Risk, quality and trust: lessons from Francis Jeremy Taylor, CEO, National Voices At CfPS Annual Conference 10 June 2014

Themes from the Francis inquiry... culture and behaviour openness transparency honesty standards the patient and public voice and it’s not just about mid-Staffs

The Government response Chief inspectors – “an Ofsted for health” Duty of candour - when things go wrong Berwick - on “zero harm” Cavendish – on nursing Hart/Clwyd – on complaints Keogh – on 14 other worrying hospitals “Hard Truths” But it’s not about the Government

What matters to patients? – the evidence Treat me as a person I need access I need information Talk to me Involve me Involve my family and friends Respect my privacy, confidentiality and dignity Help me stay well and independent Join things up, don’t pass me from pillar to post I need practical support I need emotional support

It’s not just about the ward

Living with.....

Out-of- Hours Doctors GP District Nurses Social Worker Malcolm & Barbara Consultant Continence Adviser Speech & Language Adviser Dietician Community Dentist Occupational Therapist Equipment Service Physiotherapist Alternating Mattress technician Wheelchair Service Oxygen service Direct Payments Team; Rowan Org. Alzheimer’s Soc outreach worker Care team 2 live-in carers (alternating weekly) Replacement carer [Some night nursing – Health] Emergency carers & Barbara The Web of Care (Last 7 yrs) Dementia Advisory Nurse?

Person centred coordinated care “I can plan my care with people who work together to understand me and my carer(s), allow me control, and bring together services to achieve the outcomes important to me.” Information My goals/outcomes Communication Decision making Care planning Transitions

Engaged, informed patients HCPs committed to partnership working Organisational processes Responsive commissioning Personalised care planning Coulter, Roberts, Dixon: Delivering better services for people with long-term conditions – building the House of Care, King’s Fund, October 2013

Being person-centred People - treat me as a person Partners in decisions – involve me as much as I want to be, don’t just “consent” me Self-managers - help build my knowledge, skills, confidence, I want to get on with my life Citizens - understand my needs; respect my rights whoever I am People helping people - connect me with those who can help me Communities and leaders - we want to put something back: benefit from our collective goodwill, experience and leadership

Being person-centred Risk - I want you to be safe and I want you to trust me Quality – “safety, effectiveness, experience” - but also what matters to me Trust – You need to earn my trust by being open, honest, and transparent. And you need to trust me

Kate Granger’s values Communication The little things matter Person –centred care See me – not my disease

Some questions for scrutineers Can we find out what is going on? What do patients and families think? What do staff think? What does the board worry about? Do they learn? Do things change? Are patients involved? How and where? Are staff involved? How and where? Where is the community?

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