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Patient Empowerment

and

Community Participation

The NHS Five Year Forward View

Giles Wilmore

Mar 2015

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• The NHS Five Year Forward View was published on 23 October 2014

• One of its great successes was that it is a shared vision for the future of the NHS –across six national NHS bodies:

• It identified key challenges facing the NHS and starting to shape the debate on the future NHS

Context: NHS Five Year Forward View

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“when people do need

health services, patients will

gain far greater control of

their own care – including the

option of shared budgets

combining health and social

care. The 1.4 million full time

unpaid carers in England will

get new support, and the NHS

will become a better partner

with voluntary organisations

and local communities.”

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FYFV: Challenges and opportunities

Unhealthy lifestyles drive up the burden of disease

Demand is changing

New technologies and ways to deliver

care

The financial gap remains

• 1 in 5 adults still smoke

• 1 in 3 drink too much alcohol

• Over half the population is overweight

• 70% of the budget is now spent on Long Term Conditions

• People’s expectations are changing

• Diagnosing more disease and keeping people alive longer

• Dissolving traditional care boundaries and improving outcomes

• The gap is projected to be £30bn by 2020/21

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Addressing the FYFV Challenge

• Individual and public participation are essential tools to meeting the

challenges of the Five Year Forward View

• The FYFV sets out how the health service needs to change, arguing

for a more engaged relationship with patients, carers and citizens.

• It identifies four key components to this:

1. getting serious about prevention;

2. empowering patients;

3. engaging communities; and

4. the NHS as a social movement.

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Empowering Patients and Engaging

Communities

• The Five Year Forward View made specific commitments to support individuals and communities to manage their own health, to provide better support to carers and to encourage health related volunteering.

• This included the commitment to work with voluntary sector partners to invest significantly in evidence based approaches such as self-management educational courses, as well as encouraging independent peer-to-peer communities to emerge.

• Community life, social connections and having a voice in local decisions are known to be factors that underpin good health

• Strong community engagement, and investment in the voluntary sector can likewise support individual patients to be more empowered in relation to their health and care.

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• Briefing and Full report

launched in February 2015

• Setting out an evidence-

based case for greater

community empowerment

• A new family of approaches

mapping practical options

Signposting to key resources

and reviews

What’s new

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Community Centred Approaches

• Public Health England and NHS England have recently published a joint guide to Community Centred Approaches to Health and Wellbeing

• This report calls for place-based approaches that develop local solutions, drawing on all the assets and resources of an area

• The report details a ‘family of approaches’ which can be used by commissioners to mobilise assets within communities, promoting equity and increasing people’s control over their health and lives

• The report details powerful evidence for the benefits of community centred approaches and makes a compelling case for change

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Community-centred approaches for health and

wellbeing – with examples of common UK models

Community-centred approaches

for health & wellbeing

Strengthening communities

Community development

C2 – Connected Communities

Asset based approaches

Asset Based Community

Development

Social network approaches

Time banks

Volunteer and peer roles

Bridging

Health Champions

Health Trainers

Peer interventions

Peer support

Breastfeeding peer support

Peer education

Peer mentoring

Volunteer health roles

Walking for Health

Befriending

Collaborations & partnerships

Community-based Participatory

Research

Area –based Initiatives

Healthy Cities

Community engagement in

planning

Participatory Budgeting

Co-production projects

Access to community resources

Pathways to participation

Social prescribing

Community hubs

Healthy Living Centres

Community libraries

Community-based commissioning

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Number of health and social care employees,

volunteers and carers in England

Source: The King’s Fund (2013) Volunteering in health and

care. Securing a sustainable future.

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Realising the Value

• To support the FYFV’s vision of engaged communities and empowered patients, NHS England has initiated a new programme of work: Realising the Value

• This will help strengthen the case for change, building the evidence for approaches that support individual and community engagement in health and care

• It will also work with a number of local health economies to help create practical tools which will support commissioners, clinicians and communities to implement these approaches, and tackle culture and system barriers to change.

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• Patient Participation Groups

• Local Healthwatch

• Community Groups

• Support groups

• Schools and pre-schools

• Youth Clubs, Sports Clubs

• Digital spaces and forums

• Places that people use in their everyday lives

Let’s not reinvent the wheel

Where are all the people?

A Sheffield community’s assets - drawn by a local artist as

part of an asset mapping (see Giuntoli et al 2012)

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NHS Citizen

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Conclusion

• There is widening recognition of the many benefits to community engagement (including improved services, health benefits, and wider social value)

• The Five Year Forward View set out a strong commitment for NHS England to invest in approaches that engage communities and empower patients

• NHS England is leading this through initiatives to access public voice such as NHS Citizen and supporting commissioners to undertake engagement activities

• NHS England is building the case for change and providing tools to support this through the ‘family of community centered approaches’ and work to Realise the Value of community and individual engagement.