1. Values-based Practice Reimagining Professionalism: Towards Co-Production Feb 17 2016 Bill Fulford and Ashok Handa Ashok Handa Collaborating Centre for Values-based Practice St Catherine’s College, Oxford Wednesday 25 th November 2015

2. Values-Based Practice …. ……. a process that supports balanced decision making on diverse values within frameworks of shared values

3. Values-based practice Ten Key Process Elements 4 Clinical Skills 2 Aspects of the model of service delivery 3 Strong links between VBP and EBP Partnership in decision- making Together these support balanced dissensual decision making within frameworks of shared values

4. VBP and EBP are partners in the delivery of person-centred care Values Based Practice Evidence Based Practice

5. Collaborating Centre

6. Key Areas of Collaboration

7. Education and Training

8. Values-based surgical care

9. What surgery is NOT about: ‘feeling lucky today punk?’

10. What surgery is about: ‘every man should know his limitations’

11. Surgical seminar outcomes Feedback very positive Teams keen to have follow up seminars Other follow ups – Seminars for Trainees in School of Surgery – HETV Educators forum – Embedded in Oxford UG curriculum 2016 – 6 further speciality seminars in 2016 – Online seminar learning materials – Specialist Nurse seminars eg Midwives

12. How VBP has changed my practice

13. ‘What would you do doctor?’ Pre-VBP: answer based on my values

14. How VBP has changed my practice ‘What would you do doctor?’ Pre-VBP: answer based on my values ‘What’s important to you?’ Post-VBP: answer based on patient’s values

15. Regulation and Guidance

16. The Montgomery Ruling Montgomery (Appellant) v Lanarkshire Health Board (Respondent), April 2015

17. How this will change everyone’s practice Regulation and Guidance The Montgomery Ruling Montgomery (Appellant) v Lanarkshire Health Board (Respondent), April 2015

18. Background Mrs Nadine Montgomery’s case: – High risk pregnancy (diabetes) under care of Dr McLellan – Baby born with shoulder dystocia – Child left with serious disabilities The facts: – Mothers with diabetes are more likely to have a large baby – 10% risk of shoulder dystocia Mrs Montgomery had raised concerns about vaginal delivery, but Dr McLellan's policy was not routinely to advise diabetic women about shoulder dystocia

19. Supreme Court Ruling Consent means: 1.Clinicians engaging in ‘dialogue’ with their patient to the point that 2.they have sufficient understanding of the risks and benefits of the options available to make a choice that 3.takes into account ‘her own values’

20. Supreme Court Ruling Consent means: 1.Clinicians engaging in ‘dialogue’ with their patient to the point that 2.they have sufficient understanding of the risks and benefits of the options available to make a choice that 3.takes into account ‘her own values’ Reimagining professionalism: towards co- production

21. M ONTGOMERY AND M E : I MPLEMENTING THE N EW S TANDARD FOR C ONSENT TO T REATMENT IN M EDICINE AND H EALTHCARE W HERE ? S T. C ATHERINE ’ S C OLLEGE, O XFORD W HEN ? F RIDAY O CTOBER 28 TH 2016 C ONFIRMED SPEAKERS INCLUDE Baroness Hale, Deputy President of the Supreme Court and one of the Montgomery judges Professor Sir John Bell, Regius Professor of Medicine, University of Oxford Professor Jonathan Herring, Professor of Law, University of Oxford

22. Collaborating Centre for Values- based Practice @ valuesbasedpractice.org Ashok Handa Collaborating Centre for Values-based Practice St Catherine’s College, Oxford Wednesday 25 th November 2015