1. Person Centred Care in NHS Wales
17th November 2014
Person Centred Care in NHS Wales
Mike Spencer

2. Introduction and context

3. Achieving Excellence – Person Centred Care
....the whole improvement programme will ensure a person-centred focus which champions preservation of dignity and respect. Individuals will be encouraged to take responsibility for their own health and management of conditions, supported with clear and consistent information on how to achieve this.

4. Achieving Excellence – Person Centred Care
...concerns about NHS services. The principles of Putting Things Right are there to deliver:
an approach centred on personal experiences rather than processes
a focus on learning which drives quality improvement and reduces adverse events, and avoidable harm to those using services

5. NHS Wales Planning Framework

7. Pathways

8. Planned Care - GRYMUSO CLEIFION

9. Key Components of Integrated Care
For many patients, the key point in their illness is when consideration is being given to referral for treatment. At this time patients require:
access to information about their illness and the treatment options;
methods to enable optimum decision making;
the best environment in which they can openly discuss and make decisions about the important and sometimes life changing decisions about their treatment requirements; and
“activation” to engage confidently with healthcare providers

10. NHS Wales Outcome Framework
Staying healthy
People in Wales are well supported to manage their own physical health
Safe Care
People in Wales are protected from harm and protect themselves from known harm
Effective Care
People in Wales receive the right care and support as locally as possible and are enabled to making that care successful
Dignified care
People in NHS Wales are treated with dignity and respect and teat others the same
Timely Care
People in Wales have timely access to services based on clinical need and are actively involved in decisions about their care
Individual Care
People in Wales are treated as individuals with their own needs and responsibilities
Our Staff and Resources
People in Wales can find information about how their NHS is resourced and make careful use of them

11. Prudent Healthcare
Dec 2013: ‘Simply Prudent Healthcare’ Bevan Commission Jan 2014: Prudent healthcare in a time of austerity – the Minister’s speech April 2014: Prudent healthcare workshops (to test principles)

13. Prudent Healthcare Principles
Five principles have emerged:
Do no harm
Carry out the minimum appropriate intervention
Organize the workforce around the ‘only do what you can do’ principle
Promote equity
Remodel the relationship between user and provider on the basis of co-production
These are the principles put forward in the paper ‘Achieving prudent healthcare in NHS Wales.’ They are based on the principles set out by the Minister and Welsh Government, and result from the workshops held by four health boards in April 2014.
This session will focus on [Session name], which showcases work underway that supports the principle [select principle and expand on links].

14. Co-production
an approach to public services based on equal and reciprocal relationships between professionals, people using services, their families and their communities.

16. Levels of Co-production
basic
acknowledges people's action is essential to the desired outcome
intermediate
recognises what service users can offer
power imbalance between citizens and professionals remains
Needham and Carr for SCIE
Co-production is informed by
The presence of the six principles
How power is balanced between people getting support and the people who deliver it
transformative
service users involved in all aspects of design & delivery
transforms power and control

17. Reviewing the Current Position

18. Trusted to care and Review of Concerns 2014

19. How do we Know What Our Users Really Experience?

20. Prudent=People centred=Co-produced
Co-commissioned
People centred services
Co-designed
Co-delivered
Co-evaluated
People Centred Care
First and lasting impressions
People’s Experience
Safe, supportive environment
Understanding and involvement in care

21. Framework for Assuring Service User Experience
Three domains
First and lasting impressions
Safe, supportive environment
Understanding of and involvement in care
Four broad sources of feedback
Real time
Retrospective
Proactive
Balancing
A national set of core questions

22. All Aspects of Experience
Satisfaction
Experience
Concerns
Complaints
Serious Incidents
Surveys
Complaints
Stories
Incidents
Tweets
Plus, plus………………….

23. Enablers to Person Centred Care
A wide range of expertise in NHS Wales

24. Co-creating Health
This programme aimed to embed self management support within mainstream health services by equipping individuals and clinicians to work in partnership to achieve better outcomes.
The programme focused on developing the skills and attitudes of both people with long term conditions and their clinicians, while also ensuring systems and services are designed to support and facilitate self management.
Clinicians in ABMU are being supported to take this approach into clinical practice

25. Shared Decision Making
The MAGIC (Making Good Decisions in Collaboration) programme worked with frontline health professionals in Cardiff and Newcastle to test how to embed shared decision making in clinical practice and overcome the barriers to change.
The aim was to make healthcare more patient-centred and influence more healthcare professionals to give patients the choice and involvement they are asking for.

26. Evaluation

27. Bringing it Together

28. 1000 Lives Pilot Collaborative
“Prudent Interactions”
Brings together learning from co-creating health, Magic and the EPP programme
Will give clinical teams the skills and tools to take the learning into clinical practice
Started October 2014 ends March 2015
Will be used to develop a programme that will be offered to NHS Wales from April 2015

29. So, why are we here?
Policy and strategic drive towards person centred care
Principles embedded in NHS Wales Outcomes framework
National approach to assuring patient experience
Sound evidence base about benefits and implementation of enablers
1000 lives working to give clinicians and patients the skills to move theory into practice