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Small answers to big problems
When you’re facing a complex problem or trying to do something bold, start with a smaller version of the larger problem. Focus exclusively on that small problem and solve it. Use the answers to the small issues to expand your knowledge of the larger issue. Repeat. As Caroline Corrigan, workforce lead for the new care models programme explains, when it comes to healthcare workforce modelling, if you take a look around, you can this pattern playing out everywhere.
On a recent visit to Thanet, I met staff who are delivering the primary care home model, a form of multispecialty community provider model delivered by the national association of primary care home (NAPC). This joined-up team of health and social care professionals are driving change for the communities they care for and solving complex issues by first attacking micro-problems. As a result, patients say they can better understand their condition and know how to get support when they need it. The staff see themselves as one team, where they share problems and solutions. The conversation doesn’t start with arguments about who is responsible for funding – people get the care they need when they need it.
New models of care, including the work of the vanguards, will be key to the delivery of sustainability and transformation plans which are being developed across the country. For the success of new care models to spread and embed in those plans, it boils down to a choice. Do we want to carry on as we are, or work with and learn from others to take control and change? Easy enough to say yes to but in practice it can feel like a mammoth challenge.
So the next obvious question is ‘how?’ This is where the workforce redesign team come in – part of the new care models programme support offer. We are sharing the wealth of learning from our vanguards and the one thing you need to know when it comes to reshaping workforce for a local system is – start small.
I’m going to take you back to Thanet because that’s where I met Melanie. As an experienced beauty and massage therapist, Melanie had elderly patients from a local GP practice referred to her for massage to alleviate pain. When the surgery decided they needed a care co-ordinator to support patients with advice to access a wider range of services, they immediately thought of her. What struck me most was the pride and satisfaction she had in her work. Her endless enthusiasm about the people she cares for was infectious. Care co-ordinators are not a new role but what Melanie and her patients gain from that relationship is different. She is mentored by GPs and has become the lynchpin for getting her patients the help they need.
And then there’s Eileen, part of the Gnosall Surgery team in Stafford – another primary care home site. Eileen is an Eldercare Facilitator, which means she supports older people and their families in the community to navigate their way through local health and care systems. Eileen is the first point of contact for anyone concerned about care for their mum, dad, aunt, uncle, best friend, anyone ‘elder’, and she also co-ordinates and runs the Memory Clinic.
At an emotional level I know why Eileen and Melanie are so important. I’ve seen the evidence of the difference they make and then I found the financial evidence .The amount of clinical contact achieved during the sixth year of the clinic would have cost £133,000 in a secondary care based service. Within this is a primary care based, integrated model it cost less than £11,500.
So, how do we bottle that? I’m more and more convinced that you don’t bottle it. You can’t and you don’t blueprint all ‘the answers’, shout louder or harder and you don’t look for grand strategies because they seem to end up costing a lot.
We know it’s about people, our relationships with each other, how we trust in others to care for our loved ones. If those who care are cared for, feel joy in their work and meaning in the difference they make, it saves money and gives those we serve what they want and need.
Both Eileen and Melanie said they would love to be put in touch with each other. They talked about a space to share success, problem solve with people who have shared experience and further their learning. So that’s what we will do, keep it simple and help make it happen.
We are here to help and have a range of workforce modelling tools, stories and cases to support your local planning. Please get in touch with the workforce redesign team by contacting Sharon Dixon firstname.lastname@example.org
Every one of those smaller obstacles tackled is a step closer to unlocking the many benefits (for patients and staff) of working in integrated teams.