Pacesetters Commissioning for difference conference 31st March 2010

1. Pacesetters Commissioning for differenceconference 31st March 2010  Lynda Brooks National Programme Director Department of Health

2. ‘Pacesetters Programme’What is it? A programme to deliver equality and diversity improvements and innovations resulting in: Reduced health inequalities for patients and service users Working environments that are fair and free of discrimination

3. Yorkshire and The HumberLeeds Partnerships NHS Foundation TrustNHSSheffieldYorkshire Ambulance Service NHS TrustNHS LeedsBradford & Airedale Teaching PCTNHS Doncaster

4. Pacesetter projects Wave 1 - Three local projects to challenge, stretch, sustain and spread good practice Wave 2 – Two local projects to focus on three clinical areas: cancer, CVD and stroke, diabetes Workforce projects: bullying & harassment, flexible working and representation Improving data collection of workforce and patients, related to local project

5. Service Improvement methodology Opportunity to try something new and capture all learning Small scale testing (PDSA cycles) Evidence base leading and underpinning work Using engagement to design and test innovations PDSA cycle

6. Key Questions:

8. The ‘Innovation Funnel’ outcomes

9. Tested wave 2 project Ealing PCT Diabetes self-management “Our local services have been positively challenged by the finding that Somali patients were missing out completely on structured education for Type 2 diabetes. The Pacesetters methodology has helped us to find root causes and work in partnership with patients to develop practical improvements. The project has led us to improve and use ethnic monitoring and to rally primary care professionals who can champion race equality in an area of London where there are large health inequalities”

10. Case study: Increase access to breast screening Walsall Council Lower rates of breast screening. Concern re health outcomes Many people –LD feel their health problems can be ignored. “Looking after your Bits”

11. Outcomes Increase in breast screening rates from 62-100% Success based on collaborative working Providing for difference Now part of the pan Birmingham commissioning strategy Lessons extended to increase the take up of cervical screening and the bowel cancer screening programme for the over 60 learning disabled population

12. High Quality Care for Allis Pacesetters philosophy ‘Everyone Counts NHS Newham Improving access to services & healthcare for migrant workers Co-production Subsidiarity System leader in developing more accessible services for migrant workers

13. Equality & Diversity Council SEC member: Fiona Edwards Chief Executive Surrey & Borders Partnership NHS Foundation Trust “To achieve high quality and personalisation, the NHS will need to be innovative and ambitious in the way it manages and uses delivery systems and processes. It will need to change established mindsets, cultures and behaviours and to think differently about how it engages with its communities and staff, responding with innovation and by embracing change. ” To embed a progressive approach to equality and diversity in the NHS, we also need to inspire excellence in leadership and throughout our workforce.”

14. Sustain & spread strategies East Midlands – SHA plan designed London – Commissioning South West – Public health West Midlands – Associate sites test 1 new project using PDSA Yorkshire & the Humber – Commissioning and public health SEC through their Single Equality Scheme

15. Commissioner: “…. how for a small amount of money, Pacesetters projects by design evidences how you have to plan, implement and commission difference. Otherwise, commissioning stays with what it knows and sometimes that is more of the same “

16. Our Achievements The Pacesetters programme demonstrates transferable innovative projects that have been: Tested & evaluated Improve quality, Reduce health inequalities Proven methodology: Delivers results required by NHS Constitution. Improved outcomes for patients and excellent return on investments through commissioning for difference.

17. Critical Success Factors Visible system leadership is crucial. Top management need to know about the successes of the programme to be able to support it. In return, their support can help remove barriers within the organisation Avoid the temptation to confine the programme to E&D. Demonstrate how it has made tangible improvements, and align these successes with the core business delivery goals of the Trust Consider how a service can best meet user’s needs. Are there special requirements? Commission for these – even if it’s different from what has happened before. It’s tailoring the service that makes it effective, and that means thinking innovatively. To ensure E&D innovations are properly embedded within an NHS organisation key characteristics must be in place. There are 5 key elements which combine to deliver improved E&D practice. The Pacesetters programme has successfully tested this method across 6 SHA regions. The 5 key elements are evidence, testing, :co-design, measurement and spread

18. NHS E&D innovations must share key characteristics to take root: Organisational skills People skills Analysis Operational Skills

19. Your Challenge: Scrutinise your practices, look at our evidence Have you commissioned for difference Are the changes you are thinking about Improvements As a leader be committed to dismantle institutional and cultural barriers Use a pull model with strivers not a push model with drivers Continuing doing things the same way is no longer an option Commission for difference with innovation, confidence & leadership Incorporate one new project that meets your requirements to deliver improved quality and the NHS Constitution.

20. For further information: Swarnjit Singh Programme Manager London Swarnjit.Singh@london.nhs.net