Sharing and embedding the Transformldn programme

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Earlier in the summer we held an event, which focused on sharing and embedding the TransformLDN programme.

Transformldn has brought together health and care stakeholders, from across London to co-create Our Declaration a set of “foundations” required for “good community services”. This has been developed by the view of hundreds of staff across all London boroughs, then tested and reshaped based on service user and carer feedback. The result is a combined declaration of what service users and staff want from London’s community services.

In response to the London CCG office and the emerging Vanguard landscape, following the publication of the Five Year Forward View, we have also undertaken engagement with community services staff to look at a specific model of community based care – what makes a good Multispecialty Community Provider, to help the design and delivery of this new model of community based care.

At our sharing and embedding the programme event commissioners and providers of health and social care worked together to develop an action plan for taking this work forward and embedding it into practice. The analysis and collation of the conversations had on the day have led to both a set of core recommendations and specific recommendations for different groups.

Core Recommendations

  1. Communications and dissemination: we need to begin a communications and dissemination exercise to share the outputs of this programme both locally and nationally to both share learning and gather feedback. This will help to get more organisations to sign up to the declaration and features of MCPs including health and wellbeing boards, commissioners, providers, local authorities and the voluntary sector.
  2. Creating measurable outcomes: we need to use the declaration and the features of MCPs as tools to create a quantifiable baseline to benchmark services across London. We can then turn the declaration and features of MCPs into measurable outcomes that can be used by organisations to monitor progress and performance.
  3. Building partnerships: we need to use the declaration and features of MCPs as tools for building partnerships and starting conversations with other organisations and sectors. To help with this the declaration and the features of MCPs need to be aligned with other work, including the BCF, Healthy London Partnership and primary care transformation work – creating a common vision for the future of London’s community-based services.
  4. Continuing engagement: the engagement methodology used by the transformldn network should be seen as a benchmark for future engagement activity in this area. The methodology could be used at a local level to add to the evidence base for this way of working and create the local case for change.

Recommendations for Specific Groups

Commissioners

  • Every CCG board should state their position and direction of travel on MCPs and other community based care models.
  • CCGs need to be explicit about how the foundations of the declaration are going to work in practice, expanding the declaration to provide specifications and guidance to support procurement.
  • The business model to support the declaration and the features of MCPs needs to be created – this will make the benefits and outcomes of designing services in this way explicit.
  • The declaration and the features of MCPs should be used as a baseline to assess the current state of services and identify opportunities for improvement.
  • The declaration and the features of MCPs need to be aligned with the Better Care Fund deliverables.
  • The declaration and the features of MCPs need to be used to rewrite Key Performance Indicators to ensure that they are outcome related.
  • More work needs to be done to involve social care – the declaration and the features of MCPs should act as tools to support these conversations and partnerships.
  • The declaration should be used as a tool to support the co-design of services with local communities and service users.
  • The declaration and the features of MCPs should be used to develop outcomes based commissioning models across health and social care.

Providers

  • The declaration and the features of MCPs should be used as tools to create a baseline of where services are to inform plans for future development.
  • More work needs to be done to involve social care – the declaration and the features of MCPs should act as tools to support these conversations and partnerships.
  • The declaration should be used as a tool to gather the views of service users on the future development of services.
  • The declaration and the features of MCPs should be shared with acute colleagues and used to initiate conversations about the interactions between services and areas that could be improved.
  • The declaration and features need to be used as tools to foster a united vision amongst the breadth of providers who make up the community sector.

Local Authorities

  • The declaration and features need to be used as tools to foster a united vision amongst the breadth of providers who make up the community sector.
  • The declaration and the features of MCPs need to be used as evidence of a direction of travel, to help combat risk aversion and continue the shift towards more personalised services.
  • The declaration and the features of MCPs should be used to support local discussions about joined up working between health and social care.
  • The declaration and the features of MCPs should be used to develop outcomes based commissioning models across health and social care.

Do you agree with these recommendations? Can you think of better ways to share and embed the Transformldn work, or is there something we have missed?

Please let us know what you think about the recommendations and what the priorities are for taking this work forward by emailing eileen.bryant1@nhs.net

Introducing our updated declaration

Building upon our previous declaration co-created by health and care staff, which was launched last year, we have gathered feedback from service users and their carers to create an updated declaration that reflects the views of a cross –section of Londoners, both service users and health and care staff. This is presented in the form of a simple poster, which you can download here and updated content on this website, reflecting the journey of this project.

Since the beginning of the year the transformldn network have been working to gather service user feedback to test, refine and validate our declaration of the foundations of community services. We gathered data from three streams:

  • 4 x face to face focus group
  • Online workshop
  • Literature review

The combined analysis of the three data-sets, has led to the creation of our updated declaration. 1,000+ service users and health and care staff, from 150+ organisations, representing all 32 borough of London, have been involved in the creation of this declaration.

We want our updated declaration to inspire service improvements both for the front line and those who lead the design, delivery or commissioning of health and social care services in the community. Following on from the London Health Commission, the Healthy London Partnership has been developed and Community Services are a vital component in making this partnership work, this declaration can support that work, by acting as an advocacy tool for the role of community services within the wider London transformation programmes.

We need you to spread the word. Please read Our Declaration, share it with your colleagues and tell us what you think. You can find out more about each foundation of Our Declaration by looking at the individual pages: care is about me, make London healthier and happier, working as one team, happy staff with the right skills. We have collected together evidence from our datasets, which describes what this foundation should look like and how it can be achieved. Please get involved and share your case studies and projects so we can build and grow Our Declaration and work together to realise a community-led revolution in health and social care.

Download a poster summary of our declaration here
Our Declaration - updated

Buurtzorg on Radio 4’s Today Programme

One of the organisations we keep coming back to when looking at transformed community services is Buurtzorg, from the Netherlands. Buurtzorg, which roughly translates as neighbourhood health has a flat organisational structure – empowering front-line nurses to make decisions about how they care for their patients. This has both improved the quality of care and reduced its’ cost.

The BBC recently featured the organisation on the Today programme – with a feature entitled: How can the NHS reduce its costs without sacrificing frontline care? It looks at Buurtzorg as an example of how things can be done differently, describing how the organisation has stripped away middle management. The figures reported suggest that if all of the Netherlands nursing organisations operated in this way, the country could make savings of €2bn each year. If the same process was rolled out across the UK, that could be almost £6 billion. All this achieved while improving the satisfaction of patients and staff.

You can listen to the broadcast and discussion on iplayer radio – the feature starts 33 minutes into the programme. BBC Correspondent Anna Holligan talks to the CEO of Buurtzorg Jos de Blok – who describes how this new organisational structure is based on the autonomy of professionals. Jos spoke at our conference on the art of the possible in community services last year – you can hear his talk about innovation in provisioning here.

Multi-speciality community providers – what should they look like?

Do you work on the front line or lead the delivery or commissioning of London’s community services? Do you want to join our online workshop exploring the key components of the new models of care that have come out of the ‘Five Year Forward View’? First we are focussing on ‘Multi-speciality community providers’ – what should they look like? Our workshop launches on Thursday 26th February at 4pm – to take part, please sign up using the form below and you will receive an email with details of how to take part on the day.

Sign up to join our workshop

Conference: Transforming Community and General Practice Nursing in London

Want to get involved with the community services agenda in London? Then please register here for this one day conference which aims to inspire nursing professionals to rise to the challenge of transforming our community and general practice nursing services for Londoners.

We are faced with a growing population with more complex needs, whose needs for care outside of hospitals are increasing. The solution, and our shared vision, is to have a community-led revolution in health and social care that will transform the delivery of health and social care services for Londoners. For more information download our declaration, which was co-created by 1,000+ community services staff, here.

This event is your chance to:

  • Hear about examples of innovative and new models of working in the community
  • Discuss how you can learn the leadership behaviours needed to change practices
  • Network and form links with new colleagues, and learn ways to keep those networks
  • Be one of the first to see the short film on compassion in the community by NHS England
  • This conference will bring together chief nurses, commissioning leaders, general practice nurse leaders, community nurse leaders and educational leaders, and provide an opportunity for them to unlock their expertise and creativity to deliver our shared vision.

To lead us through this exciting phase, we are delighted to have the following speakers:

  • Caroline Alexander, Chief Nurse for London, NHS England (Chair and speaker)
  • Jonathan Lewis, Chief Executive, Bromley Healthcare Community Interest Company
  • Dr Pete Thomond, Managing Director, Clever Together
  • Dr Helen Bevan, Chief Transformation Officer, NHS Improving Quality

To book your place, please register online before Friday 30 January. You can download the event agenda here.

We look forward to your valuable contribution and hope you share our commitment to bringing together community and general practice nurse leaders from across London.

If you have any queries please contact Tel: 020 7324 4330 or email karen.stewart@neilstewartassociates.co.uk

The launch of our declaration

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Download a poster summary of our declaration here.

After three very busy months of research and crowdsourcing we have now launched Our Declaration – describing how a community led revolution in health and social care can transform the health and well-being of London. Our Declaration was co-created by 1,000+ health and social care staff from 100+ organisations, representing all 32 London boroughs.

Our journey up to this point has involved a process of in depth research, which led to the creation of a draft vision in the form a one page document and an animation. We then created and empowered a network to share their feedback to improve this draft: 100+ people attended our conference and 1,000+ people, representing 100+ organisations got involved in our online crowdsourcing workshop. This process was guided by a design group of 40 experts and leaders from London’s health and social care organisations. Our design group analysed the feedback from our network – 10,000+ ideas, comments and votes, which refined and improved our draft vision. This work was distilled into Our Declaration a simple, inspiring statement of how community services can lead a transformation in the health and well-being of our city.

We want Our Declaration to support and inspire those seeking to improve the delivery and commissioning of health and social care services in the community. We need you to spread the word. Please read Our Declaration, share it with your colleagues and tell us what you think. You can find out more about each foundation of Our Declaration by looking at the individual pages: Get Personal, Make Boundaries Invisible, Real Leaders, Happy Workers, Focus on Outcomes. We have collected together data from our design group, the crowd and case studies and literature describing what this foundation should look like and how it can be achieved. Please get involved and share your case studies so we can build and grow Our Declaration and work together to realise a community-led revolution in health and social care.

Results to date: Our Draft Declaration

We have analysed 10,000+ ideas, comments and votes from our network, representing the results so far on the journey of the Transform London project. Our analysis of the inputs provided into the project, to date, reveal that health and social care staff want to make the following declaration:

London’s community health and social care services touch our lives at times of basic human need, when care and compassion are what matter most. They support us to keep mentally and physically well, to get better when we are ill and when we cannot fully recover, to stay as well as we can till the end of our lives. They are here to improve the health and well-being of our city.

London’s growing population with more complex needs is creating unsustainable pressure for our partners in acute and primary care. Something needs to change and the solution lies close to home.

We declare that a community-led revolution in health and social care will transform the health and well-being of London – the foundation of our revolution has four parts…

1 Get Personal
We must place Londoners at the heart of care – everything designed and delivered around their personal needs
2 Make Boundaries Invisible
We must ensure the boundaries of services and organisations are invisible to our service users
3 Real Leaders, Happy Workers
We must have inspiring leaders to coordinate care and a skilled, fulfilled and motivated workforce
4 Focus on Outcomes
We must always focus on improving the health and well-being outcomes for Londoners

We want as many people as possible to review our draft so please read more of our draft declaration and offer your feedback to help us improve it.

Support for our draft vision

We conducted a straw poll on our website to find out what level of support there was for our draft vision.
Here are the results:
draft vision
As you can see 91%, of those polled, stated that they supported our vision either completely or mostly. This told us that we was broad support for the principles of the vision – people were then invited to offer more detailed feedback via our online crowdsourcing workshop. More than 1,400 contributions were made – refine, revising and improving our draft. Read our declaration now and offer your feedback.