Prudent healthcare challenges us to ‘remodel the relationship between user and provider on the basis of co-production’. However co-production is a concept that is often thought of in the context of service (re-)design, rather than in clinical consultations.
So how can co-production work in one to one interactions? Co-production is an approach to public services based on equal and reciprocal relationships between professionals, people using services, their families and their communities. These are the same relationships that need to be in place to deliver person centred care through shared decision making and self management support. So, if we are able to support our service users to take a more active and confident role in managing their health and conditions, we will be nearer to achieving a prudent approach to healthcare.
This time last year we held a master class focussing on co-production, where we looked at co-production at both levels. Petrea Fagan (Centre for Self Management Support, Cambridge University Hospitals NHS Foundation Trust ), Ann Jones (Continuous Service Improvement Team, Cardiff and Vale UHB) and Andy Phillips (Director of Therapies and Health Science, Abertawe Bro Morgannwg University Health Board) presented ways to support clinical co-production. Petrea showcased supported self management and the impact it can have on people’s ability to manage their health and conditions. Ann shared the work developed in Cardiff on shared decision making as part of the Magic programme, whilst Andy introduced a seven steps framework, designed to support professionals apply person centred care in the context of clinical co-production.
Over the past year we’ve been working with these clinicians to demonstrate how the two skills sets (shared decision making and supported self management) can work together when clinicians interact with patients using the Co-creating health framework. We have also been looking at how we can further support patients through the Education Programme for Patients (EPP Cymru).
On 27th October a pilot collaborative was launched to test this approach. Teams from Cardiff and Vale UHB (Lower back pain) and Abertawe Bro Morgannwg UHB (Audiology and Podiatry) came together for the first of three learning sessions.
There is a growing body of evidence that suggest the two approaches are effective, can improve service users’ motivation, the extent to which they eat healthily and exercise, their symptoms and clinical outcomes, and can change how they use health services. The pilot is aiming to not only develop further evidence of their synergy, but also to provide a better understanding of how such a collaborative can work in practice to deliver changes in relationships between clinicians and patients.
The lessons from this pilot will inform a number of future activities from 1000 Lives Improvement that can help NHS Wales apply prudent healthcare.
Follow us on @1000LivesPlus for the latest from our National Learning Event 2014 and join the conversation using #1000Lives.
Senior Research Scientist Dr Angela Coulter joined us at our National Learning Event master classes day to speak to us about Person Centred Care, watch the video here.