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Shared Decision Making and the Public and Patient Involvement Agenda

Shared Decision Making and the Public and Patient Involvement Agenda. Mike Spencer Assistant Director Patient Experience, Cardiff and Vale University Health Board. What are patients and the public telling us?. National Survey for Wales

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Shared Decision Making and the Public and Patient Involvement Agenda

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  1. Shared Decision Making and the Public and Patient Involvement Agenda Mike Spencer Assistant Director Patient Experience, Cardiff and Vale University Health Board

  2. What are patients and the public telling us? • National Survey for Wales • 2% strongly agreed and 12% tended to agree that they were able to influence decisions made by their local health service • Over 40% wanted to be more involved in those decisions • Patient Complaints • Lack of information about choices • Lack of information about risks and benefits • “Expert Patients” • “lacks understanding of my preferences” • Don’t acknowledge my experience and knowledge”

  3. (Welsh) Context • Co-creating Health commenced 2007 • 1000 lives and 1000 lives plus – Person Centred Care 2008 • MAGIC commenced 2010 – PPI driver • Doing Well – Doing Better – Standards for Health Services in Wales 2011 • Standard 5 Citizen Engagement and Feedback • Standard 9 Patient Information and Consent • Patient experience in adult NHS services: NICE Clinical Guidelines 2012 • Together for Health. A 5 year vision for the NHS in Wales 2011 • Achieving Excellence. The Quality Delivery Plan for NHS Wales 2012-16 2012 • Francis • 1000 plus “The Listening Organisation” • Keogh • Chief Medical Officer for Wales Annual Report 2012-3 - co-production

  4. Cardiff Magic Drivers - PPI • Roll out Ask 3 questions • Use Patient Information • Centres • Patient Groups • Support to Develop • materials • Support to develop • interventions • Patients as collaborators • in decision making • Patients as partners in • designing change • Patients as advocates • of change. Patient and Public Involvement

  5. Bringing it all Together • National Service User Experience Group • 3 domains which influence the patient experience • Framework for gathering feedback • “Core” question set First and Last Impressions Patient Experience Safe, Supportive Environment Involvement and Understanding of Care

  6. Bringing it all Together • Understanding of and Involvement in Care • Receiving appropriate, timely information and being communicated with in an appropriate, timely manner • Being involved in decisions about choice of treatment options and care plans, including discharge

  7. Patient Information SharedDecision Making Involvement and Understanding of Care Communication Co-creating Health Consent

  8. Bringing it all Together • National Service User Experience Group - Framework for gathering feedback

  9. Bringing it all Together • National Service User Experience Group - “Core” question set • “Thinking about your understanding and involvement in care” • Were you involved as much as you wanted to be in decisions about your care? • Were things explained to you in a way that you could understand? • Did you feel you understood what was happening in your care?

  10. The Listening Organisation Listening on the frontline The importance of listening to the people we care for Listening as a service Whose experience do we listen to? Listening as a Board How do organisations hear their patients? Gathering feedback Creating a patient Experience report Identifying what matters most to patients Delivering person centred care

  11. Commissioning Design Co-production Delivery Delivering person centred care Evaluation Creating Health

  12. Co-production • Co-production puts the emphasis on the contribution made by the service beneficiary in the service delivery process • Several descriptions • Professionals and citizens making better use of each others assets, resources and contributions to achieve better outcomes or improved efficiency • Public services being delivered in an equal and reciprocal way between professionals, service users, their families and their neighbours • Co-production includes co- • Commissioning • Design • Delivery • Evaluation • Creation • To work, co-production requires a shift in power balance away from those who run the system – the same as SDM and Co-creating health

  13. So………… • To work, co-production requires a shift in power balance away from those who run the system • The same as SDM and Co-creating health? • Are the public an patients ready for this? • What do they expect? • The unexpected?

  14. Expect the unexpected!

  15. Discussion and Activity

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