Putting people First

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Putting people First

• Lance Gardner MBE
• Development Manager
• Citizen Involvement
• The NHS Leadership Centre

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Involving the public patients in healthcare

• Whyshould 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?

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 Frontline staff within the NHS must embrace
change on an unprecedented scale if we are not to
lose the publics commitment to the NHSAlan
Milburn, Secretary of State for Health, January
2002.
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there is no such thing as an in-appropriate
request only an in-appropriate response
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The Commission for Patient Public Involvement
in Health

• Advise the S.o.S. on arrangements for public
  involvement and consultation on health
• Assist patients forums, facilitate their
  activities
• Assist providers of independent advocacy
• Set standards for patients forums and ICAS
• Report any concerns about services/professionals
  to relevant bodies
• Must exercise its functions according to areas of
  PCTs

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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

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Other aspects of Bill pertaining to Public
Involvement

• CHCs abolished ?when
• ACHCEW abolished
• All public involvement personnel employed by
  Commission
• The Commission is not an agent of the Crown
• Local Voices based in PCTs but employed by
  Commission

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NHS Hierarchy
ICU Theatre
WARDS
Out-patients
Primary care
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Public Partnership
community
Primary Care/OPD
in - patient
Theatre ICU
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Putting People first
Citizens
Visitors
Guests
Patients
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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  
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Whats in it for the Public?

• Knowledge
• Confidence
• Self-esteem
• Sense of importance
• Sense of ownership
• ?Better health

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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
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Whats in it for the Staff?

• Education
• Support
• Validation
• Trust
• Respect
• Job satisfaction
• ?safety

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From Passive recipients to Active Participants
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What Every Trust Can Do

• Mapping current activity
• Developing a patient involvement strategy
• Creating a strategy for volunteers
• walking the floor
• patients on interview panels.
• Effective PALs

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Conclusions

• Value your relationships they are priceless
• You may find support from unlikely places
• Management leadership are not the same
• Natural teams often work better than carefully
  selected ones
• Your natural allies are your patients not your
  peers
• Public innovation needs to evolve in its own time

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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

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When in doubt,seek forgiveness not pernmission
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Civic Entrepreneurs

• Networkers
• Risk takers
• Difficult to manage
• Poor managers
• Difficult personal history
• Very stubborn
• Have a particular value structure
• Talk too much!

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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

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We learn more from failure than we do from
success
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What is in it for the NHS?

• Confidence
• Trust
• Less dependence
• Votes
• support
• Ownership

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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

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Commissioning for Wellbeing

• 3 comparative studies
• West Manchester PCT
• Langworthy/Seedley - Salford
• Daruzzaman Care Centre - Salford

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What does it look like?

• School governor model
• Delegated budgets
• - PMS
• - PCT
• -City Council
• New accountability frameworks

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D.C.C. Board

• 8 patients
• 2 team members
• 1 PCT member
• 2 Councillors
• Co-opted members
• A Lay Chair

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Whats in it for the Trusts

• Greater understanding
• Reassurance
• Support
• Assistance with targets
• Political protection
• A Mandate

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There are 3 potential levels of
interaction Level 1 Undiscussable
undiscussabilityProblems, what
problems?.with me, with us, with our
process Level 2Discussing UndiscussabilityThe
re are problems I/we are struggling to say what
I am/we are thinking and feelingLevel
3Everything is DiscussableWe clarify and
resolve problems..together! Bob Sang Sept
2001