Neurological conditions: Partnership Working and the Future of Neurological Services

Written by: Gerard Gahagan, Head of Service - Epilesy, Quarriers

Published: 02/09/2016

The role the William Quarrier Scottish Epilepsy Centre has in delivering meaningful engagement and partnerships with people at the centre.

Our latest viewpoint in a series on neurological conditions comes from Gerard Gahagan from Quarriers.  In the blog Gerard highlights the role the William Quarrier Scottish Epilepsy Centre has in delivering meaningful engagement and partnerships with people at the centre.

The National Clinical Strategy calls for transformational change underpinned by coordinated personalised care, and is dependent on collaboration and partnership. As an organisation that provides a national specialist clinical service to all NHS boards, The William Quarrier Scottish Epilepsy Centre can demonstrate evidence of positive outcomes as a result of this approach.

Our clinical service is dependent on engagement and partnership with the clinical community and support within NHS boards, and our community-based Epilepsy Fieldwork Service is similarly demonstrative of an integrated model of care: a working alliance of NHS, Local Authority and Quarriers. Here the key relationships are with the clinician, nurse specialist and epilepsy fieldworker, and the model of care revolves centre on the patient and the impact of their condition, allowing a personalised approach to empower individuals and support self-management.

A shifting healthcare culture

As demands on healthcare provision increase due to an ageing population and more people living with long-term conditions and complex healthcare needs, there is a drive for a shifting of culture in healthcare delivery in Scotland.

The newly established National Advisory Committee for Neurological Conditions presents an opportunity to be a stimulus for improvement. By examining successes and considering areas for improvement, we can develop our neurological services. I am constantly encouraged by the commitment of the clinical community and third sector partners to support continuous improvement and overcome barriers to improve care and outcomes for people with neurological conditions. The expertise is evident within the Scottish neurological community.

System complexities

Improvement in healthcare settings is challenging due to the complexity of the system. Healthcare services are complex inter-organisational networks, with relationships and responsibilities for improvement and change sometimes being unclear.

We too often hear of people experiencing disjointed services and difficulty accessing specialist expertise, and it has been highlighted that existing services may overemphasise planning around acute care models. For example, someone with a long-term condition may receive just three hours of professional contact in a year, therefore self-managing for the remaining 8757 hours.

Gaun Yersel, The Scottish Government’s Self-Management Strategy, promotes a collaborative partnership between clinician and patient, and supports conversations between experts and the patient to develop mutually agreed outcomes. Improving support services and reducing disease burden for long-term conditions are dependent on early diagnosis and ‘treating here and now’ alongside coordinated integrated care with informed patients and an emphasis on self-management.

Restructuring care plans

There is a growing recognition of the patient as the lead agent, empowered by support from professionals. This approach can lead to transformational change for the individual while supporting the efficiency and effectiveness of the healthcare service.

In considering other long-term conditions such as diabetes, there appear to be clinical benefits in considering a structured approach to Care and Support Planning Conversations. The House of Care Model has a foundation to be about ‘more than medicine’, and requires clinical buy in and leadership to support partnership working and empowered patients.

This approach demonstrates that reorganisation and focus of care planning can lead to meaningful, measurable outcomes for patients, healthcare service efficiency and effectiveness. The House of Care model is designed to adapt to conditions while retaining its principles. Models such as this can be considered to support the ambitions of the National Clinical Strategy.

The National Neurological Advisory Group for Neurological Conditions, alongside the Neurological Alliance Scotland and the new Neurological work stream within the Health and Social Care Alliance Scotland, are positioned to support improvement for people with neurological conditions. We need to maximise this opportunity and demonstrate the commitment, partnership and leadership required to enable improved outcomes for people with neurological conditions.

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