I first took notice of health and care services in New Zealand after reading a couple of Kings Fund publications on whole system redesign and accountable care.
As someone working in an organization that was delivering integrated health & social care, these publications gave me a lot to think about.
I’m eternally curious so went to a Kings Fund Integrated Care Summit. Commissioners & providers across public, private & third sector from around the UK plus international delegates discussed ways to meet the growing challenge of population health & wellbeing. The holy grail of effective & efficient person centred services. Whole system redesign. Some amazing projects were described but it was the stuff about housing & homelessness that still sticks in my mind.
At the time I wasn’t really paying much attention to the social determinants of health & wellbeing.
An organizational restructure later & I find myself responsible for care & support services in 3 extra care housing schemes. It’s all pretty straight forward. Won’t add much to the workload. Hmm…
It’s no cliffhanger that that wasn’t really the case. Don’t get me wrong we have a great team and great properties but it takes sustained effort to create and maintain a community. People with a level of need that meet the criteria for extra care living can easily shift from independence to dependence.
The question I couldn’t stop asking was but what gives their life meaning? This is not a care home. How do we help people connect or reconnect with their purpose?
Nearly 3 years later and we are very slowly nudging forward in supporting people differently on this bigger stuff.
My Fellowship has provided me with the opportunity to learn from others about their communities and identity, their traditions and rituals and how this impacts on how they deliver health and care services. It’s been a window into cultures I didn’t expect to look through.
Yesterday I shared my story of my experiences and learning so far with Te Puea Winiata and her team at Turuki HealthCare in Auckland. Te Puea and I met in Anchorage where she and some of her executive team and Board were also learning about the Nuka model created by SouthCentral Foundation.
Te Puea and her team are creating a relationship based care model that meets the specific needs of their people.
In my time with them it was clear that they have many of the fundamental elements already in place. They are standing in the gap for a community with complex health and social care needs. Their work around preventive health through the FitKids programme and support with housing shows a breadth of thinking and response that is truly integrated and person centred.
It was great to discuss my observations of how elements of the Nuka model could be adapted and adopted in other systems. We talked about the challenges of funding, how a whole system approach requires excellent data systems but that’s not very easy to achieve and how we need to pay attention to appreciating ourselves and each other.
We talked about the role of sharing story in relationship based care systems and how powerful it can be. I described a personal experience of sharing too deeply with people who were unprepared to appreciate my story. How that that made me feel and the potential impact on them. We need to tread carefully in developing these approaches in our own systems with the right support, training and assurances.
We had an interesting discussion on language and how we need to find ways to communicate with people that makes sense in our cultures but also explains the changing model and expectations on both sides. Not easy stuff.
Thank you Team Turuki for a thought provoking afternoon, your great hospitality and my lovely gift!
There is no size fits all but if we all connect and share our work we are stronger together.
Next week I will be in Hamilton with Pinnacle Health. It will be fascinating to see how their Health Care Home model works and what we can learn from that.