Creating a person centred integrated care pathway Debra Moore Debra Moore Associates

Why is this being ‘person centred’ so important?

High priority Central to government policy Across all care groups Across all settings Social Care Health Care Criminal Justice System

Hospital care – need to be vigilant People who are in congregate care settings are at high risk of institutional care delivery includes acute hospitals! Abuses of power and excessive control over patients has been a key feature in many hospital ‘scandals’ Patients in secure services can be viewed as ‘less deserving’ ‘Elimination’ of risk rather than ‘risk management’ a key concern in some services ‘Security’ is often cited as a reason not to be ‘person centred’ Secure services are often ‘isolated’ Need to pass the ‘good enough for me and mine’ test

Specific issues for those who ‘challenge’ positive reputation and identity Secure environments present few opportunities for service users to retain a sense of identity and contribution within society – a son, a brother, an employee, a neighbour etc. In CJS a significant factor in re-offending is that offenders continue to see themselves as criminal - unable to shake off this identity. People need to be engaged in their own care and treatment – increasing self care, resilience, hope and recovery.

6’s Model – confirm & challenge 6 core outcomes for in-patient services Each outcome has a set of key principles to guide commissioning and service delivery and examples of the types of evidence for each principle

What did we do? Worked with in-patient, including secure providers and a prison, also now working with acute hospital providers. Provided workshops, undertook reviews, vertical slice interviews, analysed documentary evidence, facilitated executive and clinical team days.

What have we found so far? Most people would say they deliver person centred care but the structures, tools and evidence are often absent Patients surveys and complaints often point to a lack of person centred care delivery It is not about paperwork its about concepts such as choice, power and control and ‘being human’ We can use tools and technologies to ‘set the conditions’ for person centred care to flourish and be nurtured. Executives need to model & champion and performance manage.

Our response to these findings Developed new person centred tools adapted to inpatient provision & integrated care pathway. Developed DMA INSIGHT as a response to need. A tool for all hospital sectors and care groups – acute, mental health, older people, people with learning disabilities, CAMHS, prisons.

What does INSIGHT deliver? INSIGHT is an online system that delivers an integrated care pathway. It is a ‘one stop shop’ for all staff and supports and provides information and evidence, for Quality Accounts Registration and Regulation Commissioning Professional development and training Increased user involvement