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Realising the Value: People must be at heart of care to deliver FYFV

Outcomes measures for the NHS should be reformed to encourage person and community-centred care, the Realising the Value programme has concluded.

NHS England commissioned the Realising the Value programme, led by the Health Foundation and innovation charity Nesta, to support delivery of the FYFV.

After 18 months of work, the programme has concluded with the publication of a set of resources for delivering person-centred and community-centred care.

Halima Khan, executive director of Nesta’s Health Lab, said: “We are all aware of the urgent need to design a sustainable health and care system. One of the major ways of achieving this will be through enabling people to live better with health conditions.

“This programme clearly sets out that the best way to do this is by putting people and communities at the heart of health and wellbeing – so that they feel in control, valued, motivated and supported.”

To deliver person-centred care, Realising the Value called for “a single, simplified, cross-system outcomes framework” that would measure “the health and wellbeing outcomes that are most important to people and communities”, such as independence, empowerment and social connection.

This would need to be accompanied by work to develop and test mechanisms for aggregating personal outcomes data at an individual, organisation and population level.

At the NHS Expo Conference in September, Professor Jonathan Benger, national clinical director of urgent and emergency care at NHS England, unveiled new measures established by NHS England to measure the performance of the healthcare system as a whole.

Realising the Value added that commissioners and NHS finance officers should receive training to help them commission for comprehensive personal and community value.

Will Warburton, director of improvement at the Health Foundation, said: “What is needed is a health and care workforce skilled and knowledgeable in these ways of working, as well as a flourishing voluntary and community sector, and better ways of measuring the outcomes that matter to people. This has the potential to really transform the relationships between the health service, people and communities.”

Furthermore, Realising the Value criticised the current measures to reform the health and care system, saying that efforts to deliver person-centred care and efforts to achieve financial stability and safety and manage performance can impact on each other and “impede progress”.

In addition, the programme recommended encouraging national bodies to consider people as well as systems, and to ensure that commissioners are able to provide a variety of contracts and grants to voluntary and community sector partners.

The resources from the programme include:

• A guide with practical tips on designing, embedding and spreading the five person- and community-centred approaches to maximise their impact;
• An economic modelling tool for commissioners, which builds understanding of how person- and community-centred approaches can support health and wellbeing in local populations, estimates potential savings and wider social benefits, and helps to build the business case;
• A report on system levers setting out the role of national bodies in supporting the implementation and spread of person- and community-centred approaches;
• A new articulation of value that focuses on what matters to people and communities. This includes a series of calls to action including the need to build a consensus on developing a single simplified outcomes framework, focused on what matters to people.

Dr Alf Collins, clinical lead for person-centred care at NHS England, said the organisation would help the NHS “engineer Realising the Value principles and practice into the way it works”.

He also promised it would work over the next three years with other arms-length bodies “to provide support for local health and care systems to come together with the communities they serve and the voluntary sector”.

“We will support them to create thriving social networks where people living with long term conditions feel confident to manage their own health and wellbeing and live independently,” explained Dr Collins. “In short, putting in place Realising the Value will go a long way towards delivering the vision of Chapter 2 of the Five Year Forward View.”

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