NWL INTEGRATED CARE SYSTEM
CO-CREATING OUR INTEGRATED SYSTEM STORY
Document Purpose
The following Briefing provides a summary of the work that we would like to undertake in collaboration with you as local & care organisations and communities here in North West London to co-create a shared story of changing population and care needs.
We want to use this opportunity also to invite you to join us in making this happen by:
● sharing already identified data, insight and intelligence to help us understand ‘what we already know’ in terms of what our communities, frontline staff and organisations improves or hinders system integration
●identifying ‘what we don’t know’ ; areas where we only have very limited data / insight
●moving forward together towards a shared, responsive and accountable system
Key Definitions / Assumptions
Our understanding of Integrated Care is as follows: “Integrated Care should be seen as different way of thinking, planning and delivering care –based on people not buildings, and based on outcomes not organisations”.
We understand that for change to take place, we need to come together and with our communities to test out our assumptions of ‘what needs to change’; ‘why it needs to change’; and ‘for whose benefit’. We believe this will move us forward to co-create a shared story for change that:
●Connects the individual to their own health and wellbeing story.
●Connects people together around a collective health and wellbeing story.
●Connects people to the (local and sub-regional) systems so that health and care services are commissioned and delivered to reflect the diverse needs of our communities and workforce.
●Delivers a truly integrated, accountable and responsive health and care system
Our proposed starting point is to:
●Work with you first and foremost to review share and validate ‘what we know already’ based on feedback through our surveys, consultations, research, and community conversations.
●Identify and highlight what we do not know and use this as the basis for wider conversations and to co-create the change story.
●Deliver - at this stage - a series of community conversations (with front line staff and local people) with the purpose to share and make sense of our findings.
●Use individual and community stories, social media and face to face conversations to share and present an initial shared and organically evolving narrative based on the information gathered from above.
2. WHAT PEOPLE TELL US MATTERS TO THEM ABOUT USING SERVICES AND STAYING HEALTHY?
Community, patient, user, carer and staff feedback over the past 4 years has consistently highlighted 3 key areas for improvement:
●Access and use of health and care services[1]. Key themes - where experience is far from optimal - identified across all services through the NWL Annual Patient Experience & Data:
○Contact & Information: knowing who to contact and how, finding information on condition, healthcare facility, advice and support.
○Appointment: making appointments, delay and cancellation of appointments
○Arrival: knowing how to navigate the space, who to speak with, interaction with (reception and other) staff.
○Consultation: interaction with health and care professionals
○Care: quality and effectiveness of care provided (including examination, treatment, and management of a condition).
○Going Home: knowing what to do next, how to take medication, danger signs and who to contact if needed.
●Care planning and service integration[2]. Insights into customer journeys highlighted 4 ingredients to the successful implementation of integrated, responsive and accountable care, these include:
○‘Control’ people feel listened to and involved in the design and development of their care and support, which culminates in personalised service.
○‘Quality’ All agencies do as they said, when they said they would and high calibre staff provide sufficient time to enable the outcomes which have been defined and agreed between the customer and authority.
○‘Coordination’ A health and care system which is easy to enter and navigate to find the right team or person, to meet the needs of the customer. It works in a way that feels integrated across all disciplines relevant to the individual end user.
○‘Clarity’ the end user is clear about the support that can and cannot be provided, how and when it will be provided and by whom. The user is kept informed, in a timely manner, of anything which could affect the provision of their support.
●Wellbeing and resilience[3] - insight gathered from communities and neighbourhoods overwhelmingly highlight that individual and community wellbeing improves when we have:
○A fairer and equitable access to local services
○Positive and strong family relationships
○A strong belonging to a community
○Good skills and a secure job
○Adequate housing
○The ability to help and support others
3. WHAT PEOPLE TELL US ABOUT THE LEVELS AND OPPORTUNITIES FOR BUILDING SUSTAINABLE RELATIONSHIPS WITH COMMUNITIES[4]?
●At System Level : Local people and frontline staff want to be involved in shared decision-making, sitting alongside partner organisations to co-produce a shared and agreed:
○Vision: Shared understanding of what we are trying to achieve.
○Assurance and evaluation: Whether we are delivering what we said we would do.
○Impact: Local people and frontline staff see the difference their involvement has madefeedback and share the change with others.
●At Service Level: Local people volunteers, community and staff working together by bringing their experiences to deliver responsive and accountable services.
●At community Level: Local people and communities as a positive social movement:
○Supporting themselves. By accessing support and services in a manner that reflects their lifestyle; personal individual needs and at a pace set by them.
○Supporting one another. Local people and communities actively engaged in building support networks, groups, and services.
4. WHAT IS OUR ASK OF YOU AS AN ORGANISATION / NETWORK / COMMUNITY?
●The above are simply assumptions based on our own data and community intelligence so we’d like to:
○Test with you whether we got this right?
- If so great, and we’d be grateful if you are able to share data / reports / insights or personal experiences to support this
- if not great, and we’d also be grateful if you are able to share data / reports / insights or personal experiences to challenge the assumptions above.
○Work with you to help us understand what we don’t know.
●More specifically, we plan to carry a series of activities over the next 12 months where we’d like to come together with you to agree whether these are the right areas to start the change conversations but also what we can deliver together across North West London
Create a shared Platform for Community Voices / We are at the early stages of creating a Community Voices digital platform for sharing data and community intelligence between and across our organisations. We’d like to give you access to the platform regardless but we’d also like to ask whether you’d want to involved in contributing your data / reports etc.. so that others may be able to make use of it.Shared data and intelligence / stories and change conversations / We’d like to ask you to share with us your insights and data into what good integrated care looks like in your area?
Also, What stories are you aware of that we could use to encourages service integration and innovation?
Building a shared narrative / Do you have a story or stories that you use to encourage change and how effective has this been?
Are there key ideas/concepts that support people you work with to aspire or imagine a new way of designing services? e.g. Community Champions What matters to us?
Would you like to work together to deliver a NWL large systemwide event on 24th May 2018 to present the work undertaken so far in re-imagining an integrated and responsive future health and care system
[1] Annual Patient Experience Survey Detailed Report 15/16
[2] ‘Customer Journey’ Analysis - Adult Social Care Insight Report
[3] Community Champions Social Return on Investment Evaluation
[4] NWL Wholesystems Integrated Care Plan - Embedding Partnerships plans