Mandate for change. Using AHPs to transform health, care and wellbeing. Suzanne Rastrick Chief Allied Health Professions Officer @SuzanneRastrick
NHS Five Year Forward View Published in October 2014 A shared vision across seven national bodies New care models programme key to delivery Focuses on both NHS and care services Our values: clinical engagement, patient involvement, local ownership, national support /vanguards #futurenhs 2
The challenges we face 1 Health and wellbeing gap Radical upgrade in prevention 2 Care and quality gap New care models 3 Funding gap Efficiency and investment Our values: clinical engagement, patient involvement, local ownership, national support /vanguards #futurenhs 3
50 vanguards selected. 5 new models of care with a total of 50 vanguards: 9 14 6 Integrated primary and acute care systems Multispecialty community providers Enhanced health in care homes 8 Urgent and emergency care 13 Acute care collaboration Our values: clinical engagement, patient involvement, local ownership, national support /vanguards #futurenhs 4
What will success look like? Nationally replicable models More accessible, more responsive and more effective health, care and support services Fewer trips to hospitals Care closer to home Better co-ordinated support 24/7 access to information and advice Access to urgent help easily and effectively, seven days a week Our values: clinical engagement, patient involvement, local ownership, national support /vanguards #futurenhs 5
What does this mean for the workforce? Re-design? Population health workforce modelling Integrated workforce models and team effectiveness. Future education and training?
Operational Productivity Recommendation 2: NHS Improvement should develop and implement measures for analysing staff deployment during 2016, including metrics such as Care Hours Per Patient Day (CHPPD) and consultant job planning analysis, so that the right teams are in the right place at the right time collaborating to deliver high quality, efficient patient care. Operational productivity and performance in English NHS acute hospitals: Unwarranted variations. An independent report for the Department of Health by Lord Carter of Coles (2016)
Unwarranted Variation: final report summary, January 2016
Model hospital & Single Integrated Performance Framework NHSI should develop the model hospital and underlying metrics, identifying what good looks like, so there is one source of data, benchmarks and good practice NHSI should, in partnership with NHS England, develop an IPF This should be the basis of CQC inspection and assessment
2015-16 CAHPO visits.
Professional bodies workshop AHP strategy? Agreement that gains can be made for all AHPs and the health and care by working towards common goals and challenges together. National conversation about collective impact of AHPs What do we need to start, stop, or differently? Examples of how we are doing this already.
A mandate for change.
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Across England and the UK
and wherever they were in the world!
TOTAL 1949 people engaged 16,128 contributions
Two key questions How will England be different if all AHPs were genuinely used effectively? What do you think AHPs need to stop, start or do differently to ensure they are used effectively to help transform health, care and wellbeing in England?
High level findings 4 areas of impact for individuals and populations. 4 commitments to the way services are delivered. 4 priorities to meet the challenges of changing care needs. 16 challenge questions for delivery.
Priority 3 AHPs skills can be further developed. Unique selling point What can members of your profession do that no one else can do? Extending skills and knowledge to improve service efficiency and outcomes. What tasks/roles do other professionals perform that members of your profession could do? Values and Behaviour Enhancing the skills of others to improve outcomes. What skills and knowledge can members of your profession develop in others? (with safe delegation and training) Shared skills/knowledge. What are the generic skills and competencies that your profession and other professions have which can enhance patient experience?
Unique selling point In order to avoid patients telling their story a number of times and overlapping services, we need to be better at working together to form a collaborative approach to care. This is the way to produce more innovative and individualised outcomes. On the other hand, we should also be very clear about defining our own role and specialism within the MDT so there is no confusion. We need to be clear on what they are working with (i.e. financial constraints) and be prepared to show our economic value.
Extending skills and knowledge to improve service efficiency and outcomes. We need to develop the concept of multiprofessional routes to defined ACP roles. These roles shouldn't be about single professions but open to all. does this area need to reference working in a multidisciplinary context as central to development - feels like a lot of individual professional groups identifying personal / profession specific agendas There is no doubt that prescribing is a massive issue and not only for Paramedics but for any professional who could use it for patient benefit in the right place.
Enhancing the skills of others to improve outcomes. Assistant Therapy Practitioners - the future of support staff! - This 'generic' approach frees up qualified therapists to deal with complex patients requiring more specialist knowledge. This provides a more responsive service to patients with less numbers of staff assessing and working with them. It also prevents duplication of assessments. When I was a student Occupational Therapist I was in a mental health placement for 9 weeks and within those 9 week it was clear to see just how underutilised our OTA was. Tragically she was seen as the odd jobs person responsible for very none-ot roles. Unfortunately I see that this may be the case for many AHP's. The lines of our role seem to blur and with it the risk of not using our valuable skills. Occupational Therapists are trained to do specific assessments and, interventions and therapy input with patients, and within a mental health setting this often boils down to doing activities to keep patients busy. If more OTA's were employed to do the random jobs that clog up an OT's skills then there may be more room for the skills to be correctly and appropriately utilised.
Shared skills/knowledge. The AHP professions are all unique and each has so much to add. But what we really must stop doing is fighting against each other by fighting integration of services. There is a lot of overlap in our assessments and intervention - we need to agree to collaborate on the elements that we all cover to avoid duplication, trust each other's assessments and focus on adding extra value rather than redoing what our colleagues have already done. AHPs need to stop referring to each other across the 'boundaries' of acute/community care and start sharing our assessments, goals and treatments with each other. This will avoid repetition, save everyone's time, and benefit patients.
Thank you #AHPsmandate launched October 2016 I honestly believe that if all AHPs in England were used effectively, it would signal the total transformation of health and social care which we desperately need. We save lives, we rebuild lives and we do it all at a fraction of the cost of other colleagues. We understand the medical but crucially, we understand the social determinants of health -education, poverty, housing, stigma.