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Emerging Principles

Emerging Principles. Chris Easton, Personalisation Specialist, NHS England. November 2013. Contents. The health picture What families want What can be done locally Central support from NHS England. What we know. The NHS has undergone a period of phenomenal change;

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Emerging Principles

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  1. Emerging Principles Chris Easton, Personalisation Specialist, NHS England November 2013

  2. Contents • The health picture • What families want • What can be done locally • Central support from NHS England NHS | Pathfinder Champion Presentation November 2013

  3. What we know • The NHS has undergone a period of phenomenal change; • Although there are examples of good CCG engagement in the SEND Reforms we know that health engagement is variable; • Some families rely heavily on the NHS for support and this doesn’t always connect well with support in school and/or social care; • Patient engagement is variable across the system and the voice of families of disabled children is not consistently heard in health commissioning; • We still have a system that too often deals with need by service rather than shaping around a child; NHS | Pathfinder Champion Presentation November 2013

  4. The imperatives for system change The MUSTS The SHOULDS HOW? NHS | Pathfinder Champion Presentation October 2013

  5. Health Commitments • In addition to the duties that form part of the Bill, the NHS has some specific relevant commitments: • CCGs have very clear mandate commitments to ensure that personal health budgets are available to people who would benefit: • With continuing healthcare funding by April 2014; • With any long term condition by April 2015; • In reality this represents a relatively small cohort for each CCG • There is a National Delivery Programme that supports CCGs with implementation and we are exploring specific support for children’s PHBs • Change in language from ‘right to request’ to ‘right to have’; NHS | Pathfinder Champion Presentation November 2013

  6. Health Commitments The NHS mandate is explicit in expecting improvements in: • Care that is coordinated around the needs, convenience and choice of patients, their carers and their families; • Centres on the person as a whole rather than a single condition; • Ensuring people experience smooth transition between services, agencies and life stages; • Empowering service users; NHS | Pathfinder Champion Presentation November 2013

  7. Specifically for children with SEN “One area where there is a particular need for improvement, working in partnership across different services, is in supporting children and young people with special educational needs or disabilities. NHS England’s objective is to ensure that they have access to the services identified in their agreed care plan, and that parents of children who could benefit have the option of a personal budget based on a single assessment across health, social care and education.” NHS | Pathfinder Champion Presentation November 2013

  8. What families want • Services that build around a child, irrespective of boundaries and don’t compartmentalise need; • Services viewed in the context of people’s lives and their contribution to them, not the other way round; • Services that are flexible, personalised and meet family need; • More streamlined assessment and review – services that talk to one another and work effectively together; • Services that respond to variations and are there when families need them; • Involved/engaged in their care and support at a level that suits them, having different conversations, doing with rather than doing to; NHS | Pathfinder Champion Presentation November 2013

  9. What families want • Services that are commissioned with family voice at the centre; • Reducing adversary and moving towards partnership with services and professionals; • Not having to retell their story, a single narrative, a single plan and a coordinated response; • Being clear about how to get support and where to go for it; • A system that doesn’t create a burden and allows parents time to be parents rather than, keyworkers, care coordinators, case officers, legal experts etc etc. NHS | Pathfinder Champion Presentation November 2013

  10. How might we make it happen locally? • The driver of legislation must be balanced with a relentless drive to improve things for families; • The agenda needs to resonate locally with all agencies and not be viewed as school centric; • Powerful and representative family voice – a pivotal part of commissioning; • Systemic developments must be underpinned by culture change to be effective; • Strong and collaborative leadership and clear strategic direction from health and wellbeing boards and senior leadership in health, education and social care; • A structure that supports genuine joint commissioning; NHS | Pathfinder Champion Presentation October 2013

  11. How might we make this happen locally? • Joint governance, effective joint funding arrangements that allow us to think about the whole child and not just their discreet needs; • Need to support the workforce to understand this agenda and to believe in its principles; • Frontline staff empowered to have different conversations with families and arrive at creative, personalised solutions; • Different measures of success, both in the eyes of managers and the eyes of families – changing the currency of support; NHS | Pathfinder Champion Presentation October 2013

  12. How might we make this happen locally? • Information sharing to support effective joint commissioning; • Awareness of need for different relationships with health in a new system that has undergone phenomenal change – consider the roles of the different parts of the system; • Reaching outside of services, tapping into the wealth of expertise that the VCS has to offer; • A leap of faith – how do we build trust with families that allows services to be held accountable differently? NHS | Pathfinder Champion Presentation October 2013

  13. NHS England Support • Transforming Participation Guidance available to download at: http://www.england.nhs.uk/wp-content/uploads/2013/09/trans-part-hc-guid1.pdf • Personal Health Budget Delivery Programme to include dedicated children’s component; • Support to build expertise amongst CSUs to deliver effective commissioning support services; • Development of national support programme around ‘Patients in Control’ and ‘Patient and Public Voice’ for CSUs, CCGs and LATs • Development of communications and guidance for CCGs around the implications of Children and Families Bill NHS | Pathfinder Champion Presentation November 2013

  14. NHS | Pathfinder Champion Presentation November 2013

  15. Contact Details Chris Easton Personalisation and Control Specialist NHS England Chris.easton1@nhs.net NHS | Pathfinder Champion Presentation November 2013

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