NHS England talk at CoCreating Welfare event

NHS England talk at CoCreating Welfare event


So we’ll introduce ourselves while we
just get the right slides up so I’m Lorraine Wolfenden, Leadership Support
Manager in the patient experience team NHS England and NHS improvement. Hello my
name is Helen Lee I work in the same team as Lorraine at NHS England and
NHS improvement and we lead on the Always Events programme which we’ll be
talking a little bit about and our co-creation journey and hi my name is
Lisa Ramsay I am service user voice Policy Manager
for the maternity transformation program team NHS England and NHS improvement so
how did we come together well we work that we lead on Helen and I that we’re
going to talked about in a minute which is a quality improvement methodology and
to improve the experience of care of people used in different care settings
hospitals community ecetera and one of the gaps that the people that we work
with felt they had was around co-creation some are doing it already
some it was a entirely new concept so we felt that we wanted to upskill people so
we were looking for something a course or something to do that and somewhere in
our team I’d seen something on Twitter from Gemma and Paul and with our maybe
that’s the thing that we can use so we then had a conversation with them who
put it in touch with Lisa and here we are we’ve worked together to co-create
something that’s worked really well and now l have the right slides so Gemma
talked about it this morning and co-production is the word that’s very
often used in NHS and in England and it’s not as Gemma said it’s not a new
concept it’s something that’s been around for a number of years and there
was actually a co-production model that was produced in partnership and
probably about four or five years ago know by the Center for collaborative
care and NHS England which talked about the values and steps for co-production
so it’s not a new concept it’s also in something called the NHS mandate which
is what it’s set out by the Department of Health and has key deliverables and
in there there is a specific target that states that by 2020 there’s a question
on the staff survey that goes out NHS staff around the percent asking
staff “do you use feedback, is feedback used to inform improvements in
your organization” and there is a direct mandate in there that says as an
organisation the NHS needs to get better at listening to what people are saying
about their services and with them improve services yes so Always
Events started within NHS England at the time back in 2015 and it was around the
time there I don’t know if people aware of Kate Granger the the consultant who
sadly passed away from cancer at a very young age and she had launched her hello
my name is campaign and the patient experience team at that time thought
that was a fantastic concept and something that should always happen for
people when they’re interacting with healthcare professionals but wanted to
take it a little bit further and and came across the Always Events
methodology and the aspiration was not just to deliver a program of work but
actually to create a social movement and made sure that the critical mass of
engaged healthcare organisations was reached then word would spread beyond
that direct communication between NHS England and those organizations and
people who hadn’t signed up to the programme would hear about it and think we
want to be part of that and that was the aspiration back in 2015 and a policy to
say that that’s the position we’re in now we have people contacting us that
heard about co-creation and Always Events and absolutely want to be part of that
that work so what do we mean by an Always Event people often think that it’s the
opposite you might have heard if you live in the world of the NHS you
might have heard of never events which are serious untoward incidences that
should absolute never happen such as amputation the wrong limb etc people
think oh it’s just the opposite it’s absolutely not the opposite the
difference is that an Always Event is about what’s important to people that used or
services not decided by health care professionals or clinicians it’s about
what’s really important to people using those services the official
definition is Always Events are defined as those aspects of the patient and family
experience there should always occur when patients interact with Healthcare
Professionals and the delivery system now its trademark to the Institute for
Healthcare Improvement and who took on the work from Picker America some years
ago so that we stood with the terminology but if they were to start
the work now they would actually call it an Always Experience but the Always Event is the thing that should always happen so there’s four criteria for an
Always Event to actually be an Always Event and it’s got to be important but
not important to us as healthcare professionals absolutely important to
the people that really matter the people that use those services patients their
families carers anybody that’s got a relationship with that person it’s got
to be important to them and co-created together to decide what will work
evidence-based so you wouldn’t do anything that didn’t improve the
experience of care you gather your evidence as you go along through that
journey measurable in the world of quality improvement everything’s got to
be able to be measured so you’ve got to know that you’ve absolutely made a
difference to the experience of care of those people so using simple measures
which we haven’t got time to talk about today and you will demonstrate that
you’ve actually made a difference and improve that experience and affordable
and I think the beauty about Always Events and the reason it’s been so
successful is that it doesn’t take lots of investment it’s about the relational
aspects of care little things but I’ve got that a really important people at
user services working together to improve that experience
traditionally I’m a nurse by background healthcare professionals doctors nurses
knew best and we’re taught that you know you did things to your patients you told
them what you’re going to do what the process was what the outcomes would be
and you did it they didn’t have a voice they didn’t have a say then there was a
shift towards doing for and absolutely now there’s a real cultural shift
towards doing things with patients and that’s where the co-creation bit comes
in so we ask the the organizations that we work with to really consider an
organizational level where abouts are you in that journey often people are between
somewhere between doing for and doing with we want to get to the place where
everybody absolutely does things with people using services
so that is I’m not going to go through all that but that is the framework for
the Always Events so that’s based on the Institute of Health Care Improvements
model for improvements or using PDSA cycle which you may or may not be
familiar with but we’ve not got time to talk for that but there’s a lots of
information on the website which I think is in one of the slides we’re around all
day if you want to know more come and talk to us and we will explain in a bit
more detail but we could stand here all day and tell you all about the
methodology unfortunately that’s not what today is about
ok so over the last four years there’s been lots of you learning from and
working with people and understanding some of the challenges and some of the
joys of working in this core creative way and one of the things that it’s come
up as a recurrent theme has been around people having the confidence to step
into that space and for some as Lorraine explained for some people it’s a very
different way of working to invite people in and to hold that space and
hold those conversations so that was something that came up as a recurrent a
recurrent theme so we were really curious is there aware that we could
support and enable people to have the confidence to step into that space and
that’s where we connected with Gemma and Paul and with Lisa and Lisa had done
the four day program so we were really interested in seeing if there was
something that we could create that was a kind of a bit of an introduction and
that’s where the one day programme came from that we developed which had at the
beginning had a pre-course webinar and was followed up by a sustainable
sustainability webinar that we only had last week so it’s fresh off the press
the findings from that um so hi my world is Maternity
so just so I’m gonna be really selfish and just ask maternity people to put
their hands up because I’m so pleased with so many of you here thank you
and so really having done the course what I wanted to make sure was that
these hundred plus maternity voice partnerships that we’ve got all across
England really grasped this concept of co-creation so these are local teams
made up of people who use maternity services so mums dad
along with the people who provide maternity services so midwives
obstetricians and really importantly the people who commissioned them the people
who hold the purse strings and the idea is that these small local groups work
together to Co-review and co-design maternity services but there was a bit
of a gap in terms of how that happened and so it was really exciting for me to
be able to bring that learning that I had gathered doing the co-creating
welfare course back to my Maternity world and so the map on the Left shows
the Maternity Voice Partnerships that we’ve got set up already and we also
have all of them networks by National Maternity Voices who are have a stand at
the back and so one of the things that I had taken away from one of many things
I’ve taken away from doing the four-day course was the idea that co-creation is
possible even if you’re not all in the same room and I started playing around
with this concept of using webinars and in my experience the only sort of
webinar I had been on was sort of an hour-long you log on you watch and
listen to somebody present and then you ask a few questions and so we started to
have a go at doing a webinar with a blank PowerPoint presentation and
somebody facilitating compare completing that populating those slides during the
webinar and so when we got together with Gemma and Paul and thought about how can
we take the co-creation learning wider to the Always Events people out in the
system doing co-creation and to the Maternity Voice Partnerships out in the
system doing co-creation and we started with two webinars and we had a couple of
slides that were ready to go and then we had lots of blank slides and one of the
first things we asked people to do in advance of the webinar was give us their
ideas of what the challenges were for them already doing co-creation so this
is a word cloud that we started the webinar with and we also asked them what were their successes some people were already doing it so
tell us what works what what’s the benefit what’s the success when you do
co-creation and that was the word cloud we had from that and then these are the
slides that we populated together on the webinar co-creating at the same time so
I won’t go through it all but we managed to talk together and come up with a list
of what co-creation is not and it’s really interesting when you define what
something isn’t it really makes defining what something is so much easier so it
was really interesting going through this well what is it not once we’ve
defined that then we can move on and do what is it and of course we’ve got this
huge list of what co-creation is which is interesting listening to Gemma talking
this morning about actually we’ve all got different experiences and lived
experience that we bring to the table when we’re doing co-creation and that
was illustrated when we when we did this together on the webinars so after we’ve
done the pre-course webinar we then had two collective gatherings one was in
London and one was in Manchester and there’s a few people in the room who I
can see who were with us on that day so if you want to have a chat to them and
basically we it gave an opportunity to bring together people as as Lisa said
who were working in Always Rvents and in the local Maternity Voice
Partnerships and giving them an opportunity to network but also to
share some of the fabulous tools and practical tips that Gemma took us
through this morning and you can see some of our wonderful creative Lego up
there and it took us through with on those days we went through some of the
tools and I’ll not go through them all but they’re very much were the tools
that were talked about we use the cube we used the wok we co-created our rules
for engagement you can see up there some of the posters so a really interactive
day and in total there were about 60 people who attended those two those two
days that’s the picture there of our rules of engagement with our post-it
notes and some of our Lego from the London event and last week we held our
sustainability webinar so we brought together back together those 60 people
on a webinar using the model that Lisa talks about kind
of having some slides but very much we co-created it on the day and we asked
people to give their reflections on the day and up here there’s four main themes
that came out that people found it was really powerful to have the opportunity
to network and talk to people about the challenges and successes and learn from
each other and working in those different fields something about
the fact that it was and well we’re all going to get the opportunity to
experience this today it was a real practical get stuck in there some real
tools that we could take back and use the next day really it was great fun
which was great it was lots of laughter in the room and it was a real mindset
shift that it was really about kind of and what somebody actually said that
they had shifted in their mind about their approach to co-creation and that
they actually were facilitating co-creation rather than being solely
responsible and have that burden of making that happen and we’ve got Sandra
in the room who has gone out and used some of those tools so she’s used the
cube to have conversations with midwifery students about and have women who’ve
experienced the service talking about and have very different conversations
from using the cube and Sandra if you want to give a wave if anybody wants to talk to
Sandra she sat in the middle there and people have used the co-creation tools
and that was the great thing to hear that they’ve gone away from them from
those co-creation days and six weeks later were able to tell us how
they’d changed the way they practically work they were having walk-in meetings
and walking ones and they were using the story cubes somebody said they
used it to plan their family holiday and get forget people in the family to talk
about you know what mattered to them about their family holiday that people
were taking really creative approaches now to team away days and they’ve
been really inspired by the co-creation tools to go out and invite people to
join the conversations and we asked people how would their practice change
as a result of coming on the on the course and you can see up there some of
the things that people were practically putting in place the meetings and that
people felt that the course had given them it kind of liberated them they felt
that it was you know it’s okay to co-create we can go out there and we can
do it and we can step into that space and lots of ideas about taking it
next level and somebody said could we have the cube as a virtual online so
that we could populate a cube in a webinar that that would be great if we
could do something like that so people were really kind of really embracing the
tools and have practically and practically use them and we’re using those to kind of go forward and take them to the next step and invite people for
the next meetings and as a group people wanted to stay connected some group of
co-creators are going to stay connected and we’re looking at how to do
that and how to facilitate that and how they can share continue to share their
co-creation journeys and from that course what we thought Lisa and I,
Lorraine was on holiday were at one of our directorates of nursing away days
I’m new to the director at NHS England improvement it’s recently come together
and we were just having a conversation about how excited we were around the
co-creation and we thought well what can we do how can we set this feed this
back really to the wider Directorate NHS England and NHS improvement we were
having a conversation and turned round and shared it with our director Neil
Churchill who then thought it was an absolutely fabulous idea scurried off
and unbeknownst to us had a conversation with Ruth May the chief nurse for
England and and next thing it’s been announced by Ruth that we’re going to be
facilitating co-creation for the whole of the Directorate going forward so
we’re taking that so that we hopefully can be role modelling that at NHS
England and NHS IUmprovement and be sharing with others the co-creation
philosophy and doing that together if anybody’s interested about Always Events
there’s lots of information come and find us in the day and if you’re
interested in the maternity work then Lisa and some of the maternity
colleagues are here but we’re really looking forward to spending the day and
sharing and co-creating with you so thank you

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