1. High impact actions:
The next big push for person-centred, community-focused approaches to health and care
7th November 2016

2. A recap of the Five Year Forward View
Prevention gap: “A radical upgrade in prevention and public health”
Care quality gap: Quality of care is too variable
Finance gap: £22 billion of productivity improvements
(Chapter 2) “A new relationship with patients and communities”
(Chapter 3) New models of care which are more personalised, joined up and which give people much greater control of their own care

3. Six principles for engaging people and communities: Putting them into practice
bit.ly/thesixprinciples

4. The challenge from Simon Stevens
Propose a limited set of high impact actions which will deliver on the six principles by:
Solving key problems for patients, service-users and carers
Solving key problems, challenges and “pinch points” for the health and care system
Tackling issues of equality
Being concrete, practical and helpful to those driving system reform e.g. in the STP footprints
Mainstreaming the most promising approaches
Being capable of drive and support from national bodies

5. What’s happened so far…
Secured commission from Simon Stevens 30 September
Project being run by People & Communities Board with support from NHS England strategy directorate
Invited ‘proposals on a page’ from targeted stakeholders plus open invites
35 received – including 9 under umbrella of Richmond Group
Held workshop with PCB, NHS England, other system stakeholders – 26 October
Held two Webinars – over 70 participated – 3 & 4 November
PCB board meeting on 7 November
Some are grouped e.g. Richmond Group
Workshop explored the developing framework emerging from the submissions – tested with system partners, explored the questions of what a high impact action is
First Webinar – VCSE, patients and carers; second health and care staff
Talked through the emerging framework, encouraged people to share their ideas and help us to talk through what they know works and what doesn’t.
Very similar themes emerged in these discussions to those in the proposals on a page – care and support planning, brokeage/linkage roles and social prescribing, person-centred interventions and the need for community development.

6. Timetable Action Deadline Agree longlist of proposals 11th November
Focused content discussion meetings
Draft outline of report
w.c. 14th November
w.c. 21st November
Refined draft for PCB comment
w.c. 21st November
Draft to share with Simon Steven’s office
w.c. 28th November
Final version to Simon Stevens
w.c. 14th December

7. What have we asked people?
What is your high impact action?
‘What is your justification/case/evidence?
Who would benefit?
How would the benefit be spread/rolled out?
What would it cost?
What is the impact on equality/health inequalities?
What are the risks and downsides?

8. What’s in scope?
We are likely to end up with a mixture of “the what” and “the how”. They could be:
Evidence-backed practices/interventions amenable to wider adoption
‘Road maps’ or delivery systems, where these are missing
National levers, incentives, signals
New investments – e.g. for innovations
Workforce development/capacity building
Offers from voluntary and community sector
Campaigns/pledges/social movements

9. Care and support planning
An emerging framework
Planned,
community
based care
and support
System of referral
(social prescribing)
Wellbeing
(prevention,
promotion)
Care and support planning
Reducing the social gradient in health
Skilled commissioning for wellbeing

10. Themes and questions Practices & interventions for wider adoption
Creating a national/local framework for embedding these practices
Integrating the VCSE offer
Supporting a social movement for these practices

11. Practices for wider adoption
Care and support planning; social prescribing; co-production; what else?
What do we take from Realising the Value?
How do we scale and spread these approaches?

12. A framework for the six principles
What are the key levers, incentives, requirements, “hard-wiring” the centre should put in place?
Eg in relation to narrative, metrics, STPs, GP contract, MCP/PACS contracts, Care Act implementation etc
What will add value to what is already in place or in train?
What symbolic actions (words, deeds) could be taken to demonstrate greater priority to this agenda?

13. The VCSE offer/s
What should ALBs do at national level to model partnership working?
What are the high impact actions to ensure a strategic VCSE input at local level?
What can we take from VCSE review?
What is it that only the VCSE can do?
What should STPs do – and how to give that real traction?

14. A social movement or campaign
How to connect and empower the change makers for this agenda?
What would a national “support” offer look like that really helped do this?
An innovation fund?
Training and support for patient and lay leaders?

15. Final thoughts What one thing would make a difference?
Existing practice to be scaled up?
National action to be taken?
National action to be stopped?
Please post thoughts on DH Exchange or or