A new national approach to large-scale change?

Developing new models of care in the PACS vanguards: a new national approach to large-scale change? | The Kings Fundlight-bulbs-1125016_1920This independent report was commissioned by NHS England as part of a package of support provided to primary and acute care system (PACS) vanguard sites by The King’s Fund. The PACS model is an attempt to bring about closer working between GPs, hospitals, community health professionals, social care and others.

The report offers a unique set of first-hand perspectives into the experience of those leading a major programme at the national level and those living it at the local level. The insights shared will be invaluable to those constructing future national support programmes intended to facilitate transformation in local health and care systems. The lessons learned will also be highly relevant to those involved in the ongoing implementation of PACS and similar models.

Full report: Developing new models of care in the PACS vanguards: a new national approach to large-scale change?

See also: An international perspective on developing new models of care in the PACS vanguards

 

Improving population mental health

The King’s Fund | April 2018 | Improving population mental health: five lessons from Liverpool

The King’s Fund is working  with Kaleidoscope Health and Care and the Centre for Mental Healt, it has delivered a series of learning events across England, as part of the Prevention concordat for better mental health  programme led by Public Health England. Here, Chris Naylor shares 5 key lessons from a recent event in Liverpool in a blog post from The King’s Fund. 

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These include:

  1.  We need to reframe how we understand mental health

    There has been some real progress in recent years on public attitudes and stigma, but mental health is still seen largely in negative terms – as an illness or deficit. Achieving the Prevention Concordat’s goal of better population mental health will involve thinking much more about mental health as a resource that we all possess, shaped by our relationships and the communities we live in.

  2. We can make much better use of the skills and resourcefulness of frontline staff of all kinds
    This isn’t just about ‘awareness’ – important though that is. It is about challenging the assumption that only specialists can help someone with their mental health.  The author advocates taking a public health approach to mental health to empower frontline services services, employers and community groups to have supportive conversations of this sort. 

  3. In commissioning, high standards of proof can be counter-productive
    We need to have an approach to commissioning that draws on evidence and ensures that public money is well spent, but that also allows room for creativity and local flavour. As one person at the event put it, we need to understand how we can measure something without killing it.

  4. National policy can help or hinder local attempts to focus on prevention and promotion 
    National policy has made bold commitments to ‘get serious about prevention’. Doing so in mental health will require significant changes in terms of how policy is constructed and which agencies are involved in overseeing its delivery. A key question that remains is how prepared national bodies are to lead that change
  5.  Health improvement has to build on local history and values
    National policy has made bold commitments to ‘get serious about prevention’. Doing so in mental health will require significant changes in terms of how policy is constructed and which agencies are involved in overseeing its delivery. A key question that remains is how prepared national bodies are to lead that change. (The King’s Fund)

The full, unedited post is available from The King’s Fund blog 

Related:

Connect 5 Building Mental Health Skills Across Health & Care

Connect 5 is a mental health promotion training programme developed from a unique collaboration between Public Health England (PHE) & Health Education England (HEE). It is designed to increase the confidence and core skills of front line staff so that they can be more effective in having conversations about mental health and wellbeing, help people to manage mental health problems and increase their resilience and mental wellbeing through positive changes. More details are available from the Connect 5  website 

Tackling multiple unhealthy risk factors

This report shares learning and insight from services that are using innovative ways to address the problem of multiple unhealthy risk factors in their populations | The King’s Fund

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Image source: http://www.kingsfund.org.uk/

This new report from the King’s Fund draws on interviews and information from eight case studies in local authorities and the NHS and updates the evidence base on tackling multiple unhealthy risk factors.

Previous research by The King’s Fund has shown that unhealthy behaviours cluster in the population. Around seven in ten adults do not follow guidelines on tobacco use, alcohol consumption, healthy diet or physical activity, yet most behaviour change services address these behaviours separately, not reflecting the reality of people’s lives.

Most services included in the report are local authority led and are integrated health and wellbeing services. These provide behavioural advice and support to people across a range of different behaviours, including smoking, weight management and physical activity.

Full report: Tackling multiple unhealthy risk factors: emerging lessons from practice

Summary available here

Public satisfaction with the NHS and social care

Public satisfaction with the NHS and social care in 2017: results and trends from the British Social Attitudes survey | The King’s Fund | Nuffield Trust

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Image source: http://www.kingsfund.org.uk

This analysis from the British Social Attitudes survey summarises views on, and feelings towards, the NHS and health care issues. Overall NHS satisfaction levels remain higher than they were in the 1990s and early-to-mid-2000s, however, there has been a statistically significant fall in satisfaction in 2017 which took net satisfaction to its lowest level since 2007.

Key findings:

  • Public satisfaction with the NHS overall was 57% in 2017 – a 6 percentage point drop from the previous year. At the same time, dissatisfaction with the NHS overall increased by 7 percentage points to 29% – its highest level since 2007.
  • Older people were more satisfied than younger people: 64% of those aged 65 and over were satisfied with the NHS in 2017 compared to 55% of those aged 18 to 64. Between 2016 and 2017, satisfaction fell among all age groups.
  • The four main reasons people gave for being satisfied with the NHS overall were: the quality of care, the fact that the NHS is free at the point of use, the attitudes and behaviour of NHS staff, and the range of services and treatments available.
  • The four main reasons that people gave for being dissatisfied with the NHS overall were: staff shortages, long waiting times, lack of funding, and government reforms.

Full report: Public satisfaction with the NHS and social care in 2017: results and trends from the British Social Attitudes survey

Additional links:

Integrated care systems

Making sense of integrated care systems, integrated care partnerships and accountable care organisations in the NHS in England |  Chris Ham | The King’s Fund 

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NHS England has recently changed the name of accountable care systems to integrated care systems. In this updated long read, Chris Ham looks at work under way in these systems and at NHS England’s proposals for an accountable care organisation contract.

The article looks at the following:

  • Why is change needed?
  • What are integrated care and population health?
  • What’s happening with new care models?
  • What’s happening in integrated care systems?
  • What are ACOs and why are they controversial?
  • How are integrated care systems and partnerships developing?
  • What has this way of working achieved?
  • What do these developments mean for commissioning?
  • Are these developments really a way of making cuts?
  • Will these developments lead to privatisation?
  • Where next?

The author concludes that integrated care should be supported as it is the best hope for the NHS and its partners to provide services to meet the needs of the growing and ageing population.

Full article: Making sense of integrated care systems, integrated care partnerships and accountable care organisations in the NHS in England

 

Volunteering in general practice

Volunteering in general practice: Opportunities and insights | The Kings Fund 

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The King’s Fund has published ‘Volunteering in general practice: opportunities and insights‘.  This paper explores how volunteers can provide support for the role of general practice, and the opportunities for organisations that currently support volunteering to work more closely with general practice.

Publication overview:

  • Interest is growing in the contribution that volunteering can make in health and social care. This paper builds on our previous work, which examined volunteering in hospitals, to explore ways in which volunteers are involved with, and are contributing to, general practice.
  • The authors identify four approaches to supporting volunteering in general practice: use of volunteers to enable general practice to carry out its activities; organisations using volunteer support that were located within general practice premises; social prescribing; and community-centred general practices.
  • 10 case studies are explored, which demonstrate that approaches to supporting volunteering in general practice provide an opportunity for practices to engage beyond their traditional boundaries, creating an interface with voluntary and community sector organisations and with the wider community.
  • The practice examples highlight the importance of partnership work to support and sustain volunteering, the different design and resource considerations in choosing an appropriate approach, the support and management requirements for volunteers and strategic factors that influence success and sustainability.

Full document:   Volunteering in general practice: opportunities and insights.

Making sense of accountable care

This report from the Kings Fund explores accountable care, and looks at the following questions:

  • Why is there so much interest in accountable care?
  • What is accountable care?
  • How does accountable care fit into the current legislative framework for the NHS?
  • What is happening in practice?
  • What does accountable care mean for commissioning?
  • What’s happening with new care models?
  • What’s happening in accountable care systems?
  • How is accountable care being implemented?
  • What has accountable care achieved?
  • Is accountable care about making cuts and privatising services?

The report concludes that accountable care should be supported because it offers the best hope for the NHS and its partners to provide the integrated health and care services required to meet the needs of the growing and ageing population. However, the author say that it will not deliver results quickly which is why national and local leaders need to make a commitment over the long term to developing accountable care as the main way of providing and funding care in the future.

Full report: Making sense of accountable care | Kings Fund

See also: Accountable care explained | Kings Fund blog