1.Health Foundation Programmes (Person-Centred Care)

Person-centred care

Health Foundation resources

December 2015

CONTENTS

1.Health Foundation programmes (person-centred care)

Closing the Gap through Changing Relationships

Shine

Co-Creating Health (ran from 2007-2012)

Self Management Support (2013-2015)

MAGIC (Making good decisions in collaboration) (2010-2013)

2.Publications

3.Person-centred care resource centre

1.Health Foundation programmes(person-centred care)

Closing the Gap through Changing Relationships

From 2011 seven teams have been working on projects that aim to change the relationship between people and health services. To organise healthcare services around the needs of the people using them, the Health Foundation believes there needs to be a shift in philosophy, culture and behaviour in three key relationships:

• Between communities and the wider healthcare system. Services do not always take account of local community factors such as cultural expectations, knowledge, language and access, meaning there can be a gap between the services provided and what communities actually need.
• Between the person using services and the wider healthcare system. The responsibility to ‘join up’ services is frequently with the user rather than the service provider.
• Between the individual and health providers. Effective interactions require both parties to have a shared understanding of purpose and process.

Evaluation
The evaluation from this programme can be found here:

The seven projects which ran until end of May 2013 are as below:

Mid-Staffordshire NHS Foundation Trust & the Patients Association

Speaking up: Resolving NHS complaints and preventing problems from recurring

Project summary

This project seeks to transform the current complaints system, creating greater transparency, scrutiny and independence and building a new relationship between the local community and the Trust through a new complaints ‘patient champion’ role. It will ensure that learning from complaints is harnessed and used to improve future care by recording complainants’ ‘patient voices’ – reflective digital stories of patient care for use as teaching resources.

Website Link:

University College London Hospital Charities

Promoting compassionate healthcare for homeless people

Project summary

Most rough sleepers and homeless people have physical and mental health problems, combined with drug or alcohol misuse in a life lacking routine and social support. These factors often cause friction between homeless service users and hospital staff, resulting in a lost opportunity to engage with the individual to help plan and coordinate future care. This project seeks to bring greater compassion and skill to homeless healthcare, by changing the relationship between healthcare professionals and the street-homeless community in order to improve experience and outcomes.

Primary contact details

Alex Bax

Email:

Website Link:

Nottinghamshire Healthcare NHS Trust

Transforming the culture of mental health services through peer support

Project summary

Around one in four people are thought to suffer from mental health problems at some point in their life, but mental ill health continues to carry a stigma.This has a huge impact on the lives of those experiencing mental health problems and the attitudes and behaviour of those around them, including healthcare professionals.

This project seeks to transform the culture of mental health services by employing peer support workers to inspire hope, promote recovery and challenge discrimination. It is built on the belief that people who experience mental health problems can embody recovery and challenge people’s expectations.

Primary contact details

Julie Repper,

Email:

Website Link:

University College London

M(ums)-Power: putting women at the centre of antenatal care

Project summary

Pregnancy is a normal physiological process that produces a range of changes and anxieties that most women manage within complex, busy lives.But services often meet the priorities of healthcare professionals rather than the needs and preferences of the women they serve, resulting in dissatisfaction, inefficiency and, for some, a reluctance to engage.

Primary contact details

Professor Donald Peebles,

Email:

Website Link:

Child and Adolescent Mental Health Services (CAMHS) at University College London & the Anna Freud Centre

Shared decision making in child and adolescent mental healthcare

Project Summary

When children, young people and their families reach mental health services, they are often bewildered and vulnerable. They may not feel confident about how best to ensure their feelings and wishes are genuinely taken into account.

This project seeks to enable children, young people and their families to make informed choices and become active partners in their treatment. It will support them to contribute to decision making and ongoing review of progress. It will help them, and those working with them, find ways to agree goals and review outcomes in ways that are supportive, collaborative and respect the individual's choice.

Primary contact details

Dr Miranda Wolpert

Email:

Website Link:

NHS Alliance

myRecord project: turning it on, sharing the learning

Project Summary

Today 60% of GP practices have the technology in place to allow patients 24-hour online access to their own patient records, but so far only 50 UK practices have seized the opportunity.

For many, the notion of allowing patients access to their own medical records raises fears of increased workloads, misuse of data and harm to patients or the practice. But evidence and experience shows that these concerns are unfounded, and that the approach improves quality of care, shared decision making, safety, effectiveness and patient experience.

This project will work with practices to create a cultural and attitudinal shift to make record access standard practice.

Primary contact details

Dr Brian Fisher,

Email:

Website Link:

myRecord Website:

Sheffield Teaching Hospitals NHS Foundation Trust

Enabling self-management and shared haemodialysis care in hospital based dialysis

Project Summary

Every year, 20,000 people in the UK with kidney disease receive dialysis, which usually takes 3-4 hours at a time, 3 times a week.

Although a small proportion of people in the UK manage their own dialysis at home, for most people it requires many hours every week in hospital. Dialysis is therefore a life-saving but demanding routine.There is evidence that it often leaves people feeling helpless and dependent on hospital staff, as well as having a huge impact on the lives of patients and their families.

This project will rebuild independence, control and flexibility for patients by enabling them to manage their own treatment within hospital. It also aims to transform the relationship between dialysis unit staff and patients, with staff freed up from technical tasks to become health coaches and educators, using the many hours spent in the hospital as an opportunity for building self-management skills and facilitating education and peer support.

Primary contact details

Dr Martin Wilkie,

Email:

Website:

Shine

Our annual Shine programme aims to stimulate thinking, activity and the development of innovative approaches that will improve healthcare quality. It gives teams the space and encouragement to try out, develop and evaluate new ideas.

Shine 2010

NHS Gloucestershire -3 Counties Cancer Network

Project Summary

The focus of this project was to inform and support patients to allow them to have a greater involvement and responsibility for their own chemotherapy treatment specifically to improve the management of toxicity assessment in chemotherapy.

The project team wanted to transform chemotherapy services through:

• increasing the efficiency of the chemotherapy toxicity assessment process
• increasing the effectiveness of the chemotherapy toxicity assessment process through developing a multi-disciplinary, systems-based approach that is transferable to an electronic chemotherapy record
• supporting nurse and pharmacist-led chemotherapy toxicity assessment.

Primary contact details

Peter Davies

Email:

Website:

Shine 2011

NHS Redbridge

Empowering patients in high quality chronic obstructive pulmonary disease (COPD) care

Project Summary

The Shine 2011 team at NHS Redbridge is introducing an initiative that involves providing individualised information to patients and their GPs that will empower them both to raise the standard of COPD care.

They have developed an IT system that can extract data from primary care databases, and track quality and cost of care for individual patients. Patients are sent their report; a letter advising them to request an appointment with their GP to discuss what further interventions could be made; and information about community-based services that may allow exacerbations to be managed at their home, rather than in hospital.

The reports will enable GPs to identify gaps in care at the individual patient level and they can then work with the patients to improve care, either during routine clinic appointments, or appointments arranged by patients to specifically discuss their quality report.

Primary Contact

Angela Burrow

Email:

Website:

Newham University Hospital NHS Trust

Web based outpatient consultations in diabetes

Project Summary

The Newham Shine 2011 project involved replacing routine follow-up outpatient appointments that don’t require physical examination with web-based consultations. These consultations were offered to all patients attending the transitional and young adult service, and for all patients under a consultant in the general diabetes clinic.

The project had a significant impact on patients, particularly those who have difficulty accessing care due to their busy lifestyles or multiple commitments; and those with limited mobility or who are housebound. For staff it encouraged more focused consultations and better use of face-to-face time for clinical activities.

Continued funding

We are continuing to fund this project for another two years where the team will looking at the role of web-based consultations in increasing self-management through improved interaction between health professionals and patients, and providing a more proactive and flexible model of outpatient care.

Primary Contact

Shanti Vijayaraghavan
Email:

Website:

Blog – a new DAWN:

NHS Bolton: Alcohol relapse prevention programme

Project Summary

The Shine 2011 team at NHS Bolton is implementing a relapse prevention programme that uses mobile phone technology. The programme consists of multiple phases that can overcome communication barriers between the client and the service, and provide contact during the periods between formal appointments, when the client is most in danger of relapsing.

The first phase is a text-based appointment reminder system, with an opportunity for the client to confirm whether they will be attending their aftercare appointments or not. The second phase is a ‘mood monitoring’ survey where clients are contacted a few times a week via text message with simple questions about their feelings and emotional state. This will trigger a response, the level of which depends on the answers given. The third phase allows clients to contact the service in the event of a relapse or if they are experiencing cravings. This provides clients with a secure way of obtaining support and advice when they most need it.

Consistent texts will help clients focus on their goals and stay on track. If a client is in an emergency situation, motivational advice or personal contact will help drive abstinent behaviours and help prevent relapse.

Key contact

Debra Malone

Email:

Website:

Shine 2012

2Gether NHS Foundation Trust

Coaching for recovery: active mental health long term condition management

Project summary

1,606 adults in Gloucestershire and Herefordshire currently access specialist mental health services for treatment and management of psychosis. Long term mental health conditions can often be successfully treated with medication resulting in stable psychosis. However, the vast majority of people with this diagnosis experience poorer quality of life outcomes than the general population.

Our vision is to offer people with long term psychosis the opportunity to take charge of their care and tell us how we can offer more personalised and recovery focused care. We want to build on work to train our staff to use an approach that supports the individual’s recovery and reduces reliance on specialist care.

Firstly, we plan to pilot ‘pop up recovery colleges’ to build knowledge, skills and confidence. Secondly, we will conduct a series of PDSA cycles to learn how we can best introduce recovery care plans that build on a person’s strengths, set their own goals and offer coaching and support.

Primary contact details

Tim Coupland, Gloucestershire Localities Development & Performance Lead, Ambrose House, Gloucester, GL4 3GG.

T: 01452 894784 or 07919 626489

E:

Birmingham Children’s Hospital NHS Foundation Trust

Supporting parents/carers to be active partners in their child’s care: quantifying parental concern to strengthen their voice

Project summary

Parents have a unique insight about their child’s health and Birmingham Children’s Hospital (BCH) actively encourages families to be involved in the care of their child. There is currently no assessment tool available within the NHS to capture those parental observations about when a child might not be ‘themselves’.

Currently the NHS relies on verbal communication between clinical teams and families around particular parental observations, which can sometimes be open to interpretation around the level of concern and the appropriate resulting action. BCH takes

parental concerns just as seriously as other healthcare observations. This project aims to bridge this gap by working in partnership with families to develop a new parental observation framework.

Primary contact details

Victoria Demery, Safer Clinical Handover Project Manager, Birmingham Children’s Hospital NHS FT, Steelhouse Lane,

Birmingham, B4 6NH. T: 0121 333 8611 E:

Website link:

Cambridge University Hospitals NHS Foundation Trust - COPD

Supporting patients to inform clinical commissioning to achieve best outcomes; the value of planning using patient-centred information

Project summary

COPD (Chronic Obstructive Pulmonary Disease) is a long term condition (LTC) causing disabling breathlessness, leading to inactivity and worsening health status.

If well managed with appropriate support, quality of life improves and hospital admissions can be reduced but we need to understand how best to implement support and what form is most helpful to patients.

Issues identified relating to patients getting the right support are:

1. Access to services that they recognise as appropriate and relevant

2. Existing COPD services are developed around the medical model and do not address the practical, social and emotional aspects of patients’ lives

3. The commissioning process needs to be informed by patients’ experiences, needs and aspirations.

There is no systematic means of empowering patients to inform commissioning so that services address patients’ needs and aspirations.

We propose implementing a systematic process called Working Together For Change (WTfC) to realise patient co-production in the commissioning of COPD services in Cambridgeshire.

Primary Contact Details:

Tracy Watts, Lead for Patient Development, Flat 62 Elsworth House, Addenbrooke’s Hospital, Cambridge, CB1 0QQ

T: 07951192282 E:

Website link:

Cambridge University Hospitals NHS Trust, Urogynaecology

Enabling patients using vaginal pessaries for Pelvic Organ Prolapse to reduce their hospital attendances through self-management

Project summary

Vaginal pessaries provide an effective alternative to major surgery for women with Pelvic Organ Prolapse (POP). In the UK, the management of patients who have pessaries requires an attendance every six months to have the pessary changed by a healthcare professional. The two primary drawbacks to this pathway are that:

1. Precious outpatient consultant capacity is used

2. Patients with POP who use a vaginal pessary are committed to life long six monthly follow up to change their pessary. The time commitment combined with the nature of the procedure, which for many is stressful and causes discomfort, is felt to be the leading cause of women stopping pessary use and moving to surgery.

Under the self management pathway, patients would attend an outpatient appointment to discuss the option of a pessary and would receive guidance on insertion and removal by a clinical nurse specialist. They would be able to contact the nurse specialist if they had any problems, but would only need to come back into clinic every 24 months.

Primary Contact Details:

Dr Rohna Kearney, Consultant Urogynaecologist, Box 242, Dept of Gynaecology, Addenbrooke’s Hospital, Hille Rd, Cambridge, CB2 0QQ.

T: 01223 586740 E:

Website link:

Children’s Hospice South West

Promoting Patient and Carers’ Priorities in Care – MyQuOL-T: a simple, individualised IT approach to improving care in long-term and life limiting conditions

Project summary

Children and young people receiving palliative care for long-term or life-limiting illness have complex symptoms with consequences which can impact negatively on the whole family's health and wellbeing. Professionals struggle to know which issues matter most to the child and family and so how best to help improve their quality of life.

My QuOL-T (Measure Yourself Quality of Life Tool) is an innovative web-based application that helps patients to identify, describe, prioritise and monitor health related problems or symptoms that are important to them. We plan to introduce the use of My QuOL-T to children and families attending the children's hospice and monitor the acceptability, accessibility, use and effectiveness of the tool.

Primary Contact Details:

Pennee Paige, PA, Charlton Farm, Children’s Hospice South West, Charlton Drive, Wraxall, near Bristol, North Somerset BS48 1PE