Service model and pathways

Patient and Public Involvement

‘People Powered Commissioning: embedding innovation in practice’, 2013. NESTA state that:  (1)

• Put long-term outcomes for people, not short-term outcomes for institutions, at the centre of decision-making – a refocusing on who (rather than what) commissioning is for.
• Ensure the commissioning process reflects the lived experience of users, through processes of co-design, community research and pathway mapping.
• Re-frame the role of commissioner as one of leadership of genuine partnerships and collaboratives – working in partnership with those from every part of health and social care, including patients, practitioners and providers.
• Move away from commissioning as procurement of existing services to commissioning as market-making, with a focus on commissioning different types of services, supporting alliances of providers, embracing provision from outside the mainstream and building up existing provider capacity.
• Conventional approaches to achieving efficiencies through better procurement will not be sufficient to meet the needs, obstacles and opportunities that face the NHS over the next decade.

“Commissioners have the potential to play an increasingly critical role in this. They need to take bold, brave and radical steps towards not just the commissioning of new kinds of services but entirely new models of commissioning that adopt methods that reflect the lived experience of users; re-frame the commissioner as the leader of partnerships and collaboratives; and move away from commissioning as procurement to commissioning as market-making.”

(1) Paul Corrigan, Georgina Craig and Martha Hampson with Peter Baeck and Katharine Langford: NESTA, 2013. ‘People Powered Commissioning: embedding innovation in practice’  http://www.nesta.org.uk/publications/people-powered-commissioning-embedding-innovation-practice#sthash.HkhaNSBb.dpuf

Epilepsy

Transitioning to adult epilepsy care services

Adolescence is an important time for young people with epilepsy in terms of providing them with the knowledge and tools for an ongoing self-care approach to their condition. However, in the process of transitioning to adult care services, the delivery of this information is sometimes not as effective as it should be.

Factors negatively influencing this exchange include learning disabilities, behavioural problems and epilepsy-related emotional distress (e.g. fear of seizures, dysphoria), and, commonly, from the adolescent feeling excluded from discussions of their epilepsy. There is some evidence that age-appropriate, structured psycho-educational interventions at this crucial stage can help to improve young people’s knowledge of epilepsy and that this can lead to better quality of life. However, more research is required (24).

NICE recommends that, during adolescence, a named clinician should take responsibility for the ongoing management of the young person’s condition and ensure the smooth transition of care to adult services. This individual should be able to work alongside other agencies. Multidisciplinary services provided jointly by adult and paediatric specialists have a key role in the care of the young person with epilepsy.

For references please see the epilepsy page