Hans's story
A clinician's perspective
Dr Hans Hartung, a respiratory consultant and clinical lead for NHS Ayrshire and Arran’s CCH team, explains what the intitative means to him: 'Co-creating Health is a collaborative approach. From the clinician’s point of view it is about supporting the patient in their quest to understand and manage their condition. It is about helping them to maintain their independence and their balance of health as well as possible.'
'It’s the first time so far that this has been tried in this way. I mean there have been clinician programmes, there have been patient programmes but each of them, if you really look at them individually, didn’t really have the impact that people expected at the outset.'
'So this is a very unique initiative - a project where you have a clinician and a patient programme and a service improvement programme running in parallel. I can’t draw any conclusions at this stage but the hope we all have is that it will all come together'.
Part of the initiative is helping clinicians change their practice, which can be unsettling: 'This is a big jump. You have to part from the old ways, the way you’ve always done things, and you really need to change a lot. It’s a change that doesn’t happen overnight,' says Hans.
The Advanced Development Programme enables clinicians to strengthen the skills and knowledge they need to provide self-management support to people with long-term conditions.
Hans explains how the programme has changed his way of working: ‘Suddenly a consultation has become more meaningful again”, says Hans. “Before, we just imparted our agenda on the patient, ticked the boxes we wanted to tick, and that was it. Now I am stepping back, letting the patient take the lead. It’s about tuning in to the patient’s journey: where are they and what are they ready to talk about? ‘The programme has really shown me a way in which this could be done.”
Clinicians are encouraged to co-create an ‘agenda’ with their patients at the beginning of each consultation, based around the question ‘what will make this consultation successful for you?’. They also act as facilitators for patients’ goal-setting, helping patients to set goals that are relevant to them and which will build their confidence in their ability to make a contribution to their health, rather than depending on the professional.
Clinicians also explore ways in which they can offer follow-up that suits their patients, this might mean adjusting how the service works by offering follow-up by telephone, email or group appointments.Co-creating Health also works to re-shape the service so that it better supports self-management.
Staff and patient representatives are given the time, space and support to explore and imagine how the service could better support patients to play a more active role in optimising their own health. Teams then use the well-known plan, do, study, act cycle approach to test the changes they want to make. Small changes have already been to the service in NHS Ayrshire and Arran, with the introduction of tools – such as agenda setting pre-appointment sheets – to facilitate this new partnership approach.
Hans describes how he felt after the workshop. 'It also brought home that this is not a revolution; but that it’s an evolution of very small and gradual steps.’
It's hoped that this integrated approach will equal more than the sum of its parts to make a real difference. 'The vision of a collaboration between patient and clinician, the vision of putting the patients’ concerns and issues at the centre of healthcare is carried by a number of enthusiasts in Ayrshire and Arran. It is across the board, including patient representatives, and that I think is our strength, that we have those champions on various levels of the service.'
Read Jim's story: a patient's perspective >
Read Co-creation in Ayrshire and Arran >
Read more about Co-creating Health >
