Health and Social Care update from our work as Strategic Partner to the Department of Health, NHS England and Public Health England
Disability Rights UK heads up a user-led consortium as one of 22 strategic partners in the voluntary sector. Our name is ‘Win-Win Alliance – disabled people leading change’. This programme is commissioned by our system partners, the Department of Health, NHS England and Public Health England. As strategic partner we are well placed to raise particular challenges facing our members of disabled people’s user-led organisations. We also ensure that information and opportunities to engage with system partners reach our members through this and other updates, forums, meetings and discussions, and we regularly inform about funding opportunities (which you may pursue with or without Disability Rights UK). For any comments and/or ideas about how to strengthen ‘disabled people leading change’, please get in touch with Bernd.Sass@disabilityrightsuk.org
Are you supporting disabled to pool their personal budgets or are you part of a pooling project yourself – Disability Rights UK would like to support you so we all benefit!
User-driven commissioning (UDC) is a tried and tested approach to support, gather and translate the lived experience of people’s care pathways into metrics for contracting and/or procurement. It is a more formalised version of a previous programme by the same name which we launched with six sites in 2011. There is one aspect of this former work which we want to pick up again for a funded development and research project: pooling parts or whole personal budgets can be a hard and very rewarding way to make budgets go further and also have far greater impact on commissioning. Please get in touch if you are supporting disabled to pool their personal budgets or are part of a pooling project yourself - with Bernd.Sass@disabilityrightsuk.org
Disability Rights UK currently run UDC on four sites, including the Integrated Personalised Commissioning site Tower Hamlets. A UDC project on the co-procurement of a five-year CAMHS contract in Birmingham was recently completed. The UDC sites have had a number of positive outputs.
So what improvements can user-driven commissioning help bring about?
So far we have seen disabled people drive a far greater reflection of their (self-assessed) needs, aspirations, peer support and everyday solutions in refreshed specifications of services and support, tendering documents, contracts, mobilisation phase and annual contract variations. There has been a better shared sense of what it is important to achieve and how to go about it across patient cohorts and whole communities. The projects have shifted economies of scale away from block contracts and quality has been put on a more equal footing with price, leading to further productivity gains. The impact of user-driven commissioning is currently being assessed by a research project funded by the Economic and Social Research Council (ESRC).
Patient Reported Outcome Measurement Public Consultation Patient Reported Outcome Measures (PROMs) measure health gain, and have been collected nationally in England, since 2009. Patients are asked to complete questionnaires before and after hip or knee replacement, and groin hernia or varicose vein surgery to assess the improvement in their health from their perspective. PROMs have essentially been shaped by academics (which is why would respond rather than develop measures yourself) but PROMs are still important levers to strengthen the influence of patients and disabled people on health and social care. Disability Rights UK hopes to refresh PROMs through its own work on outcome measures and metrics from user-driven commissioning.
NHS England is consulting on the current PROMs collections and the future for PROMs, regarding options around how to use resources most effectively to understand the outcomes which matter to patients, in areas with unwarranted variation in outcome and to consider indicators for future service improvement. You can give them your views via the online survey - www.engage.england.nhs.uk/consultation/proms-programme/consultation/intro/view
Framework for Patient and Public Participation in Primary Care Commissioning
The views of patients and the public, and staff are very valuable to NHS E in shaping their future approach to participation. A working group including internal and external stakeholders has developed a draft Framework for Patient and Public Participation in Primary Care Commissioning. They are now seeking comments on the draft from patients and the public, including the voluntary and community sector.
The Framework is available here along with a short set of questions.
www.engage.england.nhs.uk/survey/participation-framework/consult_view The deadline for completing the questionnaire is Friday 12 February 2016. All feedback received by this date will be considered and incorporated as appropriate into the framework, which will be presented to NHS England’s Commissioning Committee (a sub-committee of the Board) for approval in March 2016.
Disability Rights UK have previously fed back that involvement must be about listening to and valuing people but most importantly investing in local people. With the current approach to just ‘deep-dive’ quite randomly and briefly into the insights of different sections of the local community there can be no real impact. Instead, people should be supported (on competence, independence and confidence) and be put in charge by peers to take on commissioning roles themselves. This can happen through pooling personal budgets but also for lower access threshold services.
Should you have any queries, please contact the NHS England Public Participation Team in the national support centre: england.nhs.participation@nhs.net or telephone 0113 8250861.
NHS Planning Guidance 2016/17 – 20/21
National health and care bodies have come together to publish shared NHS Planning Guidance, setting out the steps to help local organisations deliver a sustainable, transformed health service and improve the quality of care, well-being and NHS finances. All NHS organisations are now being asked to develop two plans: (1) a local health and care system ‘Sustainability and Transformation Plan’, covering the period October 2016 to March 2021; and (2) a plan by organisation for 2016/17. The guidance is backed by £560 billion of NHS funding, including a new Sustainability and Transformation Fund. Drafts of the technical guidance will be shared shortly, with a view to the final drafts being published in January.
To read more, go to: www.england.nhs.uk/ourwork/futurenhs/deliver-forward-view/
The Sustainability and Transformation Plan will become the core instrument to steer the NHS so really an important space to watch. Disability Rights UK previously queried if 'transformation' will really deliver what it says on the tin. NHS England has set aside £1.8 billion for "transformation and sustainability", the former to pay for vanguard sites, devolution plans and other ways of pump-priming innovation, the latter to bail out struggling hospitals. Given the scale of problem, is it likely that there will be anything left for transformation after all the other bills have been paid?