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La voz de los pacientes en los proyectos de integracion de servicios del nhs ingles

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Ponencia a cargo del director de politicas y colaboraciones del National Voices en el National Health Service inglés, en el marco de la VI Jornada Right Care sobre Modelos avanzados en integración de servicios sociales y sanitarios, organizada por la Societat Catalana de Gestió Sanitària el 24 de mayo de 2019.

Veröffentlicht in: Gesundheit & Medizin
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La voz de los pacientes en los proyectos de integracion de servicios del nhs ingles

  1. 1. Integrated care… or person centred care? Don Redding Director of Policy, National Voices @MightyDredd www.nationalvoices.org.uk
  2. 2. About National Voices 1. National Voices is a coalition of NGOs in England that stands for people being in control of their health and care. 2. We want person-centred care: people having as much control and influence as possible over decisions that affect their own health and care. 3. We work mainly at national policy level in England; but are increasingly supporting local change. 4. We have 160 members who are national health and care charities. Many of these members work with people who have long term conditions.
  3. 3. England’s many plans for integration ‘Vanguards’ begin to replace pioneers: prototyping new care models ‘Integrated care’ is a strategic priority for national government; NHS given new legal duties Single definition adopted; 25 ‘pioneers’ funded to innovate using different approaches NHS Long Term Plan for 10 years: integration in all areas via ‘primary care networks’ 2012 2013 2015 2019
  4. 4. Person centred coordinated care “I can plan my care with people who work together to understand me and my carer(s), allow me control, and bring together services to achieve the outcomes important to me.” Information My goals/outcomes Communication Decision making Care planning Transitions The single definition: ‘narrative’ 2013 4 From ‘Integrated Care: Our Shared Commitment’, Department of Health, England 2013 https://www.gov.uk/go vernment/publications /integrated-care
  5. 5. What matters to service users? My goals & outcomes “I am supported to understand my choices and to set and achieve my goals.” “Taken together, my care and support help me live the life I want to the best of my ability.” Care planning “I work with my team to agree a care and support plan.” “My care plan is clearly entered on my record.” Care coordination “I always know who is coordinating my care.” “I have one first point of contact. They understand both me and my condition(s). I can go to them with questions at any time.”
  6. 6. Progress 2013-2018? • Too much focus on organisations & structures: “poor communication and a confusing acronym spaghetti of changing titles and terminology, poorly understood even by those working within the system” • Need for a new or revived ‘narrative’: “central to all the plans to create new structures, partnerships and contracts [must be] that these are a means to achieve more coordinated, person- centred and holistic care for patients, particularly patients with long-term conditions.”
  7. 7. NHS Long Term Plan 2019-29 ‘New Service Model’ • Historic shift to primary & community care -- £, contracts, activity • Primary Care Networks to cover England • Reduce Emergency Department usage, & cut outpatients by a third • ‘Digital first’ access • Population health management in integrated regional systems
  8. 8. Primary care network General Practices Community health Social Care Mental Health Voluntary and community sector Join together small practices to serve 30-50,000 Adopt population health management Expand workforce (new roles) Clinical leadership of the network Integration at local level Regional Integrated Care System X 5/6/7
  9. 9. ‘Universal, personalised care’ Part of ‘new service model’ A single, coherent set of interventions: the Comprehensive Model of Personalisation All local areas; 2.5m people by 2024 Primary care networks to deliver www.england.nhs.uk/personalisedcare/upc/
  10. 10. Comprehensive Model for Personalised Care All age, whole population approach People with long term physical and mental health conditions 30% People with complex needs 5% Supporting people to stay well, Building community resilience, Enabling people to make informed decisions and choices Supporting people to build knowledge, skills and confidence and to live well with their health conditions. Empowering people, integrating care and reducing unplanned service use. Whole population 100% TARGET POPULATIONS OUTCOMES • Proactive case finding • Care planning • Support to self manage • Increase patient activation • Health coaching, peer support & self management education • Personal budgets INTERVENTIONS
  11. 11. In clear language!
  12. 12. Primary care network General Practices Community health Social Care Mental Health Voluntary and community sector Join together small practices to serve 30-50,000 Adopt population health management Expand workforce (new roles) Clinical leadership of the network Integration at local level Regional Integrated Care System X 5/6/7
  13. 13. New personal journey Primary care network Community health Social Care Mental Health Pharmacist Nurses Physiotherapist Access to specialists? Support for self management health coaching; prevention; self management education; peer support; exercise; wellness; recovery; befriending; arts. Link Worker Community support groups & organisations Paramedic Care & support planning: my goals Secondary care Care coordination General Practice Shared decisions
  14. 14. Get in touch Don.redding@nationalvoices.org.uk +44 20 3176 0738 www.nationalvoices.org.uk @MightyDredd

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