Reflections from the WY&H Health and Care Partnership Involvement Panel Workshop 17/4/18

I attended a packed meeting at St George’s Centre, Leeds as a member and co-vice Chair of Bradford’s People’s Board. What follows is a short summary and some reflections on the session. Sam Samociuk.

Speakers on the agenda from WY&HP, NHSE, Trust Governors, CCG Lay members, Leeds Council and National Voices.

A general theme emerged of the tensions between the focus on outcomes and the ‘how’ of delivery. So, It ain’t what you do, it’s the way that you do it – that’s what get results! Was then later contradicted by we focus on ‘clinical outcomes’ not bothered how you achieve them. This seems to show the dilemma of 21st Century Health care and involvement – what does take prominence? Organisations want results because results attract funding and show efficiency, people receiving services want efficiency but delivered locally with care and compassion.

The first ‘table discussion’ ran over and covered a range of well known and now well worn involvement issues;

  • The need for collaboration and integration
  • Break down ‘silo walls’
  • Co-Production is an over used term
  • Patients and Public need to be really heard and valued
  • Stop asking what people want but what are the choices available
  • Need to really involve Carers and friends and young people
  • Too much consulting, not enough feedback on actions taken
  • Need more honesty from commissioners and providers
  • What works is very individual in each area

Paul Bollom (LCC) made interesting points re the need to get out into the communities’ ‘scout huts’ to devise, reshape and share jointly devised plans for Health. Shared Ownership of the process and the plan. This needs to be done frequently, one meeting doesn’t constitute engagement, repetition is the key.

The Leeds Left Shift – a simple but effective slide to show how the landscape of Health and Social Care needs to shift, from Hospital focused care, to prevention and general health and wellbeing.

National Voices – what have we to show?
Figures are interesting;
only 3% of people have a care plan
Only 23% of Carers had a Social Care assessment Co-ordination of care is not measured

It seems that the easy to measure metrics and hence easy to show results, are well catered for – e.g. waiting times But the ‘relational’ aspects of care, compassion, empathy, respect and dignity are not the foci for sustained measurement – yet this tends to be what shapes the ‘patient experience’. How can we (PB) ensure that organisations give this equal attention and use the available measures?

There did seem to be a genuine wish to ‘get this right’ but in terms of a WY&H Partnership wide approach? We have enough principles, tool kits and acronyms we need a central shift in values, attitudes and beliefs. If involvement/engagement at a meaningful level is to be a reality we need Commissioners, Trusts and Providers to really want it, to make the conditions right for it to flourish and to understand it takes huge effort, time and financial investment. The patient ‘voice’ needs to be present from the beginning of each venture.

The workshop was to include a ‘next steps’ break out session but we ran overtime and didn’t complete this.

An analogy – the NHS is like a large factory, it has many departments and workers. In the 19th Century Bradford was full of ‘dark satanic mills’, the workers, did long hours, lived in poor conditions and were paid poorly and the owners were output and profit driven.

Along came Titus Salt – he believed the factory should be ‘eco-friendly’ and that the workers, if cared for properly, would work better.

The Spirit of Sir Titus Salt – he built a factory outside of the city, focused on the health of workers, built a model workers village, it was good housing, with sanitation and local facilities – school, hospital laundry etc.

Our health and wellbeing strategy in the city and the move to prevention is a modern reflection of Titus’ vision but applied to health and social care – makes you think, doesn’t it?

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