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Intentional Community Building – An Appreciation

Last Saturday morning I was having a cup of tea with Andy talking about Friday night and trying to explain how the annual evenings hosted by David Towell.

Last year I blogged about person-centred leadership. I commented that you know it when you see it - just from being in the same room with someone. Friday night was like that. David has a gift for connecting people, and asking questions that lead to in-depth, interesting conversations.

He generously, around the time of his birthday, hosts an evening at the Kings Fund in the name of the Centre for Inclusive Futures. He jokes that paying for the food and wine entitles him to ask us to work, and talk to each other around a particular question. This year he asked:

Where are the current opportunities for making and shaping positive differences in the lives of disabled people?

May 13The nights that David hosts are a different kind of community building - intentional community building around a shared passion and interest, often called communities of practice. David achieves this through the questions he asks, his generous hospitality, the way he structures the evening and the diverse group of people he invites - his circle. On Friday night it was an international group of family leaders and campaigning self advocates, people from organisations who may in other times see themselves as competitors (going for the same tenders), an actor, writers, leaders in all senses of the word.

A little after 8pm, David takes the microphone and invites people who have been 'listening posts' to share what they have been hearing and learning.

I normally don't enjoy being in a room with lots of people that I don't know, trying to make small talk, so at any other time I would be avoiding situations like this. However, because conversation is focused on a question, I have 'permission' to ask this directly, and it leads easily to deeper conversations. This year I met another Andy (Andy Bradley) who inspired me to think about compassion and mindfulness in my work, and we have been in contact since Friday thinking about opportunities to connect what we do. I also met Julia from NEF and took the opportunity to tell her how personally powerful I have found the '5 Ways to Wellbeing' that they had developed.

It is also a great way to connect with people I do know, but may only see once a year. The work that Sally Warren and Paradigm are doing about An Ordinary Life is excellent, and seeing Sally gave me an opportunity to tell her this. I talked with Nic Crosby about where he is seeing good progress in children's budgets, and I now have some people to contact to learn more.

I left with new people to contact; having contributed to a wider conversation; inspired by a different way to think about compassion; appreciative and gently challenged at the same time by David himself.

So here is my challenge back to you David - please help more people learn from the people in your circle - the Inclusive Future blogs for example? And thank you, for your leadership, and intentionally connecting diverse people through powerful questions and great hospitality.

Meeting Hilda

April13-2As I left the meeting last night Hilda and Nick were comparing notes about old movies that they loved. Hilda was talking about her all time favourite with Cary Grant, and talked knowledgeably about the original involving the Empire State building, and the remake which was set in a plane.

Nick and I had met Hilda for the first time, with her great Niece, Gill, to begin the process of delivering person-centred home care to Hilda. Hilda calls this her 'personal shopper'. Hilda is 92, a fantastic film buff, she lives by herself near the coast, is registered blind and now is in the early stages of dementia. Gill and Gill's daughters Barbara and Rachel support her and stay over a couple of nights a week. She has great neighbours too, Jean and Brian, who call in every day. Her daughter Joan lives in the States, in Pittsburg, and whilst we were there, Joan phoned Hilda to see how the meeting was going. For Gill and Joan and for Hilda too, there had been one too many near misses with traffic as she crossed roads on the way to the shops. Hilda also needed more and more help to find the items she needed and to read her shopping list as her eyesight was deteriorating and she is now registered blind, although she does have some vision.April 13

Nick and I met with Gill and Hilda for an hour last night, to learn about her and what she wanted from a service. Here is some of what I learned about Hilda last night, through purposeful conversation, and from being introduced to her family through the array of precious photographs in the lounge and kitchen.

  • That she goes shopping every Sunday with Gill to Cleveleys where they have lunch in the café, and Hilda buys a new film on DVD.
  • That she is a great cook - whilst we were there she talked about the scones she was planning to make.
  • Hilda loves watching soaps as well as her old films. In particular, her favourites are Emmerdale, and then Strictly Come Dancing. She enjoys getting the answers right when she watches Eggheads.
  • Her garden is important to her - it has raised beds and Hilda makes new hanging baskets each spring.
  • Her family are central to her life - seeing Barbara and Rachel, and speaking to Joan and the family in the states each week too, on a Sunday and a Tuesday at 5pm.

I learned what people love and admire about Hilda from talking to Gill when we were arranging the first meeting. Hilda has a great sense of fun, is incredibly organised and tells it like it is!

Today, I am typing this information into Hilda's one-page profile, and 'matching staff' and Nick is going off to start to find the right person.

Why are we going to so much trouble for a weekly contract worth less than £30 per week? Well, three reasons. We want to demonstrate what the most person-centred home care could look like, and this is then 'simply the way we do business', whatever the size of the contract. We also want to build trust with Hilda. If we can provide her with staff that are well matched to her, and support them to do an excellent job, then as Hilda needs more support (as we all will at sometime in our future) then we would like to be her first choice to provide that. I have just finished the book, 'Raving Fans' and this relates to the third reason. If Hilda and her family are very happy with their service, they are likely to mention it to other people. Funnily enough, as we left last night, Gill mentioned to me another relative of Hilda's who lives in Chorley, who might be interested in this new service.

 

My guest blogger this month is Tanya Moore, who is a social work lecturer. She talks about her experience of one-page profiles, and how she has introduced them onto a social work course.

I was managing a busy London Learning Disabilities Social Work team when the White Paper Valuing People (2001) enshrined person centred planning in government guidance.  As a team, we invested our annual training allowance into a two day training course on person centred planning with Barbra McIntosh.

We were inspired. We were enthused. We couldn't see how we would ever have the time to include these creative and wonderfully artistic yet lengthy processes into our statutory social worker role. But our commitment to the process of person centred thinking was firmly established.

Since then, I have worked in the voluntary sector, returned to front line statutory social worker  and currently, train social workers in practice and teach on a university social worker programme. As a statutory social worker, I never did get to coordinate a full person centred plan but have been very pleased to be invited to participate in the planning process for a number of people.  Over time, I have seen fewer of the elaborate,  artistic plans associated with person centred planning pinned to people's bedroom walls to be replaced by simpler one page profiles that can sum up what matters to a person on one side of A4. I have found that these can be invaluable as a means of understanding what is important to the person I am meeting.

One page profiles can be created as part of the process of getting to know someone and they can also be used for recording what is known about the person to make it easier for them to communicate the essential stuff.

Social workers may not often have time to create one page profiles but we can offer support to the experts to do the job. The experts will probably be the subject person themselves and might also include family members, friends or support workers.

For a social worker, aiming to get to know someone in a limited timeframe, a one page profile can be an absolute boon. The ability to present a person not just a need in a matter of moments engenders a person centred approach. Clear directions about how best to communicate with someone, how they prefer to be addressed and specifically, what we need to do in order to support them can save valuable time. Where possible, it would be fantastic to see one page profiles being sent in with referrals.

I would like to see one page profiles being used in all funding applications.

I often introduce one page profiles on courses for social work and social care staff. Sometimes workers say that their services use one page profiles. Usually, service managers say that they will be introducing one page profiles to their services. Almost always, social workers say that it would be fantastic and so much easier for them to get to know people in the very limited time available if everyone they visited had a one page profile available.

On Social Work training courses as well as at the university, I ask people to have a go at completing their own one page profiles. I offer a template and bring coloured pens for the artists in the group as well as stickers for those like me who really cannot draw. People create.  I often play music (always Abba but this is not prescriptive) and put chocolates on the tables to help people to relax and enjoy the process.

On the whole, people can feel uncomfortable writing what others like and admire about them. If it's a group who know each other well, I usually ask them to get others to complete this section for them. This can be a fabulously validating exercise and can serve as a reminder that having our strengths reflected back to us; as long as they are authentic can feel a bit embarrassing but can also be empowering and fun and can strengthen our bond with the person reflecting.

The section about what is important to us is usually the easy bit and gives the opportunity to talk about our lives in a positive way.

What people need to do in order to support us is always the tricky bit and is the part that reinforces the importance of detail in any effective support planning. A profile might say that I'll beg and plead to get out of it but actually really do want to go running every Saturday so need encouragement to go. It might say that I'm horribly allergic to cats and must be reminded to carry anti histamine. Or it might say that (and yes, these are all quotes from my profile) I have no intention of ever leaving the house without wearing mascara so everyone does need to wait while I put it on. Used effectively, these can form the basis of an understanding of some of the support that I might need to live my life in the way that I want to live it.

One page profiles certainly don't replace the need to get to know people and they can never replace the need for good relationship building that is the basis of all effective social work but from a social worker's perspective, they are a useful and accessible tool for focussing on what really matters to a person. This is one element of person centred planning that can fit well into statutory social work. And you don't need to be artistic to use it.

Building the Road

Feb 13My guest blogger this month is Gary Jones, Head of Commissioning, Doncaster Metropolitan Borough Council. Gary was originally very sceptical about person-centred practices, and here he explains how he is starting to make changes in Doncaster.

Having recently moved to Doncaster Council to lead Commissioning within Adult Social Care, I felt it was important to understand the sense of direction from a 'user led perspective'. I thus participated in a workshop with a number of user led organisations to develop a personalised approach to commissioning within the borough. Towards the end of the workshop it felt appropriate to begin to understand the road map that would allow us to comprehend what success looked like. Clearly I had dramatically underestimated the task in hand and a quick and eloquent retort came from a member of the assembled groups that suggested that before we draw the map, we need to build the b****y road. With this challenge in mind I contacted Helen Sanderson to begin to 'build the road' and understand what success looked like for commissioning for adults in Doncaster.

This approach had not been used before within the council and it was with a degree of trepidation that I gathered a Directorate group together to deliver a "One Page Commissioning Strategy".  This was not just a first for Doncaster, as the delivery of a One Page Commissioning Strategy had not been delivered before anywhere in the country within any council or clinical commissioning group. Michelle Livesley led the workshop from Helen Sanderson Associates and there was instant buy in from the group and critically they were able to gain a quick view on what needed to be achieved for families/carers and providers. There was a strong movement to deliver choice in services with an increase in quality, flexibility, responsiveness without any compromise in safety. In identifying how this was to be done there was a focus on the use of Person-centred tools/frameworks especially Progress for Providers and Person-centred reviews. However it was also noted that for families, commissioning is often viewed as a complex machine that is not easy to understand so there was a strong view that commissioning should be made simple and any information provided should be in formats that were easy to understand. Finally we worked on how we were going to achieve the aspirations within the strategy through the use of baseline assessments and understanding the outcomes form the perspective of the user. However the most powerful measure seemed in the end to provide the overall vision for the strategy and that was to simply reduce the number of people Doncaster placed in institutional care. The councils performance in allowing people to remain in their own homes as long as possible is poor in the region and as a result, it places more people in residential care than other councils in the Yorkshire and Humber region.

Feb 13-2

(Click on the graphic for a larger image)

The One Page Commissioning Strategy is now ready for wider consultation and will feed into and form the basis of the draft Commissioning Strategy for Adult Social Care at the end of January. However the basis of the work has begun to allow officers in Doncaster to understand the importance and value of "co-produced" commissioning and the use of person-centred tools to achieve its aims and aspirations.

A bold new vision for patient-centred care

Earlier this month, Prime Minister David Cameron launched a new 'friends and family' test, to be introduced into every NHS hospital in England from April.  Upon leaving hospital, patients will be asked whether they would recommend the service they have received to a loved one. This measure is part of a broad governmental drive to raise standards of patient care, which I fully support. But I wish it went further.

Last April my own mother was hospitalised after a road traffic accident and her experience of care was not a positive one. From being treated like 'the broken leg in the far bed', to having the wrong name on her bed - Caroline not Carolyn, she would not recommend the service she received at hospital.

Mum's experience may not be unusual.  It made me think about how a patient's experience could be different: could be patient-centred. What if hospital care was delivered as if patients mattered as people?  What if we cared enough to ask patients about their expectations for their hospital stay before they even arrived, not just after they have left, as in the 'friends and family' test.

  • What if you only told your story once and every time a nurse or professional asked you more questions, they were building on what you had already told them?
  • What if you were known as a person and people knew a little about what mattered to you as an individual?
  • What if you knew a little about the nurses and staff, so that they felt like people as well?
  • What if you knew who your 'team' was and when they were coming each day, as well as a nurse who was responsible for making sure you were comfortable and had as good a day as possible?
  • What if you had an opportunity to tell people safely how your hospital experience was going for you, whilst there was still an opportunity to make it better (rather than a questionnaire after you have left?)
  • What if night staff saw their role as helping you sleep well?
  • What if you were part of the planning and decision-making about when you were transferred or were discharged home?
  • What if you were contacted after you arrived home to see how you were getting on?

We are exploring these and other questions with the senior management team, nurses and health professionals at a hospital in Bispham, Blackpool. Here, we have developed a process, our vision of what a truly patient-centred experience could look like, based on my mum's experience and how it could have been different.  We'll be implementing and refining this process over the next few months.

Here is a graphic of how we think my mum's experience could have been different.

Jan 12

The assessor, would have gone to meet her in hospital and started to develop a patient-centred profile about what is important to mum and how to support her at Bispham. This would include information about how mum usually sleeps, her hobbies, interests and family. During that conversation, the assessor would have built on the notes she read about mum and talked about what the unit could offer her - also giving her a chance to discuss her own expectations of the unit. They would have decided together the best day and time of day for mum to arrive. The assessor would then check the information that mum was happy to have shared on a profile, which would be posted above her bed, for staff to read.

When my mother arrived, the receptionist would know she was due and would have read her one-page patient-centred profile.  She would welcome mum by name (her right name!) and perhaps ask whether her daughters would be visiting that night (or another question to illustrate that she was known as a person).  This simple question would reassure my mother that the hospital knew all about her.  As mum was taken to her bed, she would have seen a display of the staff team, each with a photo, and their role, as well as a little bit of personal information about them.

Within an hour, mum's named nurse would have met her and completed her admission. It would have been clear to mum that the nurse knew all the information she had previously told the assessor, as the conversation built on that. Mum's patient-centred one-page profile would be on the notice-board behind her bed, large enough for people to read.

Mum's named nurse would introduce her to her 'team' by showing her the mini profiles of the physiotherapist who would be working with her, and any other professionals, and a timetable of when these sessions were likely to be.  The nurse and mum would then decide the best visiting times, personalising them depending upon mum's energy levels and what was possible for her family and friends.  The nurse would tell her about the unit's volunteers, asking whether she'd like to be introduced to someone with similar interests, then she would take her on a tour of the unit.

Each day, the nurse responsible for mum's care that day, would ask her what a good day would look like for her. Mum might say, it would be walking an extra three steps unaided, or writing a letter, or having a good game of scrabble. The nurse would write this on mum's notice-board and at the end of the day the night nurse would ask mum how that had gone.

The night nurse would be responsible for helping mum have the best night's sleep possible - this is not just about sleeping tablets, but a range of ways to help patients sleep well, including individual soothing music and eye masks.

Most patients stay at Bispham for between 10 and 14 days. After five days, the nurse manager or a volunteer would talk to mum privately and ask her about two things that were going well, two things that could be better and two things that she would like to see in the hospital in the future. This information would both be used to improve mums' stay immediately and to give feedback directly to staff.

Mum's progress would be discussed with her and the therapists involved in her care, around her bed, rather than separately in multidisciplinary meetings, reflecting the 'nothing about me without me' philosophy of the unit. Finally, when it came to thinking about discharge, mum would be asked how and when she wanted to leave. Her updated profile would be sent to the health professionals who she would be involved with after she left hospital. A week later, she would get a call from the hospital to check how she was doing at home.

We've already made a start at the Bispham unit.  Profiles of the nurses and health professionals are up on the walls, so new patients can learn about their team and understand more about them as people. Staff have started to ask each patient what is working/not working and what is important in the future.   The Bispham team is determined to implement this entire vision of first class patient-centred care.

To those who say that patient care at this level is impossible, and unaffordable, we will keep you posted on how we are doing through our new dedicated blog http://personalisinghealth.com.

In my hometown

This year I have been working in my hometown of Stockport, around the on-going challenge of transition. I think it was about ten years ago when I started working on transition with Martin Routledge as part of the North West Training and Development team, and it remains a 'black hole' for families. It is brilliant to have an opportunity to try and change transition for and with families in Stockport.  Working with Sam Newman, we began by spending time with families, schools, health and social care staff, in both children's and adult's services to learn what is working, and not working and what people wanted to be different in the future. From this analysis, families built a vision of what they wanted for the future, from 0-25 years.  I spent Thursday evenings in a community centre with families from the parent organisation PIPs, to facilitate and record this vision. Family members shared their stories and experiences, and from this we described how they wanted the future to look. We captured this as this 0-25 Vision.

Dec 12

I think this is one of the most radical and yet still ordinary visions about how 'transition' can be different. There was a strong message about having one person - whether that is a key worker, or Local Area Co-ordinator, to support a family throughout their journey. Building family resilience is central - through the support of other families (as brokers), through family leadership, and through Circles of Support. We looked at the 0-25 single plan, and using person-centred practices in schools, as well as personal budgets, housing and employment. Post 16 provision must be different in the future, and lead to paid work for example through micro-enterprises or supported internships.

Our next step was to share the 0-25 Vision with health, education and social care senior managers (this is the presentation that we filmed) and consult more widely with families through social media, meetings and events.

Last week we moved from a great vision, to starting to make it happen.  We identified 21 areas where we wanted to learn from best practice nationally. Families, HSA and people from the Children's Disability services shared the tasks of doing the research. We presented it back to the most diverse group I have ever worked with in Stockport, who met for a day to review what we had found and together identify priorities to explore further. There were head teachers from both mainstream and special schools, a health commissioner, head of adult services and the personalisation lead, social workers, providers and most importantly, a third of the group were families.  The outcome from the day was a series of priorities in three key areas - family resilience, post 16 options, and personalising education.  The next steps are to develop these into costed proposals to consult on, before any final decisions are made.

There is something important about working with families and the Council to make it happen in my hometown. I am part of co-production in action, working with family leaders from PIPs, and the council, and feeling equally accountable to both. I want Stockport to be a place where families don't fear transition, because it does not exist anymore. My daughter is 18 and I am supporting her to plan her future and leave home (however many times she chooses to come back again!) without calling it transition. This is where we started our vision - what do we want for all of our children as they become adults? As we edge into 2013, I hope that my December blog for next year, will be able to share what we have tried and learned, and what families now say is different, here, in Stockport.

The history of one-page profiles

On Monday we launched a new film about one-page profiles in schools at the House of Commons.  I introduced the film by explaining how one-page profiles got started. Afterwards, Ian Hart, a leading person-centred trainer, said that he had always thought that Arthurs was the first one-page profile, so my blog this month, is to explain how it all happened.

My daughter, Laura, had the first one-page profile when she was six, eight years ago.

She had been in Year 2, for three weeks, when she came home one day in tears, saying the teacher had told her off for wearing the wrong trousers in PE.

When we went to see Laura's teacher, she explained that she had not told Laura off, but had pointed out that if she only had shorts, and not jogging bottoms, then her legs would get cold. She also said that she had not really been able to get to know Laura, as she is quiet in class.

We decided that we needed to help the teacher to learn more about Laura - and quickly. At that time I was the Department of Health's expert advisor in person-centred planning, and I knew this could be a helpful approach, but I also knew that teachers would not have the time to read the detailed plans we were using. So, I created a one-page version for Laura - a one-page profile. At first we called it a one-page plan, but quickly realised that was wrong, as all plans should have actions. Instead, this was a person-centred summary, a profile, of who Laura is and how to support her.

Laura First OPP

The first part of a one-page profile is an appreciation - what people like or admire about the child. We involved Laura's extended family in contributing to this. It was lovely for Laura to hear what her family likes and admires about her. Then, over a hot chocolate in a cafe, Laura and I thought about what was important to her - her yellow Teddy Sunny who slept on her bed, her three cats, the stick insects and wondering if their eggs would hatch; and what we know as her parents about the best ways to help and supporter her - recognising that she finds change difficult and needs lots of reassurance, and that she can perceive a small negative comment as a big telling off.  Laura drew a picture of herself for the background of the profile and we made an appointment to share it with her teacher.

'This would have been very useful to have had at the beginning of the year', she said. She talked about how helpful this information would be at some of the important transition times, like children coming from nursery into school, and moving from class to class.

Laura's one-page profile helped her move from class to class. Each year we updated it with Laura, and her teacher and Laura drew a new picture or chose a photo of herself.

Laura new opp

Fast-forward now to 2012 when, at the same school, Norris Bank, every child has a one-page profile. This film shares, how they have made this happen, and the difference it has made. Back when Laura was six, and I was nervously sharing her first one-page profile with her teacher, I would not have believed that we would be sharing a film where the incoming Chair of the Association of Directors of Children's Services, Educational Psychologists, teachers, children and parents, from both primary and secondary schools would share what one-page profiles mean to them.

The film is part of a new website - Personalising Education, where this journey continues, and you can read how our partner schools, in the UK, Canada, and even India, are using one-page profiles, and person-centred practices to bring about deep changes through personalisation in education. A quiet revolution?

If you are interested in exploring this with schools you are connected to (as parents, teachers or Governor) please email me. We would love to know who is doing this, and will happily give you free resources and offer support in any way we can.

The MGS journey into the world of Personalised Education and One-Page Profiles

This month's guest blogger is Andrew Smith, the head of middle school The Manchester Grammar School.

 

The MGS journey into the world of Personalised Education and One-Page Profiles began with a perennial series of challenges that have presented themselves to me in my role as Head of Middle School. Over the years I have done this job I have  become increasingly aware that there are hidden dimensions at work in education linked to independence, motivation, self- knowledge and structures of support that have a profound effect on the outcomes for different pupils. The extent to which a pupil will flourish, develop a range of aptitudes and ultimately be happy, fulfilled and successful at school will often depend on factors that go beyond classroom learning. I am convinced of the necessity for schools to address and to try to positively influence this arena. The challenge, for us MGS, is to develop an evolving programme which creates opportunities for independent thinking, self-reflection and challenge, aspiration and goal setting and the development of supportive mechanisms for our pupils.  At the heart of this process should be dialogue with the Form Tutor acting in their role as academic and pastoral mentor.

The other challenge that faces the school is rather more prosaic though hardly less important. This involves the development of a functional and useful Record of Achievement for each pupil that would create a profile of achievement and experiences throughout a pupil's career at MGS and eventually act as a resource for writing their UCAS personal statement and curriculum vitae. We have experimented with various manifestations of Records of Achievement, including some rather glossy 'social networking themed' variations. However, none of these have been particularly successful either because they have degenerated into 'box -ticking' exercises or that they didn't seem to really fit the needs of pupils at MGS.  There is a need to create a 'bespoke' version for MGS which is meaningful for our pupils, allows us to value their achievements and experiences and facilitates our pupils in the independent management of their profile (which, of course, is a valuable activity in itself).

Inspiration and the first steps towards involvement with HSA and the concept of personalised education came through my wife Tabitha's work at Norris Bank Primary School where they already have a great deal of experience successfully delivering the One -Page Profile project to children at the school. After several conversations Tabitha agreed to come into school to talk to my team of deputies about her school's experience of working with One -Page Profiles. Although the needs of primary school and secondary school pupils are very different we immediately saw the value of what had been achieved at Norris Bank and ideas began to gestate about applying these principles at MGS. This was soon to be followed with a meeting with Helen where we, very quickly, had the sense that this was a truly serendipitous moment for the school. Helen brought with her a philosophy and methodology that was flexible, robust and had real integrity. We brought a question looking for an answer!  Over the course of two meetings a plan and a set of resources began to emerge. We also began to map how we could use one-page profiling across the school year.  Two year groups (Years 9 &10 ) were identified as the most suitable for the pilot project. The next step was to introduce the ideas we had generated to the Form Tutors and convince them of their value!

Making Progress for Providers

This month I have invited Commissioner, Samantha Leonard, to be my guest blogger.

 

What does personalisation look like 'on the ground' for people living with dementia? As a commissioner of services for people with dementia, this has been a big question for me, and one I know that many organisations and providers are also wrestling with. Being part of the team who developed 'Progress for Providers - Checking your progress in delivering personalised support for people living with dementia' gave me an opportunity to really think about this with providers, practitioners and an academic, Trevor Adams.

The Progress for Providers series is well regarded nationally and used extensively by all the commissioners in Lancashire, so my first question was do we need one specifically focusing on dementia?

The dominant approach within service provision to people with dementia is 'person-centred care', an approach initially developed by Tom Kitwood.

I think there is some confusion about whether person-centred care is simply the same as personalisation, and this was something that we wanted to explore. The existing Progress for Providers do not have a strong focus on the role of the carer, and this is crucial when we are thinking about personalised services. We also wanted to directly show how person-centred practices are the foundation to delivering personalisation, and show how they can help deliver the Dementia Action Alliance - National Dementia Declaration and the TLAP Markers for Progress.

Our first sessions were like going back to college - Helen Sanderson facilitated and we had posters on the wall, looking at the contributions of the leading thinkers in dementia, from Tom Kitwood to David Sheard. We wanted Progress for Providers to both reflect this legacy and show how personalisation both builds on person-centred care and extends it by its strong focus on choice, control and citizenship.

From this we built on the themes from the original Progress for Providers. Then we tested out our first drafts with people delivering services, with special interest groups, and policy folk. This took us to draft 2.

How well did we do? You will be the judge of that. I was personally delighted with the comments of Alistair Burns - National Clinical Director for Dementia, Jeremy Hughes - Chief Executive, Alzheimer's Society and Barbara Pointon MBE - Former carer, Ambassador for the Alzheimer's Society and Dementia UK, member of the Standing Commission on Carers, in the forwards!

The Alzheimers Society is working with us to extend the consultation to people with dementia and carers.

As for me, I am busy rolling it out across Lancashire County Council.

/media/75875/progressforprovidersdementia.pdf

 

Samantha Leonard, Joint Commissioning Manager, Lancashire County Council, Adult & Community Services

Using one-page profiles in GP patient records

Once a month I have an 8.30am call with my colleague Tracy Meyerhoff in Hull. We talk about the work she is doing around end of life and using Living Well. I always leave the call excited about what she is doing. In the last 5 minutes of our call today she casually mentioned how GP's from the Haxby Medical Group are using one-page profiles. This blog describes what she told me.

A care home was closing in Hull and the people who lived there were moving to another part of the city and therefore needed to change GP's as well. They joined the Haxby Medical Group in east Hull. It was not a smooth transition, and there were lots of issues and challenges for everyone in the first few months. Tracy decided to meet with the practice manager, and shared the individual's one-page profiles. The practice manager was so impressed with them, that she shared them with the GPs' and the end result was that all of the GPs, pharmacists and other staff all did their own one-page profiles. These one-page profiles were shared with the five people so that they could 'meet' the staff and GPs.

The lead GP was very interested in the person-centred thinking tools, particularly the tools around communication, decision-making and relationships. She visited her new patients and looked with them at how they had been using person-centred thinking tools.

Now, if any of the five people need an appointment with their GP, the receptionist pulls up their one-page profile, as they are on System 1. The one-page profile informs the appointment, for example, for one woman it is important to her that the person she sees does not wear a white coat, in another person's one-page profile there is specific support information with regards to taking blood, and what needs to happen to make that as easy as possible for the patient and nurse!

The GPs' describe the benefits of using one-page profiles as part of the patient records in terms of getting to know someone easily and quickly; being able to communicate and support the person in making decisions; and also, in efficiencies.

We will have more information about the benefits in a few months, as we do further work with the GPs around extending and developing their innovative practice using one-page profiles.