Catapult to Collaborative Care

Over the last two weeks I have enjoyed 5 full days of stimulating conversations and talks, at three different events with a wide range of experts about how to make the UK health and care system work more effectively. 

This started with the Digital Catapults Health and Social Care Pit Stop.  A group of academics, commissioners, technology professionals, government and local government employees spent three days unpicking how to apply digital technology to create and efficient and effective solution to integrating health and social care.  Unsurprisingly for me there was a consensus that putting patients at the centre was part of the solution.  I am however rushing ahead.  As most of the first day was spent defining the problem.  Some of the ideas discussed are illustrated on the diagram below 

 Problems with the current system included ;

• Costs - including the costs of providing health and social care are escalating
• Efficiency / customer satisfaction - including service user frustration at frequently being asked to repeat the same information to multiple providers. 
• Quality - lack of joined up information makes the analysis of information to achieve the best commissioning, diagnosis and treatment decisions impossible

Some of the problems are also illustrated on the picture to the left.

Problems and solutions were also informed by presentations from a host of speakers including;

• Charlotte Buckley - Deputy Director of People, Communities and Local Government 
• Mark Golledge - Local Government Association. 
• Hannah Miller - Croydon Council’s former Executive Director for Adult Services, Health and Housing
• Lee Omar - Red Ninja,
• Chris Hutchins - HSCIC, 
• Inderjit Singh - NHS England

 I found it interesting to hear that service users often assume that their health and care providers have access to more information than they do to make decisions

Day two started to assess possible solutions to the problems.  At this stage we were however encouraged to stick with divergent thinking, to look at the bigger picture and to generate lots of ideas before narrowing down.

Day three was focussed on applying convergent thinking to take the ideas already discussed into creating more concrete solutions.

I found it interesting that there was a lot of  consensus.  There was universal agreement about the need to put service users at the centre of the system.  Letting patients and or their family who should access to their data was suggested many times.  Another frequent suggestion was the idea of a single dashboard that could access information from all of the different information technology platforms that currently exist.  It ocurred to me that it was important to be mindful of the difference between information systems and information technology systems.  To solve the problems, we might need to create a more effective information system.  This could include a dashboard as suggested.  To do this, in the short term at least it might not be desirable or even possible to change the information technology within it.

I presented the solution created by the group I was working with.  Our ideas included;

• a dashboard 
• an information system that would enable data analysis to inform more effective treatment and commissioning decisions
• the social prescribing of physical activity and related apps /measuring devises
•  and the use of robots as companions to reduce isolation.  This last suggestion was however an April fools joke (we'd been encouraged to include one)

 The following links provide some more detail about the event 

• http://www.slideshare.net/CDECatapult/personalisation-of-social-care-pit-stop
• https://www.youtube.com/watch?feature=player_detailpage&v=KBNZytGEGdc

Last week I was one of three members of the Coalition for Collaborative Care's (Co4CC) Co-production group to be invited to attend the full Co4CC partners meeting.  The partners meeting included attendees from Co4CC's partners.  These are all organisations with an interest in transforming health and care through patient empowerment.  The meeting included staff from NHS England, Macmillan, NESTA and the Royal College of General Practitioners.  For a full list of partners see http://coalitionforcollaborativecare.org.uk/aboutus/our-partners/

Speakers clarified the aims of Co4CC.  This is focussed on putting the house of care model (illustrated below) into practice.  It has been piloted through NESTA's People Powered Health project.  More than medicine is one of the key elements to this.  As looking towards an approach based on much wider health objectives is needed to address financial issues and to provide effective care.

I found it interesting to hear that the Royal College of General Practitioners had been centrally involved in setting up Co4CC.  Their motivation was to help create an environment where doctors can continue to provide excellent care for patients.

There was discussion about how to put ideas into practice.  Building on existing good practice was  suggested to avoid reinventing the wheel.  Using the house of care as a model was generally agreed.  it was also however suggested that there also needed to be flexibility to allow for difference at local levels as different areas have different problems and differences in their structures.  One of my suggestions was that it is necessary to integrate health and care whilst engaging with the complex messiness of the system

I found it inspiring to see that there was so much commitment to the idea of patient empowerment.  It was however also emphasised that our work here is not yet done.  It does however feel like a privilege to be part of something that has the potential to influence positive change at a very high level. 

The next day I attended my first Co4CC co-production group meeting.  It was good to meet other group members.  It was good to see that the group includes a lot of different expertise from across the UK.  It was also good to see how the group was going to get involved in real initiatives and not simply just talking about ideas.