-being? Is it about community leadership? Is it age distribution? Are the solutions staring us in the face? They are in Dewar, and in the Birsay Report

The bigger picture? Healthcare is part of a bigger context – IT issues, education provision, social health, employment opportunities, lack of affordable housing Let’s tackle the WHOLE picture POLITICAL matters – bigger than the NHS Let’s sort the problems – we have the answers!

Political action The bigger picture needs political pressure applied – we can do this as a group. What about community/patient expectations? What about the next generation of healthcare workers: inspire school children, medical students!

Community action? Build up relationships in schools and the medical schools: methods of gaining work experience, writing a good application, giving a good interview, risk assessment issues Try to attract people back to communities in this way Can use Dewar materials to help with this

The Four Dewar Tests: feedback Maybe we should take a broader international perspective e.g. Gujarat, India – we can learn from other places We need to measure the outcomes of what we do ‘Everything is different but nothing has changed in the last 100 years’

The Dewar Group – future? Continue and broaden what we do – geographically, politically We need to move beyond the health service and build up partnership networks with other service providers – chief partners: our communities A programme of recruitment and information