putting people first lance gardner mbe development manager: citizen involvement the nhs leadership...
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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]