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Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb 2010 Author: Sam Bennett, Department of Health

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Page 1: Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb

Working together for change:using person-centred information for commissioning Dr Fay Haffenden, National JSNA leadNational JSNA Dataset project 24 Feb 2010Author: Sam Bennett, Department of Health

Page 2: Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb

Working together for change

Page 3: Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb

Putting People First

“It seeks to be the first public service reform programme which is co-produced, co-developed, co-evaluated and recognises that real change will only be achieved through the participation of users and carers at every stage. It recognises that sustainable and meaningful change depends significantly on our capacity to empower people who use services…”

Page 4: Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb

Co-production“This is not about consultation or participation –

except in the broadest sense…it is about broadening and deepening public services so that they are no longer the preserve of professionals or commissioners, but a shared responsibility…”

New Economics Foundation, Co-production: A manifesto for growing the core economy

Page 5: Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb

The WTfC project 2008-09

• Objective: To listen to what people said about their lives and about services so that we can commission with people to ensure they get more of what’s working in their lives, less of what isn’t working and can achieve their aspirations for the future;• Approach: Worked with 4 councils to further develop

and test an approach for feeding person-centred information from reviews and support plans into the commissioning process;• Outputs: - A fully tested, written-up approach to co-producing

commissioning plans;

Page 6: Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb

Why do this?Understanding outcomes for people:

…Using the same information in aggregate form provides the opportunity to draw wider conclusions about outcomes for groups of people, or populations”

“Outcomes focused reviews provide data about individual outcomes…

Page 7: Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb

Why do this?

• Strategic needs assessment – JSNA.• Socio-demographic data• Market intelligence• Performance and regulatory information• Historical commissioning patterns• Input from frontline staff• Consultation• Customer satisfaction surveys/complaints

The commissioning dataset:

Page 8: Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb

JSNA

• DH guidance states that other data sources “should be supplemented by information gained through active dialogue with local people, service users and their carers”

BUT - Ensuring meaningful community engagement in the JSNA process has proved difficult…

Page 9: Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb

Possible limitations

JSNADH guidance states that other data sources “should be supplemented by information gained through active dialogue with local people, service users and their carers” This has proved difficult

Data source LimitationSocio-demographic data

Highlights needs rather than aspirations

Consultation Often occurs after development of the strategy

Satisfaction surveys

Often use closed questions

Market intelligence

Imaginative constraints

Page 10: Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb

The raw data for WTfC:person-centred reviews

• The review of a person’s individual support plan or personal health plan;• Includes three key questions:

“what’s working?”

“what isn’t working?”

“What’s important to you for the future?”• You can’t use ‘working together for change’ without

doing person-centred reviews!

Page 11: Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb

The six stages of WTfC

1. Collect raw data from care plans/person-centred reviews;

2. Organise information: top 3 “working” “not working” and “important for the future”

3. Cluster the information with a diverse group of local people;

4. Analyse – what are the root causes? what would success look like?

5. Action plan – what will we do differently?

6. Share and communicate.

Page 12: Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb
Page 13: Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb

E.g. Step 3: Clustering

“I have only one friend”

“I only have staff in my life”

“I don’t see many people during the day”

“I am lonely”

Page 14: Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb

E.g. Step 4: Analysis

“I feel lonely”

• We don’t put enough emphasis on relationships when we commission services;• Staff don’t know how to connect people and don’t see it is part of their job;• Providers don’t see this as a priority;• CQC does not inspect on this so we don’t see it as important;• This isn’t part of staff training;• Care managers don’t see this as important when looking at placements…etc

Page 15: Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb

E.g. Step 5: Action plan Individual change Strategic change

“working” Plan what it would take to spread this practice

“not working” Plan what it would take to change this – action at operational and strategic level

“important for the future”

Inform market development and commissioning

Page 16: Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb

Presenting the data

Page 17: Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb

Outcomes of WTfC implementation• People using services and their families are put at the heart of

the process so that commissioning is transparent and readily understood;

• Data generated routinely from person-centred reviews can be used alongside (or as part of) JSNA to inform strategic commissioning;

• Strengthened thread of robust qualitative data adds ‘colour’ and individual voice;

• That there is a clear and demonstrable link between ‘what people said’ and ‘what commissioners did’ – the golden thread;

Page 18: Working together for change: using person-centred information for commissioning Dr Fay Haffenden, National JSNA lead National JSNA Dataset project 24 Feb