Building a people powered NHS: Beginning a journey of discovery together, part 2

Following on from my last blog where I talked about the backdrop to participation and how we are beginning to see more widespread enthusiasm and commitment for taking collective participation forward, I would like also to share with you how the NHS Commissioning Board (NHS CB) is beginning to understand its role in the context of this transformational change ambition.

We now need to build on that passion and integrity and shared purpose by also growing a shared understanding of the current picture, the assets and the barriers in order to be able to work on unlocking the full potential we have within our communities.

From this process, many unknowns and spin-offs will also emerge.

It is likely we will need resources to put in place some tangible architecture (some of which may already be in existence or being planned), eg virtual and physical networks, an information sharing platform, flagship or spearheading initiatives, and development support for individuals and communities (paid and unpaid) beginning on this journey.

It is definite that we will need collective leadership, which is the responsibility not of the few in the NHS CB, but of the many who understand the value of this social movement. There are a few things we must be careful not to do too. In particular, lose the magic of participation by formal systematising, by parachuting rigid replications of approaches and by not respecting the time, place and pace differences there will be in different communities.

So what is the role of the NHS CB? Is it facilitator, commissioner, leader? Is it there to create the conditions and the backdrop to this new relationship between people and their health and the health system? Or all of the above?

Following on from my last blog, the NHS CB is just beginning to develop and understand its role in the context of this transformational change ambition.

The NHS CB is beginning to show integrity of purpose relating to its values of ‘putting patients and carers at the heart of decision making’ in many ways including the involvement of Lay Assessors in the CCG authorisation process.

We have now recruited over 80 people from all walks of life bringing with them a vast range of experience, skills, knowledge, ideas and approaches to life. Teething problems have occurred and CCG Lay Assessors have been fantastic in working alongside staff to resolve these issues making a great contribution – not just to the authorisation process,  but also the longer term approach of the Board to participation. As people get to know each other in the many paid and voluntary roles, new relationships are being formed, knowledge and ideas are being shared and a great sense of the possible is emerging.

Reflecting over the last few weeks, it is important to acknowledge the challenges and issues that have arisen – not in the sense of failure, but in the context of a new journey. This is a journey where we can be brave enough to try out very different ways of working together. We will need to have mature, open relationships and strong emotional intelligence. We all need to be able to speak openly and honestly when things go awry, or there is human error, or where something more fundamental such as policy needs addressing. Where this happens we need to be able to pool our knowledge, skills, ideas and resources to resolve and improve the situation and system so that it becomes more accessible and effective for people.

We are half way through the design year of the NHS reforms and there is still a great sense of the possible in the air. CCG Lay Assessors are making a difference in conversations on Authorisation Panels across the country, asking probing questions and influencing new thoughts, behaviours and practice.

There is a new sense of openness and collaboration emerging, with leaders listening and having conversations with many people who are passionate about this agenda. Social media is also playing a role in developments, with ideas, opinions, data and stories being shared. You can follow the NHS CB, Tim Kelsey (the National Director for Patients and Information) and many others working in and alongside the NHS CB on Twitter for the latest insights and developments.

In the last couple of months I have had the privilege of meeting (physically and virtually) GPs who have designed new online tools to help people with long term conditions take control; practice managers who are developing their practices into Well-being Community Centres; clinicians creating amazing digital and participation innovations; and people who some might label ‘patients and carers’ – active citizens, who have the most incredible courage and community spirit.

Plans are starting to take shape and ideas are beginning to move beyond the concept stage. We have a great and shared responsibility now to take full advantage of the window of opportunity for a transformational change in the relationship people have with health to create a ‘people powered NHS’.

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