Croydon
Clinical Commissioning Group
Improving the health and independence
of older people in Croydon
Feedback Meeting
6-8pm, Thursday 3 July
Bernard Weatherill House, Croydon
Croydon
Clinical Commissioning Group
Welcome
Hannah Miller
Executive Director for Adult Services
Croydon Borough Council
The challenges
• Croydon has both a growing and ageing population
• Increasing numbers of patients are living with long-term conditions
• There is potential for Croydon to improve its performance in terms of care
for patients over 65
Croydon
Clinical Commissioning Group
What do want to achieve at this meeting?
• Set out the reasons why we are looking at services for older people
• Communicate how the views of the public, patients and carers have
impacted the design of outcomes
• Provide an opportunity for attendees to look at the outcomes and discuss
1.
2.
3.
How the views of the public, patients and carers have impacted the design of
outcomes
The outcomes and find out from you if they reflect the needs of people over 65 in
Croydon?
what difference these outcomes might make to future services for over 65’s
Croydon
Clinical Commissioning Group
5
Agenda
Time
Topic
Lead
18:00 –
18:10
Welcome
•
What do we want to achieve tonight?
Hannah Miller
18:10 –
18:35
Overview of engagement work
•
What have we been doing with the information we have collected?
Liz Bailey
18:35 –
19:05
Break-out session 1 – Sharing the Outcomes
Liz Bailey
19:05 –
19:35
Break-out session 2 – Measuring the impact
Liz Bailey
19:35 – Close
Close
• What is the vision for older people’s services and how will outcomes help us achieve this?
Dr Agnelo
Fernandes
Croydon
Clinical Commissioning Group
Croydon
Clinical Commissioning Group
Developing outcomes
with Croydon residents
Liz Bailey
Outcome Development Lead
Outcomes Based Commissioning
Engagement Programme
What have we been doing?
• Engaging with a wide range of people who live in Croydon.
• Engaging with clinicians and practitioners who work in health
and social care in Croydon.
• Collecting views, opinions and information about health and
social care for the over 65’s.
• Running working groups with volunteers to develop an
Outcomes Framework.
Croydon
Clinical Commissioning Group
Summary of Engagement Activities
3 public
Events
One to One
Interviews
Lunch Clubs
Surrey Street
Market
Access
Croydon
BME Forum
Event
Carers Day
Event
Sheltered
Housing
Primary Care
Engagement
Clinician and
Practitioner
Engagement
Working
Groups
Croydon
Clinical Commissioning Group
Quotes from engagement events
“Small groups
meant we were
able to input into
the variety of
topics under
discussion”
“There were
well run, well
organised group
discussions”
“It enabled us to
express our thoughts
and learn about
other people’s views
about the needs in
Croydon”
“Diversity of the
group – age,
ethnicity & gender.
It was very
informative”
“Good discussions
– we were able to
put points
forwards”
Croydon
Clinical Commissioning Group
What is an Outcomes Framework?
High Level
Outcomes
Outcome
Goals
Outcome
Indicators
Incentivised
Indicators
• Produced with local people, clinicians and voluntary
sector
• Give more definition to the high level outcomes.
• Allow us to clearly demonstrate achievement or
otherwise of the outcomes.
• Chosen to incentivise outcome improvement
Croydon
Clinical Commissioning Group
How the Outcomes Framework was developed.
Literature
Review
Events & 1:1
interviews
Working
Groups
• Looking at best practice care internationally
• Four themes were identified
• Themes were then used in our engagement events
• Feedback, data and ‘I’ Statements collated from the events.
• 4 high level outcomes (‘I’ Statements) were then generated
• Data used to develop first draft of outcome goals
• Volunteers from the public events, Clinicians and practitioners
• Tested and further develop the outcome goals
• Develop potential indicators
Croydon
Clinical Commissioning Group
How ‘I statements’ become “high level outcomes”
Long Term
Conditions
• I would like joined up treatment via a case manager who has access
to all areas of health and social care.
• I would like to keep a dedicated GP who knows about my
medical/personal history.
I want to be supported by a member of
the health and social care team who has
had the training and has the specialist
knowledge to understand how my
health and social care needs affect me
Unplanned
Care
• I feel known as a person and a service specific to me
• I have care with the right input at the right time to return to
“normal” as soon as possible
• I need treatment quickly and tailored to my needs.
I want to be supported as an individual,
with services specific to me
• I would like to know that support is available if my health
deteriorates.
• I want service to keep me as healthy as possible for as long as
possible.
• I would like to be advised of opportunities and facilities to improve
my healthy lifestyle.
I want to stay healthy and active for as
long as possible
Keeping
Healthy and
Well
Independence
• I feel safe inside my “home”
• I feel people should be helped to stay in their own home or
appropriate setting
I want to receive the best quality care
available in order to live as I choose and
as independent a life as possible
Croydon
Clinical Commissioning Group
The High Level Outcomes
I want to stay healthy and active for as
long as possible.
I want to receive the best quality care
available in order to live as I choose and
as independent a life as possible.
4 High Level Outcomes
I want to be supported by a member of
the health and social care team who has
had the training and has the specialist
knowledge to understand how my
health and social care needs affect me.
I want to be supported as an individual,
with services specific to me.
Croydon
Clinical Commissioning Group
How were ‘outcomes’ and ‘outcome goals’
developed
High Level
Outcome 1
Outcome
Goal 1.2
Outcome
Goal 1.10
I want to stay healthy and active for as long as possible
Prevent Obesity and
malnourishment
Eat well and keep
active from a
younger age - not
just waiting until
retirement
eat well and keep
active from a
younger age
Avoiding Loneliness
Being socially
included
Sense of purpose
Croydon
Clinical Commissioning Group
Live as sociable a
life as desired
Working Groups
• Three Working Groups were held in May and June.
• Participants were: Members of the public who attended Town
Hall Events, clinicians and practitioners from health and social
care organisations.
• Working groups used the raw information we received from
the public and patients
• Outcomes and Outcome goals were refined to produce an
‘outcomes framework’
Croydon
Clinical Commissioning Group
Working Groups
Involvement from the public
• Why I volunteered.
• How I contributed as a member of the group.
• What I understand about the process.
• Why it was important to have public involvement in the
development of the outcomes.
Croydon
Clinical Commissioning Group
How engagement has shaped the outcomes
• The engagement activities were co-designed with local
voluntary sector organisations.
• As a result, we have engaged over 400 Croydon residents
through a range of engagement activities.
• All suggestions are properly considered and priority given to
those where there has been agreement about their relevance
and importance.
• The views of the public, patients and carers have
fundamentally shaped the outcome framework
Croydon
Clinical Commissioning Group
Breakout session 1 – Sharing the
Outcomes
• What difference will these outcomes make to
future services for over 65’s?
• How might things change?
Croydon
Clinical Commissioning Group
Breakout session 2 – Measuring the
impact
Using one of the outcome domains as an
example answer the following questions:
• What will this mean for services, patients,
carers, clinicians in the future?
• How will we know this is happening?
• How will we know the outcomes are being
delivered?
Croydon
Clinical Commissioning Group
Outcome 1.
I want to stay healthy and active for as long as possible.
Outcome Goals
•
•
•
•
•
•
•
•
•
•
•
•
•
Be able to manage my memory loss and dementia
Eat well and keep active from a younger age
Have access to information, that is consistent, in a format that is accessible and understandable to me.
Expect and have access to proactive and preventative care
feel that their wider social networks (including faith groups) are involved and supported to help me stay
well
Feel that I and my family are supported to help me stay well
Have access to appropriate choices about services
Have equality of access to services regardless of where I live and my financial status.
Live an active a life as possible
Live as sociable a life as desired
Maintain positive mental wellbeing when my circumstances change.
Plan for old age – emotionally, e.g. coping with physical, mental and social decline
Plan for old age – Practically, e.g. finances, washing (life skills)
Croydon
Clinical Commissioning Group
Outcome 2.
I want to receive the best quality care available in order to live as I choose
and as independent a life as possible.
Outcome Goals
•
Meet my full physical, mental and social potential
•
Plan for a more dependent future... whilst I can
•
Plan for old age - Practically e.g. finances, personal care ...life skills
•
Meet their full physical, mental and social potential
•
Live "at home, not in a home" for as long as safely possible and for as long as I choose, including by self-care
•
Know how to access services
•
Feel that my wider social networks (including faith groups) are involved and supported to help them stay well
•
Feel safe in my own home
•
Feel safe in my community
•
Expect and have access to proactive and preventative care
•
Can access opportunities to meet my desire for social activities and choose when and where I meet others and socialise
•
Carers and families feel supported to help people to maintain my well being.
•
Access transport and travel options
•
Access respite care when needed
•
Access appropriate housing
•
Access appropriate assistive technologies to support my access to services and my independence.
•
Manage the process of gradual deterioration in: eyesight, hearing & mobility and mental capacity including self care
Croydon
Clinical Commissioning Group
Outcome 3.
I want to be supported by a member of the health and social care team who has had
the training and has the specialist knowledge to understand how my health and
social care needs affect me.
Outcome Goals
•
Be assured that when something unexpected happens their next of kin and GPs are contacted early to find out about me.
•
Can experience appropriate translation services
•
Manage the level of pain experienced
•
Expect care from the right person at the right time in the right place
•
Expect care that is on time and punctual.
•
Have help to navigate my way though the system
•
Expect information that is in line/coordinated with the care I receive
•
Expect integrated and co-ordinated healthcare, social care and voluntary sector involvement
•
Expect to be respected and treated as an individual even in a group with similar needs
•
Expect and receive support to ensure appropriate treatment / feel I am a partner in their decisions about my care
•
Expect that the care I receive will be safe
•
Expect to be treated as a whole person (holistically) and not a single condition including social, cultural and psychological
aspects
•
Expect to have a plan in place that anticipates crises
•
Expect a timely recovery to maximum possible level of health.
•
Receive information that is in line/coordinated with the care I receive
•
Expect to receive a good care when in a crisis
Croydon
Clinical Commissioning Group
Outcome 4.
I want to be supported as an individual, with services specific to me.
Outcome Goals
•
•
•
•
•
•
•
•
•
•
•
•
Expect care from the right person at the right time in the right place
Expect consistency of care between providers
Have access to information, that is consistent, in a format that is accessible and understandable to me.
Expect integrated and co-ordinated healthcare, social care and voluntary sector involvement
Expect that the care I receive will be safe
Expect my feedback will be listened to and effect change where appropriate
Expect to be treated as a whole person (holistically) and not a single condition including social, cultural
and psychological aspects
Experience care that is tailored to me, physically psychologically and socially including with regard to
issues around privacy.
Experience care that is timely including to prevent deterioration and promote recovery.
Feel supported to care for myself where appropriate
Feel I am a partner in their decisions about their care including identifying risks
Receive information that is in line/coordinated with the care I receive
Croydon
Clinical Commissioning Group
Croydon
Clinical Commissioning Group
Thank you
Dr Agnelo Fernandes
Assistant Clinical Chair
Croydon CCG