Passing the Baton

Passing the Baton A Practical Guide to Effective Discharge Planning Change Agent Team Briefing Lynda Chandler, Matt Wyatt & Iain Roberts

NationalLaunch Wednesday 11th June 2008 Aberystwyth University

Storytelling… • Increasing delayed transfers of care • Decreasing public satisfaction • Expanding bureaucratic complications • Diminishing dignity and respect • Weak private decision making • Strong public legal responses • More complicated unilateral excuses • Less simple joint solutions

Getting up to speed • Formation of the national Discharge Planning Community of Practice • Undertaking the Self Assessment of Discharge Planning in Wales • Publication of the national summary report “Six Steps from DToC to EToC” • Passing the Baton development publication and ongoing campaign

All in context…

Discharge Planning Community of Practice Step 1: Identify… • Run by the participants, a Community of Practice is an informal network of people who share a common interest in a specific area of knowledge or competence and are willing to work and learn together, over a period of time, to develop and share that knowledge.

Step 1: Identifying… • The CoP’s first purpose is to create the right culture of trusting relationships and then find simple consensus and act on it, rather than design detailed plans:

Step 1: Identified… • There’s plenty of talent and commitment to meeting the needs of individuals • Organisation centred procedures should not overrule person centred systems • Everyone agrees with the principles but its poorly interpreted into practice • Each community has assigned different priorities to the key issues • There are excellent examples of solutions that can be shared nationally

Step 2: Debate… • In 2006 a national self assessment audit tool was compiled from existing guidance with 68 questions across Policy, Practice, Partnership and Audit. It was circulated to Trust Chief Executives with instructions to work with their local partners to submit a community response

Step 2: Debating… • The SAAT encouraged organisations to work together to debate the issues in a local context, providing a framework to amalgamate that knowledge nationally:

Step 2: Debated… • The SAAT was accepted as a valid approach generating genuine responses • The process of undertaking the SAAT signposted areas for development • The intensity and range of work underway had been underestimated • Some communities took the opportunity to improve joint working arrangements • A number of corrective action plans were voluntarily submitted with the SAAT

Step 3: Engage… • In 2007 NLIAH published “Six Steps from DToC to EToC” summarising the national results of the SAAT. The Six Steps referred to the principle recommendations of the report for which there was widespread support from the participating communities

Step 3: Engaging… • Six Steps as it became known, was circulated widely and the Change Agent Team gave formal feedback to interested groups and organisations across Wales:

Step 3: Engaged… • Involvement of the patient, their family and carers is recognised as critical • There is unanimous understanding of the causes of delays and bad experiences • Structural frameworks and obligations do not help organisations to work together • Existing commissioning methods are not able to provide the continuum of care • A new emphasis on multi agency training and development is essential

Step 4: Advocate… • The CoP recognised the immediate need to make real and sustainable change and took the opportunity to reform themselves into six working groups each taking responsibility to research and develop a Guide to improving knowledge and skill in an aspect of discharge planning.

Step 4: Advocating… • The development gradually turned to focus on simple tools and the core values that drive behaviour, a process supported by the overseeing expert reference group:

Step 4: Advocated… • The Guide was conceived, developed and written by over one hundred Practitioners • The participants represented every Health and Social Care organisations in Wales • The Guide contains information and advice from practitioners, patients and carers • Effective discharge planning depends upon many simple things done consistently • The Guide has Ministerial support and will be the subject or an Assembly circular

FAQ What is it for? How does it work? What is in it?

Ronseal… • It’s aimed at frontline Health and Social Care staff to help improve discharge planning and the journey through care • The impact of implementing the Guide needs to be understood and advocated throughout partner organisations • To sustain the learning it must be incorporated within operational and strategic training and development plans

Using in practice…

What’s in it…

Back to today… • To discuss and raise awareness of the national launch of Passing the Baton on Wednesday 11th June 2008 • To determine the best approach and arrangements for a local Passing the Baton launch and campaign

NationalLaunch Wednesday 11th June 2008 Aberystwyth University

Expectations • ‘Passing the Baton’ has been written by the Discharge Planning Community of Practice, a national forum of practitioners and managers representing every health and social care organisation in Wales. Aimed at supporting frontline staff, the Guide provides practical advice to improve the journey through care. • The publication is not an isolated event and an ongoing campaign, led by the Community of Practice, is already gaining momentum to generate and support local improvement work. The NLIAH Change Agent Team will also be working with individuals and organisations responsible for education, to formalise and accredit the Guide within a national Training Framework. • This launch is aimed at a broad audience including policy leads, executives, heads of service, managers, specialist practitioners and frontline health and social care staff who are interested in improving and influencing, “how we do, what we do”. Adoption of the Guide will be the subject of a national circular.

Showcase Are you doing a great job and would like to tell people? • At the Launch there will be a room set aside to display posters and examples of some of the great work going on in Wales to improve the journey through care. • There is significant interest across Wales in how to develop the necessary relationships and systems to facilitate effective discharges and transfers of care. The best work often goes unnoticed and we want to change that. Passing the Baton aims to maximise this knowledge and experience and emphasises that “success will depend on many simple things done consistently”. • We want to showcase examples of this successful work from large formal projects to small local tools and everything in between. There are no specific guidelines for the content of submissions, so have a go if you have: • Designed new documentation, tools and techniques • Developed people with the right knowledge and skills • Created teams with complementary talent and experience • Undertaken some joint working to gain a better understanding • Implemented new structures or systems of working • Showcase submissions can be in the form of a single poster or a display of materials, no bigger than A0 (84x119cm). Submissions should either be delivered to NLIAH by Friday 5th June 2008 or brought on the day of the event where exhibitors will have access to the Showcase Room from 9:00am. • If you need some help or advice to produce your submission, please get in touch with members of the Change Agent Team detailed on the last page.

Programme

BookingInformation • To book your place at the Launch please contact the event coordinator Lisa Conway, at the National Leadership and Innovation Agency for Healthcare: • lisa.conway@nliah.wales.nhs.uk • NLIAH, Innovations House, LLANHARAN CF72 9RP  01443 233333 or  01443 233329 direct line • www.nliah.wales.nhs.uk • When booking please let us know of any special dietary or access requirements you may have. • For further information regarding ‘Passing the Baton’ or other NLIAH Programmes, please contact the Change Agent Team:  lynda.chandler@nliah.wales.nhs.uk • Matt.wyatt@nliah.wales.nhs.uk • Iain.roberts@nliah.wales.nhs.uk

Local campaign… • Principle Contacts • Influential People • Access to forums • Support from CAT • Logistics & Resources • Long Term Tactics • Improvement Work

Passing the Baton