The first step in creating a new model of care is to create an engagement process in which providers can come together with service users, voluntary organisations and other partners to create innovative models of care that will meet the holistic needs of individuals. It is vital for any new model to be designed with the individuals who will receive those services and their carers.
The fundamental principle of co-design is to involve individuals who use services in the design process of the new models of care. The Whole Systems Integrated Care programme to date has been built on a strong foundation of equal partnership with people with experience of care and support. The next stage of the design process needs to continue and expand on this approach.
The defining feature of a new model is for it to be designed around population groups that have broadly similar needs. Many of the avenues of innovation presented earlier in the chapter revolve around the ability of individuals to care for themselves and to take broader personal control of their care. In order to go down any of these avenues for groups of people with similar needs, those people need to be in the room as equal partners in developing the new models of care.
Below, we will set out a series of steps that providers and people who use services can go through to co-design a new model. These steps illustrate how people can come together, how they can design new services around the needs of individuals and their carers and how they can think about shifting resources from the current system into the new one.
1. Form a core care model co-design team
Each provider network will need to establish a core team that will design the new model of care. This team should include representatives from all the provider organisations involved, as well as lay partners and a programme manager. The responsibility for driving the design process forward will lie with this team, and so the people who will be in charge of making design decisions should be represented.
This core team will be in charge of coordinating the co-design events, recruiting a wider collection of partners with whom to engage on a local level and incorporating the feedback and design decisions from the wider engagement process into the core design of the new model.
2. Identify who to engage in the process of co-design
- Identify representatives from relevant providers. Request local organisations to name individual care professionals from across the system, including GPs, acute, community care, mental-health- and social-care, who are relevant to the target group, (e.g., nursing home providers could be included for elderly populations, community pharmacists, dieticians, personal trainers or occupational therapists)
- Include local commissioners. Relevant local authorities, clinical commissioning groups and NHS England Local Area Teams.
- Invite existing patient, carer and people who use services groups to participate (many organisations will have pre-existing user involvement groups that should be included in this process, including things like local Health Watches and patient associations).
- Launch an open recruitment process for individual service users and their carers. This could be achieved by advertising in local newspapers, putting posters up in care settings or by word of mouth.
- Engage with voluntary and community organisations. Many organisations exist that provide care on a voluntary basis. Any organisation that will be providing care should be included. Other organisations with expertise in supporting people from particular populations or with particular needs, including carers organisations, may be able to offer very valuable input.
- Other partners. For some areas, wider organisations may have an interest, e.g., housing for people with long term mental health needs or people with learning disabilities.
3. Hold a series of co-design events to gather input
After establishing a core design team and creating a wider group of partners who will come together to design the new model, the final step is convening for a programme of collaboration and co-design. Local provider networks will need to decide on the specific strategy that they will use to co-design their new models, and may already have processes in place for doing this. The following section will present one possible way to engage in the co-design process and presents an example schedule of events that providers can use.
Attendees: everyone involved in the co-design process
The core design team should convene everyone involved in the co-design process for fortnightly working sessions during the co-design phase. Each of the following six steps in this chapter should get at least one working session, and the core team should then take the comments and feedback from the discussion and incorporate them into any materials for the next working session. It is important that providers from different levels of organisations are involved in these sessions, including decision-makers and frontline staff.
Attendees: core design team
In addition to the biweekly working sessions, the core team should set aside at least two hours per week to meet and ensure that process is moving forward. The programme manager should be in charge of running these sessions, and they should be a mix of solving any problems that have arisen during the working sessions, making key decisions and creating materials to be used in future working sessions.
Attendees: wider service user and carer population and core team
Finally, the programme should hold at least one or two wider community engagement sessions. These are plenary sessions that will present the work that has already been done, present the proposals for the new models of care and gather feedback from people in the community on their needs and aspirations for care in the future. These should be open invitation events, and should be advertised in care settings to gather a larger and more representative group of people.
A rough schedule of working sessions and community engagement events is shown below.
As part of the Whole Systems Integrated Care programme, we have also put together materials on how to engage with service users across the patch, how to ensure that service users are embedded in every part of a design process, and how best to ensure that the language of the programme is person-centred, rather than organisation-centred.
For more information about co-design, how to set up an engagement process and the challenges that might arise, see Chapter 3: How do we ensure service users and carers are involved throughout?