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Putting the community at the heart of person-centred care

There was a time when ‘doctor knows best’ was the phrase that best summed up how the NHS viewed and treated us. Born in the deferential fifties, this approach to our health and wellbeing has at last been challenged from within by the NHS Five Year Forward View – there are plenty of patient activists who have been challenging the status quo for years. For sure, there are circumstances where I would hope my doctor does indeed know better than me, but even then I now expect to be a full participant in decisions about my health and wellbeing.

But the conversation has to be wider than the one I have with my doctor in the consulting room, indeed that’s generally far too late. Health and care leaders, commissioners and practitioners need to involve local people and communities in shaping local services and changing the culture. To this end NHS England established the People and Communities Board to realise the ambition set out in the Five Year Forward View to forge ‘a new relationship with patients and communities’. As a member of the Board I welcomed the opportunity to bring the valuable knowledge and experience that local infrastructure bodies have of the communities in which they work.

An early product of our work is the publication of Six principles for engaging people and communities, which aims to make it easier for local NHS bodies to create person centred and community focussed services. We hope that by using the information and suggestions in the document, it is possible to better understand and measure the impact of engaging with local people and communities. The six principles are:

Our purpose on the People and Communities Board is to ensure person-centred care and community- centred services are embedded in the Five Year Forward View programme and the expertise of patients, service-users, citizens, the voluntary sector and other stakeholders are harnessed to support and challenge the delivery of the Five Year Forward View.

We have managed to get these principles included in the NHS Shared Planning Guidance and the Sustainability and Transformation Plan guidance letter. This may sound a little bureaucratic but this means local leaders in the NHS and commissioners have to take notice. And it is important that they do because person centred care is not just a nice thing to do. As the report says “the evidence is increasingly clear that better engagement – by which we mean involvement and co-production – is not a nice-to- have, it is core business. There is a growing body of knowledge and practice that demonstrates that engagement is doable and has real impact.” Realising the Value is an important part of growing this evidence base and strengthening the case for change.

The government’s interest in this may be more focused on reducing the cost of acute care but we all have an interest in making sure that local services provide the best possible outcomes for those they exist to help. It is also the way charities do things. We have always prided ourselves on being close to our beneficiaries. Smaller charities and community groups are fundamentally person-centred.

Although the 6 principles are about health, actually they can – and should be – translated for other service areas. Shouldn’t all local services start with people?

I hope NAVCA members make sure their local NHS leaders get a copy of this document. Most will already accept the need for person-centred services. This document will help them think not just about creating person centred services but give them practical advice. It may just be the push that they need to really start looking at putting people and communities at the heart of local services.

Author

Neil Cleeveley

Neil has been Chief Executive at NAVCA since July 2014, and he was previously the NAVCA’s Director of Policy and Research. He leads a dedicated team that is the leading national advoca…