Engagement: the leadership task

Jeremy Taylor, CEO, National VoicesAt Fast Track Programme

2 July 2014

• “Few bodies have done more than National Voices to promote person centred care” Health Service Journal June 2014

• “the “sensible” patients’ group with a strong grasp on the complex reality of life in the modern NHS. HSJ 2012

• “The leading coalition of health and social care charities” HSJ 2011

A service view

A person’s view

The NHS talks the talk….

• Putting patients first• Patients at the heart• Patient focussed healthcare• Person-centred healthcare• Shared decision making• Whole-person care• Engagement• Involvement• Participation• Patient and Public Voice• PPI/PPE• No decision about me without me

…and talks this talk

• Admit

• Allow

• Attend

• Care pathway

• Consent (vt)

• Demand

• Discharge

• Manage

• Refer

• Bed-blocker • Bed 7• Case• Co-morbid• DNA• Frail elderly• Frequent flyer• Inappropriate attender• Worried well

What matters? – the evidence

• fast access to reliable health advice • effective treatment delivered by trusted professionals • involvement in decisions and respect for preferences • clear, comprehensible information and support for self-

care • attention to physical and environmental needs • emotional support, empathy and respect • involvement of, and support for, family and carers • continuity of care and smooth transitions.

http://www.nationalvoices.org.uk/evidence

Living with .....

Out-of-Hours Doctors

GPDistrict Nurses

Social Worker

Malcolm &Barbara

ConsultantContinence

Adviser

Speech & Language Adviser

Dietician

CommunityDentist

OccupationalTherapist

Equipment Service

PhysiotherapistAlternating

Mattress technician

Wheelchair Service

Oxygen serviceDirect

PaymentsTeam; Rowan

Org.

Alzheimer’sSoc outreach

worker

Care team2 live-in carers (alternating weekly)Replacement carer[Some night nursing – Health]Emergency carers & Barbara

The Web of Care

(Last 7 yrs)

DementiaAdvisoryNurse?

Person centred coordinated care – a narrative

“I can plan my care with people who work together to understand me and my

carer(s), give me control, and bring together services

to achieve the outcomes important to me.”

I have the Information

I need…

I am supported to achieve my

goals….

The professionals work as a team.

I always know who is coordinating my care

I’m involved as I want to be in

decisions…

I work with my team to agree a

care and support plan…

When I move between settings there is a plan in place….

The house of care

This stuff works• Information is therapy • Patient involvement leads to better clinical decisions• Self management education and support helps

people with LTCs lead better lives• Communication training for professionals improves

care• Health behaviours can be changed. Well designed

public health interventions work • (National Voices distilled evidence from 779

systematic reviews and turned into 5 simple guides) http://www.nationalvoices.org.uk/evidence

The journey to engagementFrom: To:

Patients as recipients People as citizens, partners and managers of their health

Primarily medical Increasingly socialExperts designing services & consulting

Co-design of services, working with patients & communities

Workforce = healthcare professionals

Workforce = patients, carers, volunteers, vol sector, patient leaders

Treatment plans Participative care and support planning

Outcomes that matter to clinicians and managers

Outcomes that matter to me and us

Hospital focus Home and community focus

The leadership challenge• Strong, visionary leadership• Clear goals• Dedicated champions• Build staff capacity• Invest in care redesign• Involve every patient• Measure experience

Based on Angela Coulter “Leadership for Patient Engagement” King’s Fund 2012

How much do you want let go?

No-one said it was easy

• What matters to the people you serve?• What are their priorities? Are you serving them?• What example are you setting?• Do you have the courage to do the right things?• How are you enabling your staff to do the right things? • What difference are you making? How do you know? • How much are you willing to let go?• Are you accepting the unacceptable?

• Thanks for listening• www.nationalvoices.org.uk• Follow us on Twitter• @NVTweeting• @JeremyTaylorNV