Shared Lives is currently part of Nesta’s Accelerator Ideas programme. For the last three years, they have also been working with NHS England, along with Shared Lives schemes and seven Clinical Commissioning Group, to demonstrate how Shared Lives can support people with intermediate or long-term health needs. Given the organisation’s track record in providing innovative forms of care along with their interest in scaling services in health, Nesta is helping Shared Lives to design and facilitate three workshops focused on how local areas can support their scaling efforts.
The NHS is great for putting us back together. In the last month alone I’ve needed three different health interventions or procedures where my body has let me down. I am amazed at what modern medicine can do where in the past I’d probably have had to grin and bear it. Some of those interventions have been brilliant – community clinics carrying out operations rather than having to go into hospital, text and book rather than a series of letters in the post to appointments I inevitably can’t make; others less so when I’ve waited many months for a repeat of an intervention that didn’t work the first time, simply because that is the protocol.
But that’s the point of the NHS, putting us back together when we need it. It’s not so good at giving us a good life when we have conditions that aren’t a ‘one off’ or ‘put me back together and send me on my way’.
I recently joined the latest cohort on the Leadership for Empowered Communities and Personalised Care (LECPC) programme. Some people have questioned why I did this, when the very nature of what we do at Shared Lives Plus is in its essence based in the heart of communities and epitomises personalised care. There are more than 150 Shared Lives schemes across the UK, providing CPC-regulated care to over 14,000 people, who have all chosen the family and community they want to be with.
I’ve ‘grown up’ very much with those values at the heart of what I do in community-based roles, advocacy and even as a commissioner very much engaged in finding community-based solutions to the needs of local people. However, I think it’s important for all of us as leaders to find time to stop, step back from the day job, listen and reflect.
On the first day of the programme I was struck by Cormac Russell’s analogy of Humpty Dumpty being picked up and not able to be put back together by the King’s horses and King’s men – what if he’d fallen on the other side of the wall and been caught by his neighbours, friends and community? What would have happened then? And we’re very quick to call something a ‘crisis’ and treat it as such (homelessness, social care, loneliness) when they are in fact a chronic situation. If we stopped the crisis reaction and looked instead to long term, community-based solutions designed with and for the people involved, we’d have a better chance of success. The more we move into the acute, crisis mode, says Russell, the more we disable citizens.
As a commissioner, I was all about commissioning for outcomes but now wonder if we are commissioning for the right outcomes, those softer outcomes which really make a difference to people’s lives – like building relationships, talking to a neighbour, volunteering in the community, joining a local group. These are the things that give our lives meaning and purpose and ultimately give us well-being, not just ‘being’.
We know all about these outcomes in Shared Lives. By spending time in the carer’s own home, in a friendly and loving environment, people tell us they make new friends, join groups in their community that aren’t labelled as being for disabled people and gain a sense of wellbeing they have not previously experienced, all of which can have profound benefits on both physical and mental health. I was inspired by others on the LECPC programme who are leading some really innovative work in small patches around the country and I know there is a wealth of amazing stuff happening.
Shared Lives excels in complex or challenging situations where patients have a mixture of medical and non-medical needs. It can also support people with an ambition to leave Assessment and Treatment Units and can facilitate reablement.
People can live with a Shared Lives carer long-term, visit for a short break or receive day support. They benefit from a flexible and personalised approach and receive their healthcare and support with a family and community they know and have chosen.
When I tell people about Shared Lives, they always say it’s a no-brainer, that it’s a brilliant solution etc. But that no-brainer is still small and struggling to break any ground as a healthcare solution. The 200-plus people who our Shared Lives Ambassadors (who have lived experience of Shared Lives) spoke to at NHS Expo in September all agreed that it was a brilliant idea, but still the system bogs us down and makes it difficult to do new things.
My take away from the LECPC programme was to give away more power, listen more, and get more disruptive. So, for any health commissioners out there who are ready to get disruptive and develop new ways to give people a good life, not just put them back together when they need it, get in touch and give us half an hour of your time!
We’ve already delivered sessions in London and Manchester to a number of health practitioners following the NHS Health and Care Expo in September, where we launched our new report showcasing the work we’ve done to date with NHS England.
We’re also currently working with Nesta to look in more detail at how you could develop Shared Lives further where you are.
In the meantime, we really need people who think Shared Lives is a no-brainer to make it a reality. Spread the word and let’s get disruptive.