Monday, September 5, 2016
Want to know more about participation in transport planning?
As one of our experts in planning consultation and engagement, Lucy Farrow is co-delivering a course on Participation in Transport Planning, hosted by the Chartered Institute of Logistics and Transport on the 11 and 12 October 2016. Focussing on the principles and practice of participation, this two-day course is aimed at transport planners, managers or those that work in a profession that contributes to the transport planning process e.g. a highway engineer, development planner or land use planner. For more information either complete the application form or contact firstname.lastname@example.org.
Thursday, July 23, 2015
Identifying and recruiting participants for health research
A public dialogue for the Health Research Authority
The Health Research Authority (HRA) in conjunction with Sciencewise commissioned OPM Group to run a public dialogue on identifying and recruiting participants for health research. The final report is available to download.
The specific objectives of the dialogue were:
1. To inform the development of the HRA’s new UK wide Policy Framework to replace the Research Governance Framework and its associated operational guidance.
2. To provide opportunities for members of the public and patients to discuss and explore their aspirations and concerns about the governance of health research in relation to recruitment, data and consent, especially:
a. How patient data might be used in order to invite people to join research studies and who participants think should be allowed to access patient records in order to check eligibility
b. Different models for approaching potential research study participants including consenting to being approached directly about research
c. The plan to develop simplified models of consent for simple and efficient clinical trials of already licensed drugs and other interventions in common use.
Friday, May 1, 2015
Patients in control: ‘assume it’s possible’
Imagine walking into a GP surgery. For most of us, the first thing we normally face is a reception desk with overworked staff fielding phone calls in front of long queues of waiting patients.
What would happen if you took the reception desk away? Can you picture the waiting room as a place to talk to healthcare advisers, to find out about different wellbeing programmes without needing to necessarily even see a GP? The experience might feel something like going into an Apple Store and being greeted with a friendly smile and an iPad to search for options.
This is one of the latest ideas from the Bromley-by-Bow centre – reimagining the waiting room as a space to actively engage with patients, rather than a space where people are passively processed.
Operating in one of the most deprived areas of Tower Hamlets, BBBC is a pioneering community organisation – a vibrant hub with a café, arts workshops, offices, a nursery, garden, GP surgery and officers from the local housing association. The programmes that they run include helping people with long term conditions to take control of their lives, learn new skills, supporting people to find work and establishing social enterprises. The GP surgery (along with five others in the local area) refers patients to BBBC programmes through social prescribing.
The philosophy underpinning this approach is not necessarily new or unique – The Marmot Review into health inequalities emphasised a social understanding of health, and more recently Dr Atul Gawande dedicated one of his Reith lectures to the importance of medicine shifting from a focus on health to wellbeing. There is also evidence from social prescribing pilots elsewhere in the UK of the success of the approach. But the BBBC has put a wellbeing approach into practice and made it sustainable – based on an unswerving belief in the power of stronger, and more networked communities, and people’s capacity to achieve their goals and raise their aspirations.
OPM worked with the Bromley-by-Bow Centre (BBBC) to create a commissioning simulation as part of the South East CSU Person-Centred Care project. This aimed to explore the tools and knowledge that CCGs might need to confidently commission programmes and services that put patients in control. Participants had to imagine they were at a Commissioning Challenge event for a fictional CCG – although not dissimilar to what some CCGs are already doing. At our event, commissioners, patients, local authority representatives, clinicians and voluntary sector providers had come together, to work up an idea on how to reduce Type 2 diabetes and heart disease through a living well programme.
Simulations always risk being slightly contrived, but the aim was to go beyond commissioners’ usual environments, draw inspiration from the setting and think about how to join the dots between different organisations in local areas – all of whom could have something to contribute to a wellbeing approach that puts patients in greater control of their health.
What did we learn?
Creating the space for CCG commissioners to come together with local organisations and patients is essential to understand what each has to offer. Patients in control programmes will rarely sit in isolation – they are part of a menu of options, and commissioners need to think across the local system.
We found many examples and case studies of programmes that could be described as putting patients in control. But commissioning these are not yet the norm.
Participants talked about the importance of CCGs being less risk averse – finding ways to challenge entrenched cultures, and influence others internally and externally. This is not an easy task in a time of tight budgets and long lists of priorities.
Within this context, being able to demonstrate impact and outcomes is vital – we have blogged about measuring impact in the context of commissioning earlier on in this blog series on person centred care.
Despite these challenges, overall, we found that there is real desire amongst CCGs to use the commissioning process to ensure that there are person centred approaches in place. As one participant in the simulation said: ‘The aim should be for a Bromley-By-Bow Centre in every local area…’
In the words of the Centre itself: ‘assume it’s possible’.
This is the third in a series of blogs to be published following the development of a set of online tools and resources by OPM in support of the person-centred care agenda for South East Commissioning Support Unit. The first is entitled: Person-centred care: putting patients in control and the second: Person-centred care: measuring impact.
Thursday, April 2, 2015
South East London Commissioning Strategy Programme – Local Stakeholder Engagement Events
The south east London Commissioning Strategy Programme brought in OPM to design and facilitate two local stakeholder events to inform the development of a new five year commissioning strategy for health services across south east London.
The six NHS organisations (Clinical Commissioning Groups – or CCGs) in south east London with the job of planning and buying local healthcare services, are working in close partnership with local councils, NHS hospitals, mental health and community service providers and with local people, patients and other key stakeholders to develop the strategy.
Its aims are to improve health services for everyone in the London boroughs of Bexley, Bromley, Greenwich, Lambeth, Lewisham, and Southwark. The strategy will address those issues that cannot be solved by one area alone or where there is more that can be achieved by working together.
What we did
OPM invited key local stakeholders from the voluntary and public sector to these events to share their views on health services in south east London, and to learn more about the partners’ shared emerging vision for local healthcare services.
A large proportion of the participants at the events were from a Community and Voluntary Sector (CVS) or health service delivery background. Other participants included Healthwatch representatives and a small number of service providers.
Participants shared their views on the emerging strategy across seven key areas: Urgent and emergency care, Primary and community care, Maternity, Children and young people, Integrated care for physical and mental health, Planned care, and, Cancer.
Our engagement approach was designed for participants to learn about the background and strategy, and to share their views on emerging thinking. We wanted to test the thinking of the SE London Commissioning Strategy Programme to date, and identify what local stakeholders agree with and what needs more work.
OPM facilitated the events, with input from a Programme representative. The event mixed plenary sessions with facilitated table discussions, also providing participants with information sheets reflecting early thinking and clinical experts were at hand to give expert input on the emerging strategy, in particular the specific Clinical Leadership Group themes.
Participants at the local stakeholder events welcomed the overall direction of the strategy, but also raised a number of questions regarding its implementation. Issues such as joined up working and continuity of care, variability in quality of care and patient outcomes were discussed. A strong message coming out of the events was the need for involving patients in setting outcome and experience measurements and indicators for all services.
The local stakeholder events fed into the development of their five-year south east London commissioning strategies, and formed part of a wider programme of engagement across south east London around.
Thursday, April 2, 2015
Care Act Scenarios Workshop: with local authorities, residential care providers and service user groups
The Department of Health commissioned OPM to conduct a scenario workshop into the potential impact of the Care Act on local elderly residential care markets, including residential care, nursing and dementia care. Based on earlier consultation responses received by the Department of Health, our work focused on the following two changes:
- Increased transparency around local authority rates (through the allocation of an Independent Personal Budget for self-funders in order to meter their progress towards the cap on costs), and information and advice on the way individuals chose to purchase care.
- The new ability of individuals to ask local authorities to meet their eligible care and support needs, which may result in them paying a different price for their care.
The purpose of the workshop was to provide a way for a group of people across the ‘whole system’ (in this case the elderly residential care market) to experience potential future scenarios in a safe learning environment.
What we did
We started with 21 scoping interviews with a range of Local Authority (LA) officers, care providers, groups who represent or advise service users and carers and experts in the English care market. These interviews were used to inform the design of the scenario event, held on in November 2014 in central London.
During the day long workshop, participants worked grouped as Local Authorities, care providers and user representatives and at other times came together for facilitated 3-way conversations. For example, participants discussed how increased transparency about rates would be likely to impact on user behaviour, how providers would prepare in response to this and what local authorities would have to bear in mind in to meet obligations under the Act.
We used market scenarios to stimulate the discussion, varying in potential impact of the reforms introduced by the Care Act (based on factors such as wealth, needs and market scale), as well as geographical location, square mileage, population size, rural or urban characteristics and ethnic diversity.
There was an Advisory Panel in the room, who were at participants’ disposal to consult for additional insight, information and clarification.
One of the key findings from the interviews and workshop was the need for greater clarity about the responsibilities of local authorities as a result of the Care Act, and the impact of the cap on personal care costs, and how this is metered. Our report is with the Department of Health’s Social Care Strategic Policy and Finance Team and is being used to inform the implementation of the Care Act.