Towards a new deal for people with long term health conditions

c4ccMartin Routledge is the director of the Coalition for Collaborative Care, and tweets at @mroutled

The Coalition for Collaborative Care launched towards the end of last year. It was set up to “light the blue touch paper for big changes in how people with long term heath conditions and professionals work together to produce better lives”. From an initial partnership of 15 organisations, C4CC has rapidly expanded to almost 50, including the BGS. These represent professional and system leadership in health and care, key evidence and innovation bodies, major charities for people with long-term conditions and organisations at the cutting edge of person-centred, community focused care and support. Crucially C4CC is embedding “co-production” – through people with long-term conditions and family carers being central to what it does. We are very pleased that the BGS has joined us.

Simon Stevens’ Five Year Forward View sets out two key challenges for the health and care system – achieving long-term sustainability and improving outcomes – in significant part through new relationships with people and communities. But what does this mean in practice and how can it be brought about?

We have set out our Vision for the Future, but of course the future has to start now. Over the past few months I’ve met with many health professionals and people with long-term conditions including older people and their families. I think there is a mutual recognition of great potential for new and better ways that people’s expertise can come together for improved outcomes. But this is accompanied by frustration that the promising practice that can be seen in patches around the country is not quickly becoming mainstream.

C4CC wants to work with those determined to move person-centred collaborative care from the margins to the centre of practice and experience. How will we do this? Our approach might be summed up as is “Supporting the doers, changing the conditions”.

Changing the conditions will involve attention to workforce development, providing powerful evidence and pulling the system levers to drive positive change in practice. This will be of vital importance in achieving the kind of major shift we are looking for – but it won’t be enough. The bottom line is that the health and care workforce and the people who use the health and care system will increasingly need to develop and adapt their ways of working and interacting with each other so that they can get the win-wins that person-centred approaches can provide. People will need help to do this and C4CC aims to be an important part of that help.

We want to support the building of a powerful movement for change amongst both practitioners and people living with long-term conditions and give this movement the tools, connections and support it needs to help fully realise the potential for person centred care and support. We know this can’t be simply mandated by policymakers or system leaders, it has to be built by the people delivering and using health and care services. That is why the partners and members of C4CC are people and organisations who don’t represent a single part of the system but bring together a wide coalition that can have impact in all key areas and at all levels – with people living with long-term conditions at the heart, energising positive change.

As well as playing an important part in key developments that will shape the future of health – like the Integrated Personal Commissioning Programme and New Care Models Vanguards, we are looking for all opportunities to get significant support targeted to those local systems showing clear commitment to transform practice and to the people with long term conditions contributing to this. Sometimes involves partners of the Coalition taking direct initiatives, alone or in partnership with others with C4CC, at other times we will aim to direct resources and support emerging from NHSE and other programmes.

In supporting the movement for change we want to support our individual and organisational members to become better informed, to link together for support and develop their ability to have positive local impact. We are developing this support in various ways including through provision of targeted information and tools, support to networks and the identification and activation of champions nationally and locally.

We are confident that the unique nature of our coalition – bringing key organisations and people from across the system and with lived experience into the room together with a clear focus and purpose – models the change we are trying to make. We believe we can have a real impact. But for deep, large scale change to happen we need all those who believe there is real potential for person-centred collaborative care to transform people’s experience and use resources better to join us on this journey.

We agree with Colin Nee that BGS’s 3000 plus members have a vital role in ensuring more older people who present at hospital are assessed and discharged promptly, staying no longer in acute beds than necessary. Geriatricians are often system leaders, collaborating with local partners from primary, community, social care and VCS. This role, along with involvement in intermediate care, long term care and the growing number of community based work of geriatricians makes BGS an important part of C4CC. We very much look forward to a fruitful collaboration – for more information see

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