A person centered approaches and services user involvement in health and social care

profilerachealbizz1
WK2-Historicalperspectives-SUI1.ppt
Home>Nursing homework help>A person centered approaches and services user involvement in health and social care

HISTORICAL PERSPECTIVES –

SERVICE USER INVOLVEMENT
PERSON CENTERED CARE

WEEK 2

RECAP

  • Explored the meaning of service user involvement and person centred approach in health and social care

  • Why this is an important and continuously evolving concept of health and social care

  • Some levels of involvement explored to start to explain how SUI might be adopted within health and social care

  • With some illustration/class examples and discussion of how SUI/PCA currently takes place in a health and social care setting

TODAY’S SESSION

To consider

  • The historical perspectives on service user involvement / person centered care

  • The rationale for service users involvement.

CONTEMPORARY TREND

  • Over the past two decades, the NHS has brought about a series of reforms to how health and social care services are delivered and to improve healthcare outcomes for patients and users.

  • It is safe to assert that such reforms will keep taking place with the UK healthcare system.

CONTEMPORARY TREND

  • Therefore, the NHS needs continuous adaptability and response mechanisms to the changing needs and demands of the growing and diverse population

(The Marmot Review, 2010; HM Government, 2010).

  • This will take place at both local and national level and with statutory and non-statutory organisation

  • To influence and improve healthcare services

WHAT IS SERVICE USER INVOLVEMENT?

Term 'user involvement' draws on the INVOLVE

(2004) Definition – available on www.invo.org.uk

"An active partnership between the public and researchers in the research process, rather than the use of people as the 'subjects' of research. Active involvement may take the form of consultation, collaboration or user control. Many people define public involvement in research as doing research 'with' or 'by' the public, rather than 'to', 'about' or 'for' the public."

*

WHY SERVICE USER INVOLVEMENT MATTERS

  • Service user involvement refers to the process by which people who are using or have used a service become involved in the planning, development and delivery of that service.
  • There is a growing recognition that because of their direct experiences of using services, service users have a unique insight into what works, which can be used to improve services.

HISTORICAL TIMELINE OF INVOLVEMENT 1948 - 2017

YEAR KEY SENTENCE COMMENT
1948 – 1974 Very little public involvement The main idea was that the Doctor knew best
1974 – 1979 NHS in an almost continuous state of reorganisation. Increased emphasis on SUI starts and design of SUI 1974- Community Health Councils introduced-to provide a voice for patients and the public in NHS It remained the foundation for PPI for over 20 years (1974 – 2003). *In 2001 legislation was passed to abolish CHCs. Came into effect December 2003*.
1979 – 1997 The rise of new approach within NHS – consumer rises. SUI strategies continues Carers started to gain more recognition; new carer policy developed 1980s – development of the consumerism approach. Consumerism policies - Griffiths Report, 1983; Working for patients, 1988; NHS & Community Care Act 1990 Patient’s Charter, 1991; Carer’s Act, 1995; INVOLVE launch, 1996; Partnership policies NHS Executive Patient Partnership Strategy, 1996

What is known about SUI (What is its history). Why is it a developing culture in healthcare?

The 1980s and 1990s saw a big shift in the client-worker relationship, with great emphasis on the rights and abilities of clients to describe and understand their own situation.

*

HISTORICAL TIMELINE OF INVOLVEMENT 1948 - 2017

YEAR KEY SENTENCE COMMENT
1997 – 2009 SUI remained a recurring policy theme in UK; several structural challenges Improvement of patient experience onwards from 2002 – Department of Health More focus on Carers NHS Plan, 2000; Health and Social Care Act, 2001; PPI forums, 2003; Carers Equal Opportunity Act, 2004; A stronger local voice, 2006; Commission for Patient and Public Involvement in Health (CPPIH), 2007; LINKs, 2008; Care Quality Commission (CQC),2009
2010 – 2013 In 2010, coalition government was formed. Coalition reform – A ‘patient-led NHS’; Battle for NHS service improvement continues; advocating a “no decision about me without me” approach to health and social care services NHS Constitution, 2010; revised in 2012/13; Liberating the NHS –White Paper, 2010; Health Watch England – to start April 2013

This timeline shows the origins of interest in service user involvement and how the government now activity seeks service users and carers views on health and social care services

Service user involvement has literally become one of the formal guiding principles in health and social care services.

*

YEAR KEY SENTENCE COMMENT
2014 - 2017 Department of Health commissioned published a full initial government report of the Mid Staffordshire NHS Foundation Trust   Work to developing new relationships with patients – transforming the way involvement takes place Ongoing government policy on health and social care integration Further reinforcement of rights via the – The NHS Constitution for England   Next Steps of the NHS five year forward view is published In February 2013, the Francis Inquiry into failings of the Mid Staffordshire NHS Foundation Trust (in lack of quality in care) was published. Patients First and Foremost In 2013 - Transforming participation in health and care ‘The NHS belongs to us all’ In 2014 - Five Year Forward View document reinforced similar ethos on developing new relationships with patient and communities – empowering patients and engaging communities An integration policy - 2010 to 2015 government policy: health and social care integration – 2016 - New Care Model - Integrated Personal Commissioning – Built to supports the improvement, integration and personalisation of services (NHS England, 2016) NHS England (2017) - Next steps of the Five Year Forward View published

This timeline shows the origins of interest in service user involvement and how the government now activity seeks service users and carers views on health and social care services

Service user involvement has literally become one of the formal guiding principles in health and social care services.

*

CRITICAL PERSPECTIVES ON HISTORICAL DEVELOPMENTS

  • There is so much aspirations and discussion around engaging with service users.

  • However, how well this translates to the public remains a challenge.

  • The continuous interest in re-defining involvement as observed from the timeline may thus, limit the forward advancement of service user involvement (SUI) making it difficult for its practice to be well grounded and form an integral part of health care systems.

CRITICAL PERSPECTIVES ON HISTORICAL DEVELOPMENTS

  • SUI in the UK, still presents persistent challenges in health services today. A main reason being the diverse ways in which participatory initiatives takes place and the wide range of stakeholders.

  • Often times, participation is still seen as an ‘extra’, added to the decision-making processes already in place?

  • not allowed to reach its full potential still breathes a sense of apprehension about its whole process – how genuine the processes are for service users to participate with the continuous emerging new participatory opportunities?

WHY DO IT?

  • Service users and carers are increasingly referred to as ‘experts by experience’ and it is recognised that by them becoming involved in important decisions about the way services are delivered,...

  • those services are more likely to meet the needs of people who come into contact with them. 

*

Patients asked to rate their GP

Telegraph

01 Apr 2009

The hospital of death

'Appalling' care may have led to hundreds of deaths

18 March 2009

Shock levels of care

home MRSA

One-in-four nursing home

residents carries MRSA

Thursday, 4 June 2009

Patients face alcohol quiz as GPs chase

counselling target.

15 June 2009

Why was nobody listening to patients?

23 March 2009

Hospitals reviewed over death rates

7 May 2013

• Sharing treatment decisions with service users can lead to better decisions and better, more cost-effective outcomes

• It can improve safety and reduce claims and litigation

*

RATIONALE FOR SERVICE USER INVOLVEMENT

  • Service user involvement (SUI) is not often scrutinized in a way that ensures that participation has had an impact on how much input service users have had in relation to health care service design, delivery and provision.

  • Numerous studies highlight the growing trend encouraging SUI in healthcare planning, decision-making, delivery and provision

(Forbat, et al, 2009; Coulter and Collins, 2011; The King’s Fund, 2012; De Freitas and Martin, 2015; Caine, 2014; McPeake, et al, 2014; Health Foundation, 2014; Lichon et al, 2015; Fredriksson and Tritter, 2017).

  • Some areas of focus for involving service users - meaningful outcomes for people, public health, local communities, and the health services itself.

RATIONALE FOR SERVICE USER INVOLVEMENT

  • Service user involvement (SUI) is not often scrutinized in a way that ensures that participation has had an impact on how much input service users have had in relation to health care service design, delivery and provision.

  • Numerous studies highlight the growing trend encouraging SUI in healthcare planning, decision-making, delivery and provision

(Coulter and Collins, 2011; King’s Fund, 2012; De Freitas and Martin, 2015; Caine, 2014; McPeake, et al, 2014; Health Foundation, 2014; Fredriksson and Tritter, 2017).

  • Some areas of focus for involving service users - meaningful outcomes for people, public health, local communities, and the health services itself. (DoH, 2005, 2001; NHS England, 2017b)

RATIONALE FOR SERVICE USER INVOLVEMENT

Benefits to People

  • More meaningful and satisfying experience of using healthcare services
  • More accessible and responsive health services to people’s needs
  • Greater satisfaction of care experience, leads to improved health
  • An increased sense of being able to and having the capacity to control own lives
  • Greater sense of ownership of the NHS
  • Makes few complaints than those who have not been involved in decisions
  • Thus, moving from rhetoric to now enabling or even empowering people to have a confident say in their care and healthcare service provision (Clarke, 2005).

Benefit for People. It is obvious from the rationale presented that the main focus around involving service users is what matters to individuals. Each individual accessing healthcare will seek a meaningful outcome.

Therefore, this affirms that the main rationale for involving service users in planning, delivery, shared decision making, and provision of care services are based on the preferences of people (Redding 2016; De Silva, 2012; Coulter et al, 2014; CQC, 2016).

*

RATIONALE FOR SERVICE USER INVOLVEMENT

Benefits to Public Health

  • Advance equality and reducing health inequalities
  • Improving public health outcomes
  • Challenges assumptions made by service providers and commissioners
  • Having a greater sense of understanding of link between population’s health and social determinants of health (i.e. circumstances in which people live their lives)
  • Development of more tailored policies to address wider issues –environment, economic, social.

  • Thus, engaging in shared decision-making with voluntary organisations on the public’s health and social care issues is no doubt a highpoint to responding well to public health needs.

Benefit to Public Health. The continuous deficiency of equity in care confirms another rationale why service providers and commissioners need to understand how the wider public view health and care and how health h is experienced so that healthcare services can be tailored to meet people’s needs. This calls for the NHS looking beyond statutory means of involving the wider public, supporting organisations such as Healthwatch whose goal is to advocate for a wide range of voices that could be lost.

According to the Department of Health (2006) non-statutory/voluntary organisations play a greater role in relation to patient and public involvement. Even though national initiatives have the potential to engage with service users, collaborating with local voluntary organisations to develop and trial new approaches (Wood and Henderson, 2016) offers potential that will be significant to achieve much wider service-user centered approaches in healthcare and wellbeing of the wider public.

*

RATIONALE FOR SERVICE USER INVOLVEMENT

Benefits to Local Communities

  • Community centred approaches that support people improves social cohesion = people becoming more in control of their health and wellbeing

  • Community wide collaboration consultation = a health service better able to meet the needs of its citizens

  • More attention to commissioning of integrated services and policies=closer cooperation between various agencies (statutory/non-statutory), all with roles to play in improvement healthcare outcomes

*

RATIONALE FOR SERVICE USER INVOLVEMENT

Benefits to Local Communities

  • Improves financial sustainability and enables the efficient allocation and better use of available resources. This will in turn reduce democratic deficit

  • There is growing evidence to support the importance of working with communities to raise cohesion that can contribute to better experience of care for local communities and in turn, improve health
  • (The Marmot Review, 2010; Wood et al, 2016).

Benefit to Local Communities. There is growing evidence to support the importance of working with communities to raise cohesion that can contribute to better experience of care for local communities and in turn, improve health (The Marmot Review, 2010; Wood et al, 2016).

It is also crucial to use community based initiatives to understand the nature and needs of people within communities. This knowledge will provide useful insights on how to develop coordinated efforts, that will reach people who seldom get involved in their healthcare.

This could foster more change in people’s behaviour, their ability to take control of own health (Michie, et al, 2011) and confident to engage with local initiatives within own communities (Burd and Hallsworth, 2016).

*

Benefits to Health Services (NHS)

  • The success of health service organisation is centred on its involvement with its users
  • Use of health services in appropriate way = greater cost-effective measures
  • Improves outcome of individuals experience of care
  • Builds public’s confidence in health services
  • Sharing of responsibility by involving people in their own healthcare
  • Shared decision making between service providers and service users contributes to resolving problems amicably
  • The rationale of benefits to the NHS suggest that commissioning service user participation in all aspects of healthcare is a key requirement for all healthcare services across UK.

RATIONALE FOR SERVICE USER INVOLVEMENT

SUMMARY OF RATIONALE

  • Involvement in individual care and treatment can increase self-esteem, improve individual outcomes and increase people’s satisfaction with services.

  • The greatest benefits arise when people agree about the purpose of their treatment, and they have choice and control over it.

  • Involvement in communities can provide opportunities for peer support and mentoring.

*

SUMMARY OF RATIONALE

  • Involvement in services can lead to enhanced quality of care, improved quality of life, improved relationships between staff and service users, and improved outcomes for service users; it can also lead to improved outcomes for providers.

  • Involvement in planning, commissioning and governance can improve information and access for service users, and have positive effects on decision-making processes and staff attitudes and behaviour.

*

SUMMARY OF RATIONALE

  • These rationales suggests that health service providers, commissioners and professionals are more accountable to patients and the public who, according to the Health Committee (2007) are users and funders of health services.

  • Also suggests that it is feasible for service users to have their voices heard.

*

REFERENCES

  • Caine, J. (2014) Integrating people with dementia and their carers into service design. Journal of Integrated Care, 22(3), pp. 91-98
  • Carr, S (2004) Has service user participation made a difference to social care services? [Online] Available from: https://www.scie.org.uk/publications/positionpapers/pp03.pdf
  • Coulter, A. and Collins, A. (2011) Making shared decision-making a reality No decision about me, without me. London: The King’s Fund
  • DeFreitas, C. and Martin, G. (2015) Inclusive public participation in health: Policy, practice and theoretical contributions to promote the involvement of marginalised groups in healthcare, Social Science & Medicine, 135, pp. 31–39.
  • Department of Health (2001) Involving patients and the public in health care: A Discussion Document. London: Department of Health
  • Department of Health (2005) Creating a patient-led NHS: Delivering the NHS improvement plan. [Online] Available from: http://webarchive.nationalarchives.gov.uk/20130107105354/http:/www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4106507.pdf [Accessed 25 January 2017]
  • Foot, C. ,Gilburt, H., Dunn, P., Jabbal, J., Seale, B., Goodrich, J., Buck, D. and Taylor, J. (2014) People in control of their own health and care The state of involvement. London: The King’s Fund

REFERENCES

  • Fredriksson, M. and Tritter, J. Q. (2017) Disentangling patient and public involvement in healthcare decisions: why the difference matters. Sociology of Health & Illness, 39(1), pp. 95–111
  • Health Foundation (2014) Helping measure person centred care. [Online] Available from: http://www.health.org.uk/publication/helping-measure-person-centred-care [Accessed 20 December 2016]
  • King’s Fund (2012) Leadership and engagement for improvement in the NHS - Together we can. [Online] Available from: https://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/leadership-for-engagement-improvement-nhs-final-review2012.pdf [Accessed 15 March 2017]
  • McPeake, J., Quasim, T. and Daniel, M. (2014) User involvement: Beyond the tick-box. British Journal of Nursing, 23(14), pp. 810
  • NHS England (2017b) Involving people in their own health and care: Statutory guidance for clinical commissioning groups and NHS England. [Online] Available from: https://www.england.nhs.uk/wp-content/uploads/2017/04/ppp-involving-people-health-care-guidance.pdf [Accessed 14 May 2017]