Ready Steady Go and HelloPatient empowerment

Shared decision making

Transition

Dr Arvind Nagra

Consultant Paediatric Nephrologist,

Clinical Lead for Transitional Care

Ready Steady Go:

•What? • Generic empowerment programme

• Equips users with the skills and knowledge to

manage their healthcare

• Why?• Reduce morbidity and mortality

• Improves vocational readiness

• Who? • Young people >11yrs with chronic condition

• How?• Ready Steady Go programme

www.uhs.nhs.uk/readysteadygo

Ready Steady Go: Improves Outcomes

• Improves long term

outcomes

Outcomes for young

people within 2 years

of transfer to adult

services

No transition Using a Transition

programme e.g.

Ready Steady Go

Comments

Kidney transplant patients:

% who lost their transplant or

died within 2 years of transfer

to adults

25% 0%

Diabetes patients:

% of YP attending clinic in adult

services

57% 78%

only had time to

complete ‘Go’ as

patients older

Diabetes patients:

Number of emergency

admissions

1.01 0.45 50% reduction

only had time to

complete ‘Go’ as

patients older

Ready Steady Go: How?

Provides a structured framework covering:

• Knowledge

• Self advocacy- speaking up for yourself

• Health + lifestyle

• Education/future

• Psychosocial issues

• Transition

Paone et al 1998, J McDonagh et al 2006

Ready Steady Go: Self advocacy

• Speaking up for

yourself

• Shared decision

making

‘No decision about me

without me’

Video

• www.uhs.nhs.uk/readysteadygo

• 6 minutes

Ready Steady Go: Moving through the programmeReady Steady Go: Each Young person (YP) progresses at their own pace

11-12 yrs.. YP and Carer

Introduced to

Ready Steady Go

programme with

information leaflet

+ video

www.uhs.nhs.uk/

readysteadygo

11 – 13 yrs.YP completes Ready

Issues addressed in

bite sized pieces.

YP Introduced to

shared decision

making +

confidentiality

When ready YP seen

on own for few mins

during clinic.

Agree goals

14 – 16 yrs.YP completes Steady

Issues addressed

In bite sized pieces

Aim to see YP for

longer on own in

clinic. Keep

parent/Carer fully

involved

Duplicate clinic letters

offered to YP

Agree goals

16 – 18 yrs.YP completes Go.

Issues addressed

In bite sized pieces

Work towards YP

conducting whole

clinic on own. Keep

parents/carers

involved

Referral letter to

adult team.

YP meets adult team.

On-going issues

highlighted to adult

team. Ideally all

issues addressed

prior to transfer.

Write transfer letter

Agree goals.

1st adult clinic YP +/- Carer

completes Hello

Issues addressed in

bite size pieces by

HCP.

Clinic letters sent to

YP

Periodically Hello

completed again to

ensure knowledge +

skills maintained

Any issues

addressed.

Agree goals

Carer completes parent/carer questionnaire alongside YP questionnaires. Any Issues addressed.

YP with learning difficulties completes as much as possible alongside carer who is YP advocate

Nagra et al 2015

Ready Steady Go delivers:

• CQC report: From pond into the sea (2014)

• Institute of Public Policy Research: Patients in control (2014)

• Best practice statement for transition - TYAC, Mental Health, Renal …..

• Health Foundation: Ideas into action: Patient centred care (2014)

• NHS England generic transition service specification (draft)

Ready Steady Go: Adoption + Support

• NHSE, National Youth Forum

• BAPN + IPNA

• Sub-speciality groups

– Diabetes, Cystic fibrosis, Epilepsy, renal, SEND, mental health, haemophilia, oncology……

• Numerous hospitals in UK

• Adult engagement with Hello to Adult Services

• Public Health England- example of good practice

• International interest

Ready Steady Go: Next steps

• Easy Read version Co-produced with

-Available by end November 2015

• ‘Hello’ to children’s services for parents

-Available by end 2015

• My Health Record- patient owned record

– Includes online/app Ready Steady Go

Ready Steady Go + Hello: Summary

• A generic programme that works across sub-specialities and age groups

• Shifts emphasis to empowering the young person and adult patient

• RSG succeeds because:

– The staged ‘traffic light system’ is appealing, it’s simple to use, easy to implement and has minimal cost

• RSG-Hello continuity from paediatrics to adults

Ready Steady Go and Hello

Further Information can be found at:

1. Website: www.uhs.nhs.uk/readysteadygo

2. Article: Implementing transition: Ready Steady Go.

Arch Dis Child Educ Pract Ed June 2015

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