1. ‘Whole Systems Change’ Co-producing new models of care and health in London 16/04/15

2. Who are we? Healthwatch is the consumer champion for health and social care in England. We make sure the views and experiences of service users are heard by those who run, plan and regulate health and social care. KCSC is the local voluntary sector support agency for the borough of Kensington and Chelsea.

3. “…too few occasions are there for citizens to get involved and shape the strategy and priorities of the NHS” Better Health for London, London health Commission http://www.londonhealthcommission.org.uk/better-health- for-london/ “(This report) argues for a more engaged relationship with patients carers and citizens to promote well being and prevent ill health” Five Years Forward View, NHS England http://www.england.nhs.uk/wp- content/uploads/2014/10/5yfv-web.pdf Better engagement is needed in London

4. THE NEED FOR INTEGRATED CARE AND CO-PRODUCTION Maria’s story

5. Catherine: My Mum!

6. Why work together? Care Culture Communication Continuity Coordination Care Plans Crisis Management

7. Decision making structure for Whole Systems Integrated Care for over 65s Engagement Over 70s & Carers 1-to-1 interviews Focus groups Voluntary Sector Patient Panel Model of Care Working Group Whole Systems Steering Group Out of Hospital Committee Patient & Public Engagement Committee West London CCG Governing Body

8. What we did: Created and providing ongoing support for a patient panel & patient reps on the governance structure Healthwatch CWL and KCSC were commissioned by NHS West London Clinical Commissioning Group (CCG) 30 face to face interviews with carers or people over the age of 65 with one or more long term conditions. Focus groups with an Arabic-speaking women’s group, an African-Caribbean day centre, and a sheltered housing scheme for older adults. 1. Co–design of integrated care in WLCCG

9. 1. Co–design of integrated care in WLCCG (cont.) Findings and recommendations: Accessible transport will need to be in place The ‘hubs’ of health and social care will need to be integrated within the local community All care should be coordinated around the patient Frontline staff should be trained to enhance the service There must be an agreed communication protocol between GPs, hospitals, social services & community health services Patients should have access to self-management courses and resources.

10. 2. Developing the business case To show to the CCG what the sector can deliver to meet their outcomes The sector’s contribution to reducing hospital re-admissions Sending a message that this needs investment

11. 2. Developing the business case How we are doing this: Collecting data from organisations on services they deliver - events and survey Unit costing each service Mapping outcomes against CCG outcomes Segmenting users Looking at commissioning models

12. 2. Developing the business case Next steps: Producing a report – Summer 2015 Recommending a model of social prescribing A holistic view of patient need – health and wellbeing

13. Lessons learnt Define co-production Time consuming process Be prepared e.g. segment users, anticipate new monitoring trends, test the market Unit costing is challenging Need to get stronger on evidencing how the sector meets CCG outcomes

14. Companions in Care

15. Any questions? www.healthwatchcwl.co.uk www.kcsc.org.uk