2017 started well for me - a new job with Shared Lives Plus – as Regional Officer for the NHS England funded programme. With the overstretched NHS in the news almost every day, it seemed an ideal time to be part of a project, exploring alternatives to traditional hospital and/or residential care for people with health needs. The idea that health and happiness are interlinked may be radical for the NHS, but for most of us it is obvious that a good home and living situation will improve your health and well-being.
In January, I met with colleagues from Shared Lives Plus, along with Shared Lives carers and ambassadors at our Awayday in Liverpool. I was struck by the positive energy, skills and commitment in the room. I went away wondering why the Shared Lives model is so little known about, when it can offer so much to Shared Lives carers, families, people in Shared Lives and health and social care providers, as well as to the wider communities in which we all live.
Since then, I’ve been finding how hard everybody involved in Shared Lives works to be able to offer and nurture these unique arrangements. I’ve started to understand the resources and skills we have in Shared Lives scheme staff, Shared Lives carers and the people who use Shared Lives. The Shared Lives Plus report A Shared Life is a Healthy Life illustrates the many health benefits of living in a Shared Lives arrangement, and shows how many Shared Lives carers already support people’s health needs day to day, as they would a family member. The knowledge and expertise that Shared Lives carers have built up in this way, is a resource that we will need to draw upon to develop the work of the NHS programme. For example, one Shared Lives carer in North Somerset produced her own list of do’s and dont’s based on her experiences of people with dementia. We hope to involve experienced and proactive carers like this in peer training where good practice is shared.
Recognising and valuing the contribution of our experts by experience, and ensuring that this project is co-created by people with understanding and knowledge from the ‘bottom up’ will be important to ensure the success of our NHS programme. This is not just about doing something new, but involves doing more of what we do already, and shining a spotlight on what Shared Lives arrangements are capable of in terms of peoples’ health. Shared Lives recognises the strengths of people and communities and I think it embodies the Asset Based Community Development (ABCD) approach. ABCD sees individuals and citizens as producers of health and wellbeing within the community, rather than as recipients of services. This is a different approach to traditional health and social care services because it asks the question ‘what makes us healthy?’ rather than ‘what makes us ill?’
Shared Lives Plus has received funding for this project from NHS England, and we are currently working with five Clinical Commissioning Groups (CCGs) as part of the match funded programme (there are more to come). The hard reality is that NHS England and the CCGs will want to see savings to the NHS budget arising from their investment in Shared Lives; and we have appointed our evaluators (the New Economics Foundation) to help us with this. I’ve been discovering more about the inside workings of the NHS from attending CCG meetings, learning about integrated care services, commissioning, health budgets, referral and care pathways. I’ve been finding that the NHS is awash with jargon –abbreviations bounce around in these meetings until your head is spinning. To calm my nerves I have produced a short jargon buster for people in Shared Lives new to the NHS. I referred to a very helpful and much longer jargon buster produced by Think Local Act Personal . See link(https://www.thinklocalactpersonal.org.uk/Browse/Informationandadvice/CareandSupportJargonBuster/)
Definitions and language are important, but I’ve also been discovering that the right words are not always followed by the right actions. The NHS seems committed at policy level to person centred care and support building on peoples assets, but the reality is that health and social care services and funding streams are not as flexible and integrated as they might appear and the focus remains on services to fix problems. We all need to be careful of assuming that real change will follow good intentions. This is why we need the input of the people on the ground who can tell us what they know and what they need and how and if change is being delivered and experienced.
I look forward to meeting more Shared Lives scheme workers, Shared Lives carers and people who use Shared Lives in the coming months, as we steer our way together through uncharted waters in this exciting project.
Geraldine (Gerry) Cooney