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Third Sector Engagement 19 June 2019 - Full Event Commentary

On this page you can find an overview of the event we held on 19 June 2019 to engage with our Third Colleagues about the Moving Forward Together Programme.

Jump to:

  1. Introduction and overview
  2. Presentations and commentary 
  3. Table top discussion summary
  4. Displays and discussion themes
  5. Evaluation 
  6. Next steps, find out more and get in touch

Introduction and Overview

On 19 June 2019 the Moving Forward Together Programme engaged with Third Sector organisations about how we need to transform health and social care services across Greater Glasgow and Clyde. Engagement is one of the principles that underpin the Programme and there has and will continue to be opportunities developed to involve patients, service users and carers to shape and influence how we transform health and social care services for the whole population.

Recognising the critical role the Third Sector has in directly supporting people and the reach into and trusted links they have with people and communities we hosted an event to engage, in this instance, directly with some of the larger organisations. The purpose of this event was to strengthen old and establish new relationships to enable us to work alongside each to jointly meet the challenges we are facing; and to ensure that the voice of those potentially most affected by transformation is heard to inform any redesign around their needs.

The event had 61 people participating from across 34 Third Sector organisations plus 11 colleagues attending from social care, Scottish Ambulance and Scottish Fire and Rescue services. To facilitate and engage in discussion at the tables and at the displays we had a range of senior management and clinical staff from across the Moving Forward Together Programme Board and Executive Management Group.

All feedback was captured and will be analysed to influence and shape how we further engage with the Sector to transform health and social care services. An evaluation of the event was also carried out by the Scottish Health Council. To briefly summarise what we heard we would say that:

  • The vast majority of participants recognise and understand the need to transform how we deliver health and social care services and agree with our direction of travel
  • There was enthusiasm and support from our Third Sector and other colleagues to transform services and we need to develop ways of communicating and engaging with them to ensure that they are not only more visible but incorporated in planning and redesign processes
  • We not only need to recognise and welcome the expertise that the Third Sector has but look at how we support and where appropriate work with and embed provision alongside or as part of statutory provision
  • Collaboration and true partnership working across settings and systems will enable us to consider the full range of resources, assets and expertise available and will allow us to develop new ways of working based on individual need to improve experience and outcomes

Presentations and Commentary 

The event was opened by NHS Greater Glasgow and Clyde’s Chief Executive Officer, Jane Grant, who welcomed everyone and reiterated the need for health and social care to embrace and integrate the important role of the Third Sector in care delivery. She presented and explained that the Programme was about taking a whole system approach to planning health and social care so that what happens in the hospital setting and in the community is truly joined-up.

Jane described that via the Programme a blueprint for future delivery models for health and social care in Greater Glasgow and Clyde and the West of Scotland Region had been developed by specialists from across the whole system. Using population data and available evidence we asked  cross-system teams to consider the demand and challenges we are facing and identify good practice or new ways of working to meet this that make best use of all our resources, skills and expertise.

She said that the concepts had been reviewed by people – patients, service users, carers and their representatives and together they will set our strategic direction of travel for the next three to five years and beyond. However, the detail of what this actually looks like is still to be determined and that working alongside the Sector was vital to ensuring we jointly deliver a new system of health and social care that meets people’s needs. Jane finished by playing an animation that provided an overview of the Programme and introduced Dr Chris Deighan.

Chris, who is NHSGGC’s deputy Medical Director, presented and started by talking about his experience as renal consultant, or as he put it a kidney doctor. He spoke about the medical advancements for treating kidney disease and improvements in outcomes and experience of people receiving care. However, over the years there has been a doubling of people undergoing treatment such as dialysis and following successful transplants there are more people on treatment and undergoing follow-up. He said this is happening in other conditions, including some that would have previously been fatal and the result was an increase in demand and complexity of care that the system is struggling to keep pace with.

Chris then stated that even if resource was available that simply doing more of the same was not the right thing to do. He explained that for most people being admitted to hospital for treatment and care should be the last resort and when they do need to be there then the time limited as it can often lead to a loss of function. This means that some people go home less able than before admission and for some conditions it can lead to symptoms being brought on easier and eventual readmission – the spiral of decline. This is why we need to move away from the traditional fix and treat model of care to one that focuses on self-management and reablement.

Chris went on to describe the tiered model of care proposed by the Programme that aims to provide integrated and seamless person centred care based on individual needs. This would see some services typically provided in hospitals shift delivery into the community setting with more care provided closer to people’s homes. However, as treatment and care becomes more complex this might be provide in fewer specialist centres to serve the whole population or region. To do this the Programme has three overarching strategic priorities:

  1. Maximising primary, community and virtual care opportunities
  2. Alignment with West of Scotland Regional Plans
  3. Optimising our hospital based services

He explained that innovation and the use of technology and digital information will be central to how we transform services. This will use joined-up records with improved information sharing across a range of settings with the right people involved – including patients, service users and carers given access to help them make better decisions. Chris finished by playing a video about the use of eHealth and technology before introducing Louise Long.

Louise, who is the Chief Officer for Inverclyde Health and Social Care Partnership, has background in social work and provided an example of how she had seen first-hand how services have changed over the years. She described that more and more there was a team approach to providing health and social care that also recognised and looked to the Third Sector, volunteers and community assets to not only support people, but help connect them to their communities and reduce isolation.

She presented the background to the Legislation around the establishment of Integration Joint Boards that direct how health Boards and Local Authorities will work together to provide health and social care services. She explained that via Health and Social Care Partnerships they have a responsibility to plan and commission a wide range of integrated services based on their strategic priorities and that these, across the 6 in Greater Glasgow and Clyde, aligned with the principles and aims of the Moving Forward Together Programme.

Louise spoke about the approach the Programme had taken to look at the whole system and said that Integration and the Partnerships offered increased opportunities to work with communities and create positive conditions to engage and support them in the improvement of health outcomes. However, it was also acknowledged that statutory services won’t be able to meet the challenges alone and again stated the vital role that the Sector and other community assets will play in transforming health and social care services.

Fiona MacKay, the Deputy Director of Planning for NHSGGGC, then finished the presentations by describing the engagement that had been undertaken with the public and some of the feedback heard to date. She said that as well as asking people if they understood our need to change and the direction of travel set out by the Programme that we wanted to know what mattered most. For this people told us that the things that contribute to person centred care were important. They expect care that is consistent and coordinated with people treated as individuals and for services to recognise the knowledge, skills and experience they have, but above all good communication with them and across services and settings was crucial.

She said that although people fed back that wherever possible they wanted local, timely access they also recognised the challenges that health and social care were facing and that change was required. They widely accepted the direction of travel to provide more services closer to home and an increased use of technology; however it was important not to just shift care to home and ensure that people also remained connected to their communities. We also need to ensure we educate and support people to use services differently, to take more responsibility for their own health and to have more knowledge of and trust in alternative new models and roles.

Fiona finished by saying that people had also told us about the important role that carers, the community and the Third Sector play in supporting people and that they need to be more visible and involved going forwards. She said that today was part of working towards that and that the feedback generated from the table top discussions and through conversations at the displays would help shape this and explained the format for the rest of the afternoon.


Table Top Discussion Feedback

During the session we asked participants to spend some time broadly discussing the following two questions:

  1. How can health and social care service optimise how we work alongside the Third Sector to meet the challenges we face?
  2. How can we ensure that we are able to reach, engage with and involve people to deliver services that meet their needs?

All feedback was logged and collated and the following is a summary of the key themes discussed:

Recognition and Parity

We heard that statutory services need to acknowledge the significant role that the Third Sector plays in providing not just additional, complementary support but direct care that contributes to reduced demand for health and social care services. We need to welcome and better understand the knowledge, skills and experience the Sector has ‘working with people where they are at’ and enabling them to live more independent healthier lives and factor this in to future planning.

There was some discussion that that the Sector can be seen as a ‘lesser’ or ‘cheaper’ alternative; however the expertise, albeit deployed differently, is often on par to that of statutory services. There is also a perceived ‘imbalance of power’ with some describing unequal partnerships where statutory services make all the key decisions. If we are to work more effectively together then we need to consider the skills and resources each other has and jointly assess how these can be better aligned and utilised to meet people’s needs across the whole system.

Resourcing

There was discussion about the commissioning and funding of services and the Sector having to ‘chase the money’ which is often short-term. This not only pits services against each other but prevents long-term strategic planning, consistency and sustainability. The increased demands and financial challenges within statutory services is also affecting the Sector and they need to work with us, but also collaborate look at best use of limited resources to prevent competition by mapping out and recognising each other areas of expertise and working together to maximise efficiency across the system.

We heard it is not a case of ‘paying lip service’ to the sector and any recognition needs to be backed up with adequate support and resourcing – this always doesn’t need to be financial, but looking at how to share space, assets or providing support through access to technology and admin can help ensure the viability of some smaller organisations. This was tied to parity and if the Sector provides a valued service then this needs to be considered as part of the shifting the balance of care and any resource attached to it.

Relationships and Communication

There was discussion that relationships can often be at a very senior strategic level and often only with the bigger organisations, or alternatively there is sporadic individual level relationships with some frontline staff and services. However, there is no consistency and often health and social care staff know very little about what the Sector provides locally and vice versa. Better communication could help bridge the gap and improve knowledge of and use of services and although this requires resource there is already expertise within the Sector to help facilitate this.

We heard that there is better knowledge and use of services on sites that have patient information centres, but that this is often self-directed or something ‘you give people information about on discharge’. There was talk that organisations could be involved much earlier in pathways and that health and social care staff have a key role in ‘opening doors’ for patients and service users and can instil confidence by directly referring or making the connection with people. However, we heard that there are often barriers to this around internal governance, assurance and protocol – something that can be overcome via establishing better communication and relationships. 

Reach Into Communities

We heard ideas about how to raise awareness of the programme and reach into and engage with communities about the transformation of health and social care services. The means and methods varied depending on the audience, but most agreed that use of social and digital media was increasingly how to communicate with people and how they communicate with each other.

However, articles and stories for newsletters that can easily transfer to print can be useful and we also need to be mindful of those with any sensory impairment and make our content as accessible as possible e.g. have British Sign Language on videos. Also, we heard that often what is valued most is having someone from health and social care speaking to people in person to present ideas and hear feedback and the Sector can help develop opportunities to do this.

There was general agreement that we could work alongside the Sector to enhance how we communicate with communities about the Programme and that they could utilise their channels of communication and trusted networks to extend our reach. This included using social media including ‘closed groups’ and peer networks to not only raise awareness but to empower and educate people to self-manage or used services differently.

There was positive discussion that if we link more closely going forwards and work in partnership we can communicate with people and specific communities via the Sector to reach those potentially most affected by any redesign. This will ensure the Programme and any emerging project can hear what matters most to them to influence our plans to transform health and social care services around their needs.

A copy of the complete presentation can be downloaded by clicking here


Displays and Feedback about the Programme and Workstreams

Following the table top discussion we invited attendees to browse the displays on the following topics:

At each display there senior programme leadership, clinicians and topic experts available to engage in discussion and hear feedback and comments. Below is a summary of the key themes we heard:

The Programme and direction of travel

  • People understand the need to change, but that we need to ensure we involve the Third Sector going forwards to enable patient, service user and carer led co-design.
  • People agree with the direction of travel but the values (key elements) and principles displayed that underpin the Programme need to be incorporated and visible.
  • People said we need to develop a system that is not based on diagnosis with disease specific pathways as those with multiple conditions can experience disjointed care. Instead the system should recognise individual and complex needs and work together with carers and non-statutory services to deliver coordinated care.

Third sector, community planning partners and other assets

  • We need to tap into the other expertise and intelligence that is available to us via other colleagues in housing and homecare as they often know a lot about the people they support
  • Can Third Sector services/expertise be introduced/utilised earlier in pathways e.g. in older people’s care they can support testing equipment and undertaking assessments at home
    • How do we bring all the local services together to have a clear picture of the range of support available to people at each point on their journey based on their needs
  • Make use of other community assets and resources e.g. libraries to improve digital skills, health literacy and other more social/dementia friendly activities to reduce isolation
  • Outreach models to provide more local care access to specialist services, but how will we ensure people have the same level of access to Third Sector services that might be co-located at specialist centres e.g. cancer services located at Beatson/Gartnavel

Coordination of Care

  • We need to recognise multi-morbidity – people can have more than one condition and we need to get better at coordinating care across consultants/appointments/interventions more efficiently e.g. people going to different hospital appointments on several occasions in the same week, or how one condition can impact another such as referral for surgery
  • Palliative care services need to be coordinated better to manage multiple needs e.g. look at col-locating different services currently across different sites. A person only dies once and often time is of the essence so services need to be able to move fast.
  • Homecare and other non-statutory services could be more embedded as part of health and social care services to be coordinated at a locality/cluster level e.g. via GPs alongside rehabilitation and district nursing services
  • Where and when appropriate we need to involve carers, identified or not, in care planning as early as possible

Supporting self-management

  • A good idea, but the new system (digital platforms) in terms of access would be a challenge to a person with dual sensory loss and how will we assist those who cannot read e.g. sensory impaired, learning disability or don’t use English as first language
  • Services for physical conditions need to consider and incorporate services that promote /support good mental health e.g. within diabetes a focus preventing mental health issues arising in teenage years in those diagnosed very young
    • Alternatively how do we ensure that those with mental ill health get appropriate support and care for any physical long-term conditions
  • We need to proactively make people aware of the Third Sector organisations and other services that can support them as early as possible in their journey
  • As well as more traditional health improvement there needs to be a focus on social prescribing to improve confidence, connect people to wider community, reduce social isolation

eHealth Digital Innovation and Technology

  • People agree that technology will be critical to how we redesign services, but the focus should be on how we enhance treatment and care without it replacing personal contact and relationships.
  • We need to ensure that people without access to/don’t use technology are not left behind; however recognise that efficiency realised via this can allow specialist to focus their time on those that need it most
  • Technology could help provided easier access to services and specialists for people that are disabled by reducing the amount of travel e.g. increased use of video consultations

Evaluation

An evaluation of the event was carried out by colleagues from the Scottish Health Council and the results of this can be accessed here.

Although we have tried to ensure that the above commentary and summary of feedback heard is as accurate and comprehensive as possible we welcome any further comments and observations from those that attended. If you want to get in touch with us about the event then please email us at: feedback@movingforwardtogetherggc.org You can also get in touch via this with us via this email to arrange a briefing or engagement session for your organisation and the people you support.


Next steps, find out more and get in touch

The Moving Forward Together Programme want to thank all our colleagues from the Third Sector and other organisations that took part and provided comment and feedback at the event. We want this to be the first of many conversations and we will use the intelligence we have gathered as the basis for this going forwards.

In terms of the next steps we are going to work with each of the 6 health and social care partnerships to scope how we engage with the Sector and other providers at a local level. Our intention is to create diverse networks to share information and allow us to reach out to communities and individuals to hear what matters most to transform services across Greater Glasgow and Clyde to meet the needs of the whole population.

If you are part of a Third Sector or other community organisation that wants to find out more about the Moving Forward Together Programme then please get in touch with us by emailing: feedback@movingforwardtogetherggc.org