www.nationalvoices.org.uk@NVTweeting

Person-centred coordinated care:opportunities and challenges for

the VCS

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National Voices is:• “the leading coalition of health and social care

charities” Health Service Journal, Dec 2011

• Mission: to strengthen the voices of patients, service users, carers and their representatives

• Focus on health & social care policy in England • 130 organisations as members• Founded in 2008

In this presentation

• ‘Integration’ – brief policy context• The narrative for person centred coordinated

care• Using the narrative• Some challenges

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Integration: policy context

• Not a ‘government plan’• Who does what?• The national collaborative• The pioneers• The integration transformation fund

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Why a narrative is needed

• Integrated care is ‘a hodgepodge concept’*• At least 175 definitions**• Process (‘integration’) confused with outcome

(‘integrated care’)***• Defined by policy makers, system leaders, clinicians

and researchers – neglecting outcomes for service users

* Kodner D, ‘All together now: a conceptual exploration of integrated care’, Healthcare Quarterly 13(Sp), 6–15.** Armitage GD, Suter E, Oelke ND and Adair C, ‘Health systems integration: state of the evidence’, International Journal of

Integrated Care 9(17), 1–11 2009*** The Audit Commission, ‘Means to an end: joint financing in health and social care’, Health National Report, London

2009

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Why a narrative?

• “The most fundamental prerequisite to the development of integrated care at scale is the crafting of a powerful narrative at both a national and local level”

– King’s Fund/Nuffield Trust: Integrated care for patients and populations: Improving outcomes by working together, January 2012

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Torbay

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The narrative for person centred coordinated care

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Subject

person centred coordinated care

(‘Integrated care’ means...)

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I can plan my care with people who work together

to understand me and my carer(s),

allow me control, and bring together services

to achieve the outcomes important to me.

Definition - service user perspective

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Generic ‘I’ statements

My goals/outcomes

All my needs as a person are assessed and addressed.

My carer/family have their needs recognised and are given support to care for me.

I am supported to understand my choices and to set and achieve my goals.

Taken together, my care and support help me live the life I want to the best of my ability.

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Generic ‘I’ statements

Care planning

I work with my team to agree a care and support plan. I know what is in my care and support plan. I know what to do if things change or go wrong.

I have as much control of planning my care and support as I want.

I can decide the kind of support I need and how to receive it. My care plan is clearly entered on my record. I have regular reviews of my care and treatment, and of my care and support plan. I have regular, comprehensive reviews of my medicines. When something is planned, it happens.

I can plan ahead and stay in control in emergencies. I have systems in place to get help at an early stage to avoid a crisis. 13

Using the narrative

• Common vision, shared purpose• Transforming services - personalisation• Co-production?• Benchmark and monitor progress• Derive measures of experience• Keep telling the story...

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Using the narrative: VCS

• Convene relevant local groups – is the narrative what you want? Ratify/amend/add/adapt

• Demand a conversation – goals & outcomes• Seek formal partnership – governance/steering

group level• Healthwatch on your side – HWB and

commissioners need them• Be clear about VCS offer – as partners and

codesigners – keeping it person centred

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Some challenges

• No requirement for VCS partnerships or HW involvement

• Medical model still dominates health side – poor understanding of personalisation & of VCS

• Lack of good contracting models for VCS• Managing local vs sub-regional planning• Generic not condition specific approaches

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www.nationalvoices.org.uk@NVTweeting

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