A true partnership

Anyone who has worked with me knows that I am all about the patient and their family.  The reason why I entered healthcare as a profession, and my inspiration every day, is how can I play a part in improving patient outcomes and experiences.  It’s so central to my work, that a reminder is even printed on my business card!  So I was delighted to read Joan Saddler’s Report, “Public and Patient Partnerships”, [PPP] which was launched at last week’s NHS Confederation Conference.  Here is the link to her report, do take a little time to read it. http://www.nhsconfed.org/resources/2016/06/public-and-patient-partnerships

But, here’s the thing, we have been talking about patient involvement for decades.  We invite them (or should be inviting them) on to our steering boards, our reader groups, our stakeholder panels.  Whenever I take up a new programme of work, one of my first questions is “do you have patient and carer input?”  Frequently, the answer is either “not yet” or “do you feel it would be appropriate?”   Trust me, nine times out of ten, it is ALWAYS appropriate.  Worst still, though, is the “tick box” approach.  We have the patient involvement, but very much on the periphery.  This is where Joan Saddler’s report comes in; patient and public involvement must mean much more than developing self-management skills or life post treatment, we now need to look outside of our hospitals and GP practices to our communities,  learn what they need and empower them to be our partners in developing new services. We know that medical models of care in isolation do not work, the ten minute catch-all GP appointment doesn’t work, what we need to focus on is the “5,000 hours that a  person with a LTC [long term condition] manages their condition at home” (quote from report, page 6).  So we need to know our communities, and know who has influence within those communities, then harness their knowledge.

Two excellent case studies are contained within the report, one of which (from Newham CCG) centres on Type 2 Diabetes.  Using the Carman Framework (which, in a nutshell, allows an organisation to gauge where they are now, and where they want to go by looking at forms and levels of engagement and factors of influence) Newham CCG developed a collaborative, community driven project which resulted in avoiding over 200 new cases of Type 2 Diabetes and consequently provided a saving of over £330k each year.  This is just one example of what can happen with genuine, front and centre, collaboration with PPP and integrated commissioning.  But there is an important point to make – Newham CCG achieved this project over a three year period.  One thing we need to learn in the NHS is to take a little time; the pressures on making continuous change creates enormous stresses for all those involved and results in a staggering 70% failure rate for change programmes within the sector – a great use of time and resources, eh?  Little wonder that staff often have little energy or appetite for yet another change model when it comes their way.

Finally, we need to elevate the standing of public and patient partnerships to a place where their opinions, advice and expertise are central to decision making.  This will be a brave move for some, but it is an essential move towards sustainability for all in the NHS.  Put public and patient involvement into the implementation box, not the tick box.