community involvement in commissioning
TRANSCRIPT
PPI IS IMPERATIVE FOR SUCCESSFUL COMMISSIONING BECAUSE:
• It’s a financial imperative– Save money – Get pathways used
• It’s a moral imperative– Who’s NHS is it anyway?
• It’s a political imperative– No democratic legitimacy
• It’s a practical imperative– Safer– Better design
• It’s a legal imperative
COMMUNITY INVOLVEMENT AND COMMISSIONING
Dr Brian Fisher MBE
Chair of the Socialist Health Association
WHAT KIND OF INVOLVEMENT?
• Democratic• Participatory
–Influence through engaging with–Individuals–Groups
• Listening Responding
CONSORTIUM GOVERNANCE OPTIONS
• DEMOCRATIC– Democratic elections to the Board– Councillors/LA on the Board (?)
• PARTICIPATORY– HealthWatch on the Board– Other lay people on the Board– Foundation Trust consortium– Lay reps on every key committee– A super patient participation group– Community development
HEALTHWATCH
• Son of LINKs, grandson of Fora, great-grandson of CHCs
• A network of networks and groups• To influence commissioning of health and
SC by understanding key issues for local people.
• Future responsibilities?– Complaints– Shared decision-making
HEALTH AND WELL-BEING BOARD
• Consortium, HW, LA, NHS CB if relevant
• Chaired by LA
• Joint decision-making on commissioning
• Start with Joint Strategic Needs Assessment
• Has the semblance of democratic legitimacy, but no substance
WHAT TO BECOME INVOLVED IN
• The consortium’s agenda– Priorities– Service development– Setting standards – quality in SLAs– Service monitoring– How to spend savings
• The community’s agenda
PROACTIVE DIALOGUE, DEEP AND WIDE
• Experience based design
• Database
• Community development
CONSORTIUMHEALTHWATCH
LOCAL VOLUNTARY GROUPS
HW
HEATH AND WELL-BEING BOARD
COMMUNITY DEVELOPMENT/ORGANISING
• Improves PPI
• Improves health protection
• Tackles health inequalities
• Supports behaviour change
ASSET-BASED COMMUNITY DEVELOPMENT
• People as assets, not problems• Individuals, organisations and statutory services
working together to improve civil life• Both local people and statutory services have
skills that need to be combined for maximum effectiveness – co-production
• Enhancing health promoting/protecting mechanisms
• Strengthening the capacity of indiv and communities
CD Stronger and deeper SNs
RESILIENCE
Health protectionResilience to economic adversityBetter mental health
ENHANCED CONTROL
Can negotiate with servicesMore strength for self-careHealth inequalities reduce
7 STEP MODEL
• Listening event
• Brings together local agencies (health, police, education, SC) and residents
• Partnership
• Forms ‘organizing hub’ for activities and initiatives
• Leaders appear
• Rapid changes in commissioning
HELP - COMMISSIONING @ 9 MONTHS
• Company formed
• Playpark
• GP surgery
• Dental surgery
• Benefits advice
• Tai Chi
• Plans for radical change
HELP – OUTCOMES @ 5Y
• Life expectancy + 6 yrs • Increased Breast Feeding 50% • Postnatal depression rates down 60% • Child accident rate down 50% • 78% reduced fear of crime • Other benefits .. escalated impact of other
Public Health programmes, and changes to services and commissioning
• Estimated savings based on 5% reduction across a basket of conditions = £70k per year for 5000 population.
BIG SOCIETY?
• REDUCED STATE PROVISION • SOCIAL JUSTICE • INCREASED ACCOUNTABILITY • TRANSPARENCY• ENHANCE PUBLIC SECTOR MARKETS • LEADERSHIP BY FRONTLINE PROVIDERS • FUNDING • IMPROVED LOCAL COMMISSIONING • NEIGHBOURHOOD GROUPS MUTUALS AND
COOPERATIVES • CHARITABLE GIVING • VOLUNTEERISM