Driving forward the patient voice and partnership working across the NHS is one of the keys tasks of NHS England and, in fact, all staff in the service.
The My Shared Pathway programme has demonstrated that patients within secure mental health services − some of the most vulnerable and isolated groups of individuals in health services − have been given a real voice. And they are determined to make sure they are heard.
The programme was launched in 2010 with three key objectives in mind:
To shift secure services towards a much more outcomes-based approach to the delivery of care;
To place as much responsibility as possible into the hands of patients and to engage and drive their own pathways;
To support a shift in the culture of secure services towards a greater emphasis on recovery, increased collaboration between staff and patients, and greater transparency in system processes.
As a pragmatic starting point, work was undertaken to identify current best practice in relation to outcome measurements and a draft outcomes framework for secure services was developed as part of the “managing successful programmes” method. The eight outcome areas related to the following clinical factors:
Mental health recovery
Problems with substance misuse
Nature of future plans
Physical health status
With the rollout of the programme, secure services have moved closer to a recovery and outcomes-based approach to care delivery, with an agreed number of explicit outcome areas providing a framework for individual care planning, the care programme approach, and potentially the ability for services to performance report against outcomes instead of inputs.
More importantly, the recovery approach, patient involvement, participation and transparency will all be intrinsically embedded as part of the outcomes focus, so that patients can drive their own pathways as much as possible.