Strategic partners programme March 2013 update

Wed,27 March 2013
News

The Strategic Partners last met on 19 March 2013

This month’s update includes a report from the latest Strategic Partners meeting and news and insights on a new programme ‘Health Partnerships’, volunteering, local Healthwatch regulations, an inquiry into social care for working age adults, financial sustainability of local authorities, provider quality profiles – informed choices for better care and the NHS e-referral service which should include a generic right to peer support as we advocated. We have also had fed back to the Monitor 'fair playing field review' and various NHS Commissioning Board initiatives.

1.   NHS e-Referral Service – a future patient journey

Peter Appleton, Ben Gildersleve and Stephen Miller (Choose & Book; Connecting for Health) introduced aims, scope and progress of the NHS e-Referral Service. Choose & Book takes about 1m referrals per year and will run for another 18 months at least. The choices can be made via different routes, though most choices are currently made in the GP surgery. ‘Choice conversations’ between GP and patient are often based on criteria that are not questioned further such as physical distance to the clinician-led team and waiting time. Any further questions on these criteria can be followed up with the Choose & Book team on the phone.

DRUK (together with Shaping Our Lives and Change) pointed out that the problem is that there is no support infrastructure to help the individual “bring to live” the different options at stake. Above all, this includes a ‘right to peer support’, that is a right to hear from someone who has travelled a similar path in the past. Such a peer supporter/mentor could also help the person form a view as to whether or not the clinical procedure is deemed necessary or not. After all, health outcomes are shaped by many factors – in addition to a clinical intervention.

The Department of Health responded that a ‘right to peer support’ may be realised at GP practice level but not in a central system such as Choose & Book – via social prescribing initiatives GP could be supported to make referrals to local patient groups which could be regarded as a service in its own right.

DRUK (together with Shaping Our Lives and Change) reiterated that precisely a central system offered new opportunities for (on- and offline) peer support networks to flourish. After all, many communities do not form within local boundaries, eg people affected by rare diseases or LGB&T people. The Department of Health announced there should be a sub-group taking the proposals further to which we will contribute. Our aim would be to co-produce a new service specification to include peer support as an integrated element.

2.   Building Health Partnerships

This new learning site-based programme follows on from the former project ‘Power of Partnerships’ to address the challenges faced in delivering better health care for less – both funded by DH. It is delivered by NAVCA, Social Enterprise UK and the Institute for Voluntary Research (IVAR). The 12 chosen learning sites contain local voluntary sector and clinical commissioning groups as partners. They are offered diagnostic sessions and then choose freely an intervention to focus on – most are expected to choose social prescribing through GPs.

DRUK (together with Shaping Our Lives and Change) urged DH and delivery partners to build on the lessons from the previous informal programme on user-driven commissioning and seek out ways to directly involve and pass on choice and control to people rather than necessarily to voluntary sector organisations. This will foster self-care, reduce admissions into A&E and hence make the business case for mainstreaming. In response to this there may be a seat for us on the advisory panel.   

For the time being, there are deeply routed cultural barriers to personalisation and choice and control in social care and NHS – despite the case that positive health outcomes go back to lots of variables that are in the control of the person and not just social work and clinical procedures. The Francis report on the failings at Mid Staffordshire and the Winterbourne View reports have drawn our attention to the absence of people’s voice and peer support. So how can we bring on a hands-on devolution of power to people and stop all rhetoric? In various forums – such as the NHS Commissioning Board (and an initiative on people-powered commissioning), Health & Social Care Information Centre, Monitor’s ‘Fair Playing Field Review’, NHS EXPO and the National Stakeholders Forum – we have made some proposals:

  1. Could there be a right to peer support at diagnosis at GP level and nationally via Choose & Book e-referral systems – so that we can bring the different (treatment or support) options to life by hearing from someone who has walked a similar path in the past?
  2. Could there be payment profiles related to minimum level achievements of providers on Patient Reported Experience Measures?
  3. Can we establish a power shift to train more and more people up to become experts by experience and peer supporters while quality checking, non-complex reviews and contract monitoring are increasingly carried out by User Led Organisations and patient groups?

 General updates

Dissemination of the Power of Partnerships
The Power of Partnerships, is a resource developed to support the new health structures; Clinical Commissioning Groups (CCG), Health and Wellbeing Boards (HWB) and voluntary community and social enterprises (VCSE) organisations to work together to address the challenges faced in delivering better health care for less. A basic overview is available in our document ‘Health and social care reforms at a glance’ https://remote.radar.org.uk/owa/redir.aspx?C=87354a08bd2a492ca941fcd8fb76ae92&URL=http%3a%2f%2fdisabilityrightsuk.org%2fpolicy-campaigns%2fhealth-and-social-care-reforms%2fhealth-and-social-care-reforms-glance

The new resource is based on the learning from the Health Commissioning Improvement programme funded by the Department of Health and delivered by Social Enterprise UK and the Institute for Voluntary Research (IVAR). The programme brought together partner organisations in four locations in England to develop better approaches to local health needs, through partnerships between the new health structures and the VCSE sector. It worked in local communities to identify how new structures like clinical commissioning groups can be used as a catalyst to develop new approaches and new methods, employing all of the resources and facilities available to the local communities. Its aim is to help people think differently, more creatively and more practically than ever before, about the opportunities you have to meet changing health needs in difficult economic times.

http://www.socialenterprise.org.uk/about/about-us/our-programmes/health-commissioning-programme#Resources

This programme has now evolved into a new programme called 'Building Health Partnerships' delivered by NAVCA – discussed at the latest Strategic Partners meeting as reported above. While there is no direct association, Building Health Partnerships mirrors the work Disability Rights UK has been doing in social care in user-driven commissioning as reported previously https://remote.radar.org.uk/owa/redir.aspx?C=87354a08bd2a492ca941fcd8fb76ae92&URL=http%3a%2f%2fdisabilityrightsuk.org%2fpolicy-campaigns%2fhealth-and-social-care-reforms%2fuser-driven-commissioning-building-%25E2%2580%2598lived-experience

King’s Fund report on volunteering in NHS and social care
The King’s Fund has published a report on the use of volunteers in health and social care. The report highlights the vital role volunteers play in delivering services. It calls for a strategic approach to volunteering in the health and care system and asks commissioners and service providers to focus on how volunteers will help improve quality and bring benefits to patients and communities. It also includes a number of recommendations.

http://www.kingsfund.org.uk/publications/volunteering-health-and-care and
http://www.guardian.co.uk/healthcare-network/2013/mar/14/nhs-underestimate-value-volunteers

Local Healthwatch Regulations Explained: campaigning not forbidden
On 12 March, the Department of Health and the Local Government Association jointly published ‘Local Healthwatch Regulations Explained’. This document aims to explain and provide clarity in relation to the following issues for local Healthwatch audiences:

•       lay person and volunteer involvement in local Healthwatch and;
•       restrictions on activities of a political nature – there will be no restrictions on campaigning

http://www.local.gov.uk/c/document_library/get_file?uuid=63371855-2af6-4c97-a9da-fbcc37f1d44e&groupId=10171

Healthwatch England has published information on what the regulations mean for local Healthwatch and will shortly publish further resources on other aspects of the legislation.
http://www.healthwatch.co.uk/news/understanding-local-healthwatch-regulations-information-local-healthwatch

Regulations on procurement, patient choice and competition laid
The government has laid regulations on procurement, patient choice and competition. The regulations are to help ensure that commissioners’ decisions on buying clinical services are transparent and fair, and that they improve the quality and efficiency of health care services for patients. These regulations revoke the regulations laid on 13 February 2013. http://www.dh.gov.uk/health/2013/03/pccr/

Inquiry social care for working age adults

The All-Party Groups on Disability and Local Government have launched an inquiry into social care for adults of working age (18-65). They welcome written evidence on the following four key areas:

  • right to independent living
  • impact of changes to eligibility
  • value of preventative care
  • Dilnot funding proposals and working age disabled people

The inquiry is supported by Scope. For more information and to download the questionnaire go to http://www.scope.org.uk/campaigns/social-care-and-support/appg-inquiry-social-care

Much of the detail of the law and funding proposals for social care is yet to be worked out (eligibility criteria; eligibility threshold, etc.). The inquiry is an opportunity for us to tell MPs and peers how the changes in social care affect us and what needs to be done to ensure that the proposals will support our right to independent living.

The inquiry report will have authority in parliament, and this comes from a cross-party group and is a joint inquiry of the APPGs on local government and disability. We want to make sure that disabled people’s voices are leading it.

Financial sustainability of local authorities: report published
In a report examining central government’s approach to local authority (LA) funding, the National Audit Office has highlighted the increasing difficulties LAs face in absorbing reductions in central government funding without reducing services. The spending watchdog recommends the Department for Communities and Local Government work with other government departments to improve evaluation of the impact of decisions on LA finances and services.
http://www.nao.org.uk/publications/press_notice_home/1213/1213888.aspx

Provider quality profiles – informed choices for better care
The Department of Health launches new online information on local care providers to help people choose and compare good quality care and support. The Department of Health is launching new online profiles for every registered care and support provider to the public in April 2013, alongside information and advice to help people understand their care and support options.

People will be encouraged to use these new provider profiles on the NHS Choices website http://www.nhs.uk/aboutNHSChoices/professionals/healthandcareprofessionals/your-pages/Pages/social-care-service-providers.aspx to help narrow down their search for good quality, registered care that meets their personal needs and preferences. The profiles are a major step in enabling people to make more informed and confident choices about care for themselves or family members.