Putting people First Lance Gardner MBE Development Manager: Citizen Involvement The NHS Leadership Centre

Involving the public & patients in healthcare Why:should 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?

Frontline staff within the NHS must embrace change on an unprecedented scale if we are not to lose the publics commitment to the NHS Alan Milburn, Secretary of State for Health, January 2002.

there is no such thing as an in-appropriate request – only an in-appropriate response

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

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

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

NHS Hierarchy

Public Partnership

Putting People first

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]

Whats in it for the Public? Knowledge Confidence Self-esteem Sense of importance Sense of ownership ?Better health

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]

Whats in it for the Staff? Education Support Validation Trust Respect Job satisfaction ?safety

From Passive recipients to Active Participants

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

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

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

When in doubt, seek forgiveness not pernmission

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

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

We learn more from failure than we do from success

What is in it for the NHS? Confidence Trust Less dependence Votes support Ownership

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

Commissioning for Wellbeing 3 comparative studies West Manchester PCT Langworthy/Seedley - Salford Daruzzaman Care Centre - Salford

What does it look like? School governor model Delegated budgets - PMS - PCT -City Council New accountability frameworks

D.C.C. Board 8 patients 2 team members 1 PCT member 2 Councillors Co-opted members A Lay Chair

Whats in it for the Trusts Greater understanding Reassurance Support Assistance with targets Political protection A Mandate

There are 3 potential levels of interaction: Level 1 Undiscussable undiscussability Problems, what problems?……….with me, with us, with our process Level 2 Discussing Undiscussability There are problems –I/we are struggling to say what I am/we are thinking and feeling Level 3 Everything is Discussable We clarify and resolve problems……..together! [Bob Sang Sept 2001]