Promotion of Self Care and Commissioning

1. Promotion of Self Care and Commissioning College of Medicine 3rd Annual Conference 11 June 2013 Susan Summers Head of Long Term Conditions NHS England

2. David Nicholson - patient power and the future of the NHSNHS Confederation 32013 • “the future of the NHS depends on people…taking control of their own condition” • What would it mean if our patients took more control or power….controlled their own health and healthcare? • …took more control of their own records and administration”? • The NHS needs to do more to recognise the contribution that our patients can make directly to the improvement of the NHS, and the financial consequences of that. • to then shift the conversation away from “what we as health professionals can do for you but what we can do for each other…that would genuinely transform the relationship between the NHS and the patients and communities we serve”.

3. Pure self care Responsible individual Pure medical care Professional responsibility The self-care continuum Daily choices Self-managed ailments Long-term conditions Compulsory psychiatric care Lifestyle Minor ailments Acute conditions Major trauma Healthy living Minor aliments Long-term conditions In-hospital care The self-care continuum

4. Population: • 62.26 million in 2010 projected growth to 71.39 million by 2030. • No. of people over 65 expected to grow from 10.49m to 15.77m by 2031 • Life expectancy men in 2008-10 78.2yrs and for women 82.3yrs • Health: • Between 1993 – 2010, obesity in men inc. from 13.2% to 26.2% and in women from 16.4% to 26.1%; • 2.8 m people with diabetes in 2010, double the number from 1996 with 4 million predicted by 2025; • 15.4m people in England with LTCs; more than half the people attending primary care have multiple chronic conditions. Data… • Workforce: • NHS employs 1.358 m staff of which 146,075 are doctors and 369,868 are qualified nursing staff. • 50.5% are professionally qualified clinical staff • Activity: • The NHS deals with over 1 million patients every 36 hours.

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7. The vision for Nurses, Midwives and Care Staff

8. 6Cs - Values essential to Compassionate Care Care Competence Compassion Care is our core business and that of our organisations; and the care we deliver helps the individual person and improves the health of the whole community. Caring defines us and our work. People receiving care expect it to be right for them consistently throughout every stage of their life Compassion is how care is given through relationships based on empathy, respect and dignity. It can also be described as intelligent kindness and is central to how people perceive their care Competence means all those in caring roles mist have the ability to understand an individual’s health and social needs It is also about having the expertise, clinical and technical knowledge to deliver effective dare and treatments based on research and evidence Commitment Courage Communication Communication is central to successful caring relationships and to effective team working. Listening is as important as what we say. It is essential for ‘No decision without me’. Communication is the key to a good workplace with benefits for those in our care and staff alike Courage enables us to do the right thing for the people we care for, to speak up when we have concerns. It means we have the personal strength and vision to innovate and to embrace new ways of working A commitment to our patients and populations is a cornerstone of what we do. We need to build on our commitment to improve the care and experience of our patients. We need to take action to make this vision and strategy a reality for all and meet the health and social care challenges ahead

9. Six areas of action Improving Patient Experience Helping People Stay Independent Measuring Levels of Care Positive Staff Experience Strengthening Leadership Getting Staffing Right

10. Pure self care Responsible individual Pure medical care Professional responsibility The self-care continuum Daily choices Self-managed ailments Long-term conditions Compulsory psychiatric care Lifestyle Minor ailments Acute conditions Major trauma Healthy living Minor aliments Long-term conditions In-hospital care The self-care continuum

12. What are the Fact Sheets for? • The Self Care Forum Fact Sheets for common ailments aim to help clinicians and patients discuss issues around self care within the practice consultation and especially how to handle the symptoms in the future. They provide patients with information around: • Useful facts • What patients can expect to happen (the natural history) • What people can do to help themselves – now and in the future • When to seek medical help (the ‘red flags’) • Where to find out more

13. What is included in a Fact Sheet • Description • Useful facts • What can I expect • What can I do myself to get better- now and in the future • When should I seek medical help • Where can I find more • (http://www.nhs.uk/conditions/indigestion/Pages/Introduction.aspx) has more

14. The conditions they cover: Low back pain Eczema Heartburn and Indigestion Fever in children Constipation Headache and migraine Coughs Acne Sprains and strains Sore throat

15. Pure self care Responsible individual Pure medical care Professional responsibility The self-care continuum Daily choices Self-managed ailments Long-term conditions Compulsory psychiatric care Lifestyle Minor ailments Acute conditions Major trauma Healthy living Minor aliments Long-term conditions In-hospital care The self-care continuum

16. The LTC Model of Care Structured around the needs of patients and carers using the best evidence available Central to the ‘house of care’ is collaborative care planning. Listening, supporting and collaborating for continuity of care Enabling individuals to self manage…no decision about me without me should be the reality. Should be seen as a quality improvement process

17. eDSM/EPaCCs DoH QIPP LTC workstream Risk Profiling Skills audit & development Albert & Mary! ‘Year of Care’ Self-care & care planning MDT meetings Multi-provider pathways Patient representation Volunteer co-ordinators Primary care at the centre Systematic engagement

18. What the people we serve want wants…. My goals/outcomes Communication Person centred coordinated care “My care is planned with people who work together to understand me and my carer(s), put me in control, co-ordinate and deliver services to achieve my best outcomes” Information Emergencies Transitions Care planning Decision-making

19. 3 levels of me… • Me as an individual – ‘first look to thyself’ • Me as a professional – how do I help and support you? • Me and my organisation – how do I support the vision and values to achieve 1 and 2? NHS | Presentation to [XXXX Company] | [Type Date]

21. The NHS ConstitutionPatients and Public – your responsibilities Please recognise that you can make a significant contribution to your own, and your family’s good health and wellbeing, and take personal responsibility for it.

22. Thankyou. Susan.summers3@nhs.net @susansummers16