co production overview for carers week in herts
TRANSCRIPT
Co Production some work and some opportunities for Herts
10th June 2015Carers Week
Jim McManus, DPH, Hertfordshire County Council
What does it mean - SCIE
• Co-production is a potentially transformative way of thinking about power, resources, partnerships, risks and outcomes,
• ‘Co-production means involving citizens in collaborative relationships with more empowered frontline staff who are able and confident to share power and accept user expertise.
• Staff should be trained in the benefits of co-production, supported in positive risk-taking and encouraged to identify new opportunities for collaboration with people who use services.
• The creation of new structures, regulatory and commissioning practices and financial streams is necessary to embed co-production as a long-term rather than ad hoc solution.
Herts Network on LinkedIn
• http://uk.linkedin.com/grp/home?gid=5181118
Any examples, however early days?
• Caritas Older People• South Oxhey• Co-Production Training • Co Production Network • Infection Control in Care Homes• Sexual Health Service Re-procurement• Workplace Health Programme• CAMHS Review• Primary Care Heart Services (Previous work)
Why is it necessary?• Economic reasons• Diversity of Outcome Reasons• Intrapersonal reasons• Interpersonal Reasons• Outcomes – control, self-efficacy and
empowerment – Better implementation (org psychology)– Better and healthier living (health psychology)
Why hasn’t it happened?
• Hard work in a very busy workload• Users “It’s your job, why should we tell you?”• Professionalisms• Risk• Cost• Time• Willingness• Commissioner timeframes – 1 year
How could it work or more reasons
why it hasn’t happened?
Collaborative Economy
Co-produce JSNA
Co-produce commissioning
intentions
Co-produce Pathways
Co-produce Standards
Co-produce Training
Co-assess4Es
Co- implement
Co-determineOutcomes
Getting to making it happenrole distinction - Public Health Roles
Macro Meso Micro
What are our priorities for older people in Hertfordshire?
What do we do about older people at higher risk of seasonal death?
How does Mrs X choose and buy her care packages?
Accessible information presented with clear priorities
Evidence of what worksCase finding
Information to users about choosing their care
How can we change things?• What outcomes do you want? We want to
consider where we can contribute• We think co-production could result in
– Better pathways for x….– Less costs for y….– Better outcomes in this area……
• Can we explore together how existing resources and systems can be aligned to achieve this?
Starting Again
Obstacles
• Workload in NHS Commissioners
• Commissioning Structures and Systems
• Professionalisation• Complexity
Confused structures and pathways to commission
• Styles of working
Opportunities
• GP Localities• New Outcomes
Framework• Interface Work• Culture change at small
level and major level• Clarify roles and
contributions• Re-think the business
Areas Ripe for Co-production
• Long term conditions
• Behavioural pathways for prevention
• Carer Support
• Post operative care
• Cardiovascular event rehabilitation
• Primary care mental health
Building the Commissioning Landscape
• Bring partnerships together – Formation of DASB as overarching partnership– Elected member led
• Public Health led commissioning cycle and approach from County
• Working with every other agency (Sports Partnerships)
Monitor/ Evaluate
Plan
Review Need for Service and
Effectiveness of existing services
Public Health Input into the Commissioning Cycle. Can be throughout or can be on
specific areas playing to the PH strengths
Community Engagement
Support in establishing meaningful indicators of delivery and outcome
Model whether need willBe met by proposed volume
Check whether plans equateTo evidence and need andTest for equity / inequity
Support and advise onEvaluation and conductBits of it if enough resource
Needs AssessmentsEquity AuditingEvidence of EffectivenessHealth Impact Assessment
Triangle of critical influence – where public health should be most visible
Contract/Deliver
Triangle of critical influence
Triangle of critical influence
Working out who does whatLead Enforcement and
ControlPrevention Support,
Treatment and Care
Community Safety
County Community Safety Unit
County Community Safety Unit?
Probation, NHS, Public Health
Domestic Violence
County Community Safety Unit
Domestic Violence partnership
?Childrens Services
Drugs and Alcohol
County Community Safety Unit
Both working together
Public Health
Alcohol related violence
County Community Safety Unit
Multi agency NHS Acute Trusts
People with learning disabilities who are victims
County Community Safety Unit
Multi agency LD Partnership
