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Social care – New ways of working
Marie Roulston ‐ Director of Children’s Services/ExecutiveDirector of Social Work, NHSCT
Phil Hughes ‐ Assistant Director Mental Health, NHSCTSeamus McErlane ‐ Social Care Commissioning Lead HSCB
Geoff Huggins ‐ Director, Health and Social Integration, Scottish Government
Leading Transformation Mental Health Older People Services in NHSCT
New Ways of Working
Karen Harvey – Head of ServiceMaureen Serplus – Locality ManagerNI Confederation Annual Conference
Tuesday 28th June 2016
Background NHSCT
• Adding Life to Years 2007• New Ways of Working 2013 • Ramp 2015
Background Mental Health Older Peoples Service• Dementia Inpatient services on 3 wards • 7 CMHTOP’s – fragmented pathway• Inpatient and Community responsibility• Inconsistent links with
voluntary/community/independent sectors• Resources
New Ways Working
• Focus Bamford, Dementia Strategy, TYCand RAMP
• Right professional, Right time • Change to the model of service delivery • Enhanced multi-disciplinary team working• Workforce Development
What needed to happen?
Engagement Management of change process Practical arrangements Staff re-allocation 5 Team Model Training
NWW June 2016 • Memory Service • Consultant CMHTOP or Inpatient • Dementia Home Support Team • Rapid Assessment Interface Discharge• Supported Living• Dementia Friendly Communities• In Patient Services
Real Benefits for Service User Real Benefits for Service User • Dementia Care Pathway• Comprehensive Assessment• Increased Diagnosis rate• Right person right time • Increased accessibility to services • Dedicated Advocacy
Service User/Carer FeedbackService User/Carer Feedback“the practitioner was very professional, competent and understanding and put me at ease throughout”
“helped me get my dad back”
80% very satisfied 14% were satisfied
Next StepsNext Steps
Acute Pathway Consolidate Memory Service Extend to phase 2/3 Dementia Care Pathway Dementia Intensive Care Unit, CMHTOP and
Dementia Home Support Team Partnership Dementia Friendly Communities
Thank - YouThank - You
Leading Transformation: New Ways of Working in Dementia Care
NI Confederation Annual Conference
Tuesday 28th June 2016
Technological and Medical advances in Health Care
Improved Life Expectancy / Demographics
Increased prevalence - chronic conditions
Costs
Financially
Personal
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Dementia Care
G8 Dementia Summit - London 2013
WHO Ministerial Conference - Geneva 2015
Prime Minister’s Challenge - 2020
National Strategies
Improving Dementia Services in NI: A Regional Strategy (2011)
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Global Perspective
Launched November 2011
44 recommendations / 7 themes
Transforming Your Care (2013)
Making Life Better (2013-23)
Service Frameworks and Standards Guides
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Local Perspective
Regional Implementation Group
Investments
Executive’s Delivering Social Change Programme
Memory Services Collaborative
Research
Legislation (Capacity)
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Improving Dementia Services
Dementia Friendly communities
Regional and Trust initiatives
Dementia Innovation Lab
Dementia NI
Delivering Social Change - Phase 2
Beyond the Strategy
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Other Developments
Training Strategy
Research Programme
Health Economics and Analytics (next 30 years)
Environment / Accommodation / Technology
Dementia Alliance
Centre of Excellence
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Next Steps
Co‐production and involving people – change
that works?Laura Collins ‐ Carer
Martin Quinn ‐ Regional Lead on Personal and Publicinvolvement PHA
Maeve Hully ‐ Chief Executive, Patient Client Council
Co-production and Involving People –
Change that Works?
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Laura Collins
Family Carer
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Martin QuinnRegional PPI Lead
PHA
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What is PPI?New term, not a new concept.
Personal and Public Involvement (PPI) is a process whereby service users/carers and the public are empowered and enabled to inform and influence the commissioning, planning, delivery and evaluation of health and social care services in ways that are relevant and meaningful to them.
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Policy and legislative contextPolicy influencers - Health for all (2000) - WHO
- Wanless (2004/5) and Appleby (2005) Reports- DHSSPS - PPI Circulars 2007 & 2012- Quality 2020- Putting Patients First and Foremost - Transforming Your Care
Legislation - Equality legislation 1998- Health and Social Care (Reform) Act (NI) 2009- No decision about me, without me, DoH 2010- Judicial reviews, growing body of case law
Public Interest - Francis Report 2013- Donaldson Report 2013/14- Human Rights Commission Inquiry 2015
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PPI roles & responsibilities
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Organisation Role
DoH Policy Lead, issuing formal guidance, setting priorities
PHA Policy Implementation Lead. Operational leadership, consistency of approach, building capacity, develop training, raising awareness, chair and facilitate the Regional PPI Forum, develop PPI standards and undertake monitoring and provide assurances to the DoH.
HSCB Ensure PPI is embedded into Commissioning, encourage Family Practitioner services to adopt PPI approaches
PCC Promote public involvement, represent public interest, challenge function
RQIA Independent assurances to DHSSPS re PPI structures
Trusts Organisational and governance arrangements to meet Statutory Duty of Involvement
Other HSC Bodies
Comply with / encouraged to adopt PPI
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Co-production definition
“A delivery model for health services, co-production isbased on the sharing of information and on shareddecision making between the service users and providers(Bettencourt, Ostrom et al, 2002; Needham and Carr,2009). It builds on the assumption that both parties have acentral role to play in the process as they each contributedifferent and essential knowledge (Cahn, 2000).”
The Health Foundation, 2010
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Level of Involvement
Briege Quinn PHA & Rodney Morton HSCB
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Personal
Volunteering g
Co-design(Commissioning)
Co-Delivery(Providing)
Social Capital (Peer Led Service & Social Enterprises)
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Bringing PPI and Co-production together
• The PHA undertakes PPI using co-production/delivery methodology.
• Examples are:• HSC Regional PPI Forum • PPI Standards • PPI Monitoring • Engage & Involve Training Programme
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Co-Production in ActionMaeve Hully
Chief Executive
Our role in Health and Social Care
To provide a powerful, independent voice in health and social care for patients, clients, carers and communities.
We aim to:
• Listen and act on people’s views
• Encourage people to get involved
• Help people make a complaint
• Promote provision of advice & information
What has the
done?
“No decision about me, without me”Clare Rayner
Past president of the Patients Association
Future Planning SuccessBrian Sinnamon
Expert by experience
Raising Awareness of Choking John Toal & Angela Crocker
Help Stop Choking
“Choking is when food sticks in your throat. You might cough or not be able to cough, speak or breath. If you can’t breathe you could collapse and you could die.”
“I have a learning disability, epilepsy, Cerebral Palsy and swallowing difficulties. I choked a few times and it scared me. I worked with Speech and Language
therapy to make changes to help reduce my risk of choking. I haven't choked since, I think my experience with Angela saved my life.
I want to share my story to help other people reduce their risk of choking.”
Hi I’m John
Before I did this work I didn’t realise choking was so serious. I would take big bigbites and my mum would say slow down your going to choke but I didn’t know
that I could die. This is me telling my story and how I feel being through it (choking), even if I help one person it will be fantastic.
Made my story into a DVD.
DVD available on eLearning training and YouTube.
The DVD helps empower service users
I had a very bad choke on lettuce. I don’t eat it now. If I had known it was a hard food I might never
have choked.
My friend's brother died from a choke when he went to live in a new house. We all need to know what to
do to help.
I used to eat all my food dry, now I take gravy and the food doesn’t get stuck in my throat
anymore.
We make sure everyone is quiet
during lunch to help John.
John doesn’t eat on his own anymore.
Secured funding from the BHSCT Health Improvement Consortium to create a website and mobile app
Comments • Excellent project that could save someone’s life should be shared across
trusts in all LD areas also brilliant for children
• Absolutely superb. Johns teaching was excellent he is obviously a choking expert
• Brilliant, great idea to have service users perspective
• Excellent presentation will help many people make better choices and others to better support individuals
• Great session, I didn't know lettuce was hard to eat. Put it on YouTube.
PPI
John is a real service user, talking about what matters to him. Listening to him talking about his experience brings the subject of choking to a human level. This project has given John a strong voice, helped him influence the NHS work and play a significant role in shaping services.
“Thank you for listening to this presentation about choking.I hope it helps you to think more about choking to try to stop people dying from
choking”.
CO-PRODUCTION IN NORTHERN REGION
RECOVERY COLLEGE
CO-PRODUCTION IN NORTHERN REGION
RECOVERY COLLEGEAUDREY MONTGOMERY
ROSEMARY HAWTHORNEAUDREY MONTGOMERY
ROSEMARY HAWTHORNE
BACKGROUND TO RECOVERY COLLEGE
BACKGROUND TO RECOVERY COLLEGE
All courses must be co-produced and co-facilitated
There is a physical base (hub) then courses are taken out to different areas in the community
BACKGROUND TO RECOVERY COLLEGE
BACKGROUND TO RECOVERY COLLEGE
The college operates on mainstream college principles (ie, prospectus, enrolment forms, semester timetables.)
It’s for EVERYONE There is a personal tutor (or equivalent) to
give information and offer guidance about courses
BACKGROUND TO RECOVERY COLLEGE
BACKGROUND TO RECOVERY COLLEGE
The college is not a substitute for traditional assessment and treatments
The college is not a substitute for mainstream colleges.
The college must reflect recovery principles
How did we go about co-production
How did we go about co-production
Steering group Working group Getting people with lived experience and
carers (PPI) involved
Ensuring Effective Co-Production
Ensuring Effective Co-Production
•Dignity and Respect for the views of all•Inclusivity, Equity and Diversity to ensure everyone who needs to and wishes to be involved is facilitated to do so irrespective of culture, language, skills, knowledge and experience
•Collaboration and Partnership Working which is respectful of the views of others and based on constructive relationships
•Transparency and openness in interactions and relationships.
Barriers to Recovery and Co-production
Barriers to Recovery and Co-production
Not understanding the ethos of recovery Not understanding the ethos of co
production Not actively listening Not enough time for co production Not enough time to develop relationships
Recovery and PPIRecovery and PPI
Recovery stories Book Recovery DVD Develop What is Recovery and Social
Inclusion Recovery College Courses Co-production and co-facilitation
Recovery College Courses Recovery College Courses
Co produced Co delivered Experts in own field Equals in the room Joint Decision Making
Benefits of PPI within the Recovery College
Benefits of PPI within the Recovery College
Reduces Stigma Change in culture Shared Learning Environment Instils Hope Joint decision making Equality Volunteering Employment opportunities Enhances personal recovery Networking
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Group Discussion
Hosted by Martin Quinn
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Want to know more?• [email protected]• [email protected]• [email protected]• [email protected]• [email protected]
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