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Slides accompanying a presentation to participants in the NHS Leadership Academy's executive fast track programme. I did this in tandem with patient leader Lynne Craven.
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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