NEW WAYS OF WORKING

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NEW WAYS OF WORKING

• Dr Pauline Roberts

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• NHS Plan 2000
• N S F
• Our Health, Our Care, Our Say - 2005
• N W W for Consultant Psychiatrists-2005
• N W W for Everyone - 2007
• Breaking Down Barriers - 2007
• Darzi Interim Report - 2007

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N W W for Psychiatrists2005

• Enhanced effectiveness,
• Person centred,
• Multi-disciplinary,
• Multi-agency,
• RCPsych, NIMH and others

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Executive Summary

• 1. Supporting and enabling the delivery of
  effective person-centred care
• 2. NOT about saving money, releasing resources
  for other initiatives or undermining the role of
  the consultant psychiatrist
• 3. Highlights changing context of service
  delivery

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4. Consultant Psychiatrists Role

• Patients with the most complex needs
• Consultant to multi-disciplinary teams
• Distributed responsibility
• Leadership across teams

Willingness to embrace change, flexibility with
stakeholders. Desired outcomes, motivated
workforce and high quality service.
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• 5. GMC clarification of medical
• responsibility in teams
• 6. Recruitment and retention
• 7. Examples of good practice
• 8. Sustaining change
• user and care involvement
• consultative leadership
• proactive communication

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• 9. Supporting teams, creating
• capable team toolkit
• 10. Evaluation 2007
• 11. Ongoing work.
• College steering group, chaired by
• Sue Bailey.

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New Ways of Working for Everyone May 2007

• 1. LEADERSHIP
• Leadership with teams is complex, competence
  rather than profession denotes leader
• Debate and collaboration not conflict
  develops competence of all team members

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• 2. TEAM WORKING AND ATTITUDE
• Governance driver, person centred requires
  distribution of responsibility
• not delegation.
• No individual in charge of all patients in
  the team. All responsible for the care they
  give, spirit of openness
• Most experienced and skilled see the most
  complex. Less experienced supported.

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• 3. PROFESSIONALLY DRIVEN,
• USER AND CARER FOCUS
• Sharing of capabilities
• e.g.
• psychiatrists developing non- medical
  prescribing
• psychologists training and
  supervising CBT

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• INNOVATION AND EFFICIENCY Comparison of push/pull
  systems
• e.g. Push
• Routine OPC follow up
• Pull
• Seen at time of need
• Advantages
• greater patient satisfaction
• improved time management
• improved demand management

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• 5. INTELLIGENT USE OF INFORMATION
• Transparent and open caseload management
• Supervision, scrutiny and challenge

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SUMMARY

• Clarity of leadership, not solely based on
  profession but on ability and competence
• A system of distribution of responsibility rather
  than delegation
• Focus on use of skills to match the needs of the
  patients and carers

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SUMMARY (cont)

• Attitude of individuals taking responsibility for
  clinical governance standards
• Attention to the efficiency in the delivery of
  care, removal of waste and duplication
• Effective and intelligent management of caseloads

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PERSONAL EXPERIENCE

• NWW CRHT 2004
• NWW Boleyn Pilot 2006

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STUMBLING BLOCKS

• NWW for psychiatrists preceded NWW for everyone
• Focuses on patients and teams but dependent on
  other agencies,
• e.g. primary care, coroners
• Takes time and resources to develop capabilities
• Vulnerable to service reconfiguration
• 5. Misuse and misunderstanding of NWW

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THE FUTURE

• DARZI
• Fair, personalized, effective and safe care
• Pathways and outcomes