Why did we do this?
We want the health and care system to support people to have the knowledge, skills and confidence to play an active role in managing their own health and to work with communities and their assets.
There are many good examples of how the health and care system is already doing this. For example, recognising the importance of people supporting their peers to stay as well as possible or coaching to help people set the health-related goals that are important to them.
Realising the Value was not about inventing new approaches, but rather about strengthening the case for change and identifying evidence-based approaches that engage people in their own health and care. It also sought to develop tools to support implementation across the NHS and local communities. But putting people and communities genuinely in control of their health and care also requires a wider shift. The programme therefore considered the behavioural, cultural and systemic change needed to achieve meaningful transformation.
What did we do?
We collected evidence on what good person and community-centred care looks like and the potentially wide-reaching benefits, such as better mental and physical health, cost savings and wider social value, such as strong community ties.
We then developed and tested ways to embed these approaches, creating a set of tools to allow these to have national and local impact.
The programme was split into three stages:
- Assessing the potential for impact of person and community-centred approaches by reviewing existing formal and informal evidence. We also sought to understand the perspectives of people who use services, commissioners, providers and practitioners.
- We then focused on a limited number of approaches with potential for large impact, based on the evidence base. From December 2015, we worked directly with five local sites and wider networks of interest to develop and test tools and resources to support their implementation. These took account of what currently stops high potential interventions being commissioned further and used. The aim was to create and refine - with people - a set of tools and resources that could equip the health and care system to take up high impact person-centred care practice at scale - for example by developing tools and training to support practitioners and organisations to introduce new ways of working.
- In the third stage, we brought the learning together in a final set of resources and recommendations that could impact real change at scale. This includes an analysis of the policies, system incentives and behaviours that need to change for person and community-centred approaches to play a role at scale in the health and care system.
Realising the Value was funded by NHS England and led by Nesta and the Health Foundation, working in partnership with Voluntary Voices (made up of National Voices, Regional Voices, NAVCA and Volunteering Matters), the Behavioural Insights Team, PPL and the Institute of Health and Society at Newcastle University.
Realising the Value was a programme funded by NHS England to support the NHS Five Year Forward View. It ran from May 2015 to November 2016.
The NHS England 'Five Year Forward View' set out a vision for the NHS to develop a new relationship with patients and communities and support people with a long-term condition to manage their own health and care.
Many different kinds of change will be needed to achieve this overall shift. Realising the Value was a part of the overall change needed, by consolidating the evidence base, considering the behavioural and cultural change required, setting out the system levers that need to change and developing tools and resources to make commissioning and take-up of key interventions easier.
The programme built on a large body of work by the Realising the Value consortium partners and beyond, who have strong track records and expertise in this area, which puts people at the heart of health and care and develops community-centred approaches.
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