Putting people First

Lance Gardner MBE

Development Manager:

Citizen Involvement

The NHS Leadership Centre

Involving the public & patients in healthcare

Why:should we want to involve patients?

When: should we involve them?

How: do we involve them effectively?

Where: is the right environment to do this?

What: are the best methods to achieve this?

 “Frontline staff within the NHS must

embrace change on an unprecedented scale if we are not to lose the publics’ commitment to the

NHS”Alan Milburn, Secretary of State for Health,

January 2002.

“there is no such thing as an in-appropriate request –only an in-appropriate response”

The Commission for Patient & Public Involvement in Health

Advise the S.o.S. on arrangements for public involvement and consultation on healthAssist patients forums, facilitate their activitiesAssist providers of independent advocacySet standards for patients forums and ICASReport any concerns about services/professionals to relevant bodiesMust exercise its functions according to areas of PCT’s

Patients Forums

To be in established each NHS Trust

Monitor & review services

Obtain the views of patients & carers

Provide advice, make reports and recommendations

Provide information to the public

Inspect premises without prior notice

Other aspects of Bill pertaining to Public Involvement

CHC’s abolished [?when]ACHCEW abolishedAll public involvement personnel employed by CommissionThe Commission is not ‘an agent of the Crown’Local Voices based in PCT’s but employed by Commission

NHS Hierarchy

Public Partnership

Putting People first

“World Health Organisations Declarations of Intent are based

on the foundation that it is a basic human right for an

individual to self determine their health and health care.”[Declaration of Geneva, et al]

 

What’s in it for the Public?

Knowledge

Confidence

Self-esteem

Sense of importance

Sense of ownership

?Better health

“There now needs to be a shift in emphasis from one of consumerism to one of participatory democracy. The modern relationship between the NHS and patients cannot be purely based on patients as consumers. Instead it must be based on patients as citizens. This should be seen as providing an opportunity for the NHS – and those working in it - and not a threat.” [Excerpt from S.o.S. IPPR address June 2001]

What’s in it for the Staff?

Education

Support

Validation

Trust

Respect

Job satisfaction

?safety

From Passive recipients to Active Participants

What Every Trust Can Do

Mapping current activityDeveloping a patient involvement strategyCreating a strategy for volunteers‘walking the floor’patients on interview panels. Effective PAL’s

Conclusions

Value your relationships – they are pricelessYou may find support from unlikely placesManagement & leadership are not the sameNatural teams often work better than carefully selected onesYour natural allies are your patients not your peersPublic innovation needs to evolve in its own time

Bombay Hospital Mission Statement

“A patient is the most important person in our Hospital. He is not an interruption to our work, he is the purpose of it. He is not an outsider in our Hospital, he is part of it. We are not doing a favour by serving him, he is doing us a favour by giving us an opportunity to do so.”

Mahatma Gandhi

When in doubt,seek forgiveness not

pernmission

Civic Entrepreneurs

Networkers

Risk takers

Difficult to manage

Poor managers

Difficult personal history

Very stubborn

Have a particular value structure

Talk too much!

Civic Entrepeneurs

“Civic entrepeneurs understand that they need to develop the cabability, skills and knowledge of the people around them and generate greater capacity… that this is the amount of effective resources available to achieve their objectives”.

Charles Leadbeater

“We learn more from

failure than we do

from success”

What is in it for the NHS?

Confidence

Trust

Less dependence

Votes

support

Ownership

A new kind of Care

Called a care centre

Community care not practice list centred

More social networks than health ones

A governing body

The ‘Partnership’ with the black economy

Commissioning for Wellbeing

3 comparative studies

West Manchester PCT

Langworthy/Seedley - Salford

Daruzzaman Care Centre - Salford

What does it look like?

School governor model

Delegated budgets

- PMS

- PCT

-City Council

New accountability frameworks

D.C.C. Board

8 patients

2 team members

1 PCT member

2 Councillors

Co-opted members

A Lay Chair

What’s in it for the Trusts

Greater understanding

Reassurance

Support

Assistance with targets

Political protection

A Mandate

There are 3 potential levels of interaction: Level 1

Undiscussable undiscussability“Problems, what problems?……….with me, with us, with

our process” 

Level 2Discussing Undiscussability

There are problems –I/we are struggling to say what I am/we are thinking and feeling”

Level 3Everything is Discussable

“We clarify and resolve problems……..together![Bob Sang Sept 2001]