Integrated care is care joined-up around the needs of the individual. To achieve that, professionals in different services and different agencies need to work in partnership with each other. Those in primary and secondary care; physical, mental and social-care; NHS, local authority, third sector and private providers; all should communicate and collaborate more effectively with each other. And very importantly, individuals needing care and/or using services must be central to that partnership (see Supporting Material C: Embedding Partnerships Supplement).
Embedding Partnerships is the cross-cutting work stream of the North West London Whole Systems Integrated Care programme. Its purpose is to support effective partnerships among professionals and with people who use services, carers and members of the local population to ensure that changes are co-produced.
The vision and structure for Embedding Partnerships in their current form were co-developed with a group of service user leaders from across North West London (see Supporting Material C: Embedding Partnerships Supplement for further detail on our approach). This was key to ensuring that we could create something that moved beyond the traditional boundaries of ‘consultation’ or ‘service user engagement’, and something that would be meaningful for those giving up their time and energy to be involved. The name Embedding Partnerships was jointly chosen by the group of service user leaders, and the term ‘lay partners’ was agreed as the terminology for describing people who use services and carers that would be involved in co-production of the Whole Systems programme at North West London, CCG, borough and locality level through Embedding Partnerships.
VISION
The lay partners agreed a set of ‘I’ statements which would ensure that they could act to keep the focus in all work ongoing throughout the programme on how best to enable person-centred, accessible and proactive high-quality care. In effect, the lay partners act as the guardians of the programme’s vision.
Exhibit 3.4
- I can access my own health and social care data and correct any errors
- I can discuss and plan my care with a professional, focusing on my goals and concerns
- I know what I can do to keep myself as well and active as possible
- I know whom to contact and where to go when I need extra support
- I can make sure that the professionals who support me have access to my up to date health records and care plan
- I am regularly asked what I think about the care I am getting, I know that my feedback is listened to
- I know that when changes are being planned to my services, my interests and those of people like me will be taken into account because we have been part of the planning process from the start
In addition to the module working groups, lay partners from the Advisory Group have been involved at every layer of the Whole Systems programme governance structure, barring the very operational levels (the group agreed that this would not be the best use of valuable lay partner input and time). The diagram below illustrates lay partner representation across the overarching programme governance structure:
Exhibit 3.6
In my opinion, the suggestion of having lay co-chairs for the modules being raised, adopted and implemented illustrates that Whole Systems Integration is making great strides in keeping patient and public involvement at the centre.
Lay Partner
All module working groups within the programme started with a CCG and Local Authority co-chair pairing. The lay partners identified a gap within the structure of Embedding Partnerships and democratically elected a lay partner co-chair alongside the health- and social-care representative co-chairs. The Population and Outcomes working group also followed suit and elected a lay partner co-chair.
STRUCTURE
The following diagram sets out the governance structure, developed in a co-designed way, of Embedding Partnerships during the co-design phase of the Whole Systems programme.
Exhibit 3.5
The Lay Partners Advisory Group was built out from the initial small group of service user leaders. Lay partners with experience of representing others and working with professionals were then recruited through the service user leaders’ and Whole Systems programmes’ existing networks. Members of the Advisory Group have been involved as equal partners in each of the module co-design working groups from the very start of the programme, contributing the co-design of integrated solutions. They have consistently ensured that the focus has continued to be on making care more person-centred.
The Lay Partners Forum serves to ensure that members of the Advisory Group remain grounded in the real-life experience of those interacting with health and care services in North West London, and also to enable them to speak beyond their own opinions or experience. The Lay Partners Forum has representatives from the spectrum of diversity and differing levels of need across the 2 million population of North West London, and is a chance for those individuals who perhaps have less time available to give to be part of shaping change to make joined-up health- and social-care run more smoothly for individuals and carers.