Dec 092014
Peter Bradley

Professor Peter Bradley

There are several strategic-level concepts being discussed across NHS Wales right now – ideas like prudent healthcare, co-production, and shared decision making. These promise to be transformational – not just changing what services NHS Wales delivers, but how they are delivered as well.

The key theme in all these big ideas is closer partnership working between the people delivering healthcare and the people using the services. But how does this work in practice? How can we take abstract ideas and make them a reality?

Recently, I chaired Empowering Communities to Better Health, a fascinating online seminar on how to engage with people to produce healthier communities. This was a truly international occasion – hosted here in Wales with contributors from New Zealand and the USA.

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Nov 182014


Dr Ruth Hussey MBE

Dr Ruth Hussey OBE

Redesigning Healthcare – Learning from the Nuka system of care to inform the development of healthcare in NHS Wales is the latest white from 1000 Lives Improvement which is being launched today at the NHS Wales National Learning Event in Swansea. There are some very important lessons for us to learn from it about how we involve people in the design and delivery of care.

The Nuka System of Care developed by Southcentral Foundation in Alaska is recognised as one of the most successful and innovative primary care systems in the world. Its success is down to a pioneering community-led model of ‘customer-ownership’, in which users provide regular feedback to inform the development of services that more effectively meet their needs.

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Feb 202014
Paul Gimson

Paul Gimson

Imagine what a primary care service might look like if we gave the patients the money and asked them to design it themselves. This was the story I heard recently at a presentation given by the Southcentral Foundation, a citizen-owned health-service provider based in Anchorage, Alaska.

The presentation was at a recent event in Cardiff looking at Southcentral Foundation’s Nuka system of primary care. It’s ‘A customer-owner driven overhaul of a bureaucratic system centrally controlled, to one in which the local people are in control.’ It is the use of this term customer-owner which is one of the most striking features of the Nuka system.

The idea of a patient as a customer might feel wrong in the context of the NHS, but in this case the term represented a shift from a service designed around a medical model to one where the patient’s needs were put first. The provocative question for us is, if we considered patients as customers would that improve the experience of being a patient in NHS Wales? Continue reading »