Coalition, co-production and collaboration

Ed Gillett is the Communications & PR Manager for the British Geriatrics Society. In this blog he introduces the work of the Coalition for Collaborative Care

As the current coalition Government goes into pre-election purdah (you should read our BGS policy paper on the general election, if you haven’t already), another very different coalition is just beginning to spread its wings. This is the Coalition for Collaborative Care, which now boasts the BGS as a partner organisation alongside ADASS, National Voices, NHS England, the Royal Colleges and many others.

This coalition, referred to as C4CC for short, aims to bring together organisations and individuals to improve the care of people of all ages living with long-term conditions. As the name suggests, their core interest is in collaborative, person-centred care, joining the dots between different groups to provide care which responds to the needs of individual patients, rather than forcing them to adapt to pre-defined institutional structures.

On Wednesday 8^th April, I represented the BGS alongside Dr. Gill Turner at a meeting for the C4CC’s first round of new partner organisations. We were joined by colleagues from across the health and social care spectrum, covering everything from fellow medical societies and frontline practitioners to commissioners, managers, social enterprises and charities. The aim of the day was to offer an introduction to C4CC’s work, build links between different partners, and discuss future plans.

Learning about the Coalition’s aims and outlook from Martin Routledge and Catherine Wilton (its Director and Deputy Director respectively) was fascinating: the emphasis on centring decisions around individual patients rather than proscriptive systems, and on pre-emptive support and risk avoidance rather than emergency care, was visible right from the start.

Of course, BGS members and other colleagues specialising in the care of older people have been making these arguments for longer than most: seeing this kind of thinking become so commonly accepted is a real testament to the hard work done by geriatricians and many others over several years.

Equally inspiring were the presentations from members of the C4CC group dedicated to “co-production”, which they define as “ensuring that people with long term health conditions, health and social care professionals, carers and charities work alongside one another to co-design services and support”.

In practice, this meant hearing from three very different patients, learning about each person’s experience of collaborative care, and how they see excellent care working in the future; these stories were a challenging and powerful reminder of the importance of placing the individual and their experience at the centre of care.

Taking this idea a step further, subsequent presentations spoke about “activating” patients to be more involved in decision-making around their own healthcare, not only through changing professional and patient mindsets, or designing and delivering services which are more responsive to patients’ needs, but also through improving public education and health literacy.

This presents another opportunity for the BGS and its members to offer forward-thinking leadership: if individual patients are encouraged to become “the main decision maker”, what does this mean for older people living with frailty, dementia or cognitive impairment, who may not be able to take on the additional responsibility for themselves, or for their carers?

Advance care planning can be crucial for older people living with complex long-term conditions, but may not be applicable to everyone: if we take the wrong approach, the noble aim of empowering patients could risk becoming more of a burden than an opportunity to some. When thinking about empowering individuals, are we also making sure that our most vulnerable patients have directive support available if and when they need it? Would the issues identified in our recent Fit for Frailty guidance benefit from this approach?

Of course, the whole point of C4CC is to bring different perspectives together so that questions like these can benefit from insights across the full breadth of health and social care! In our small group discussions, the issue of making the coalition’s aims fit with the needs of older people came up regularly: it was refreshing and encouraging to see people accepting this as a core part of the discussions around collaborative care. There’s a lot of work to be done in turning those discussions and ideas into real-world changes, but we’re very excited to be taking that challenge on as a C4CC partner, and very optimistic about the improvements we can all make through doing so.