Lessons learnt from the BHF House of Care programme
The BHF House of Care programme has contributed to lessons learnt from implementing the care and support planning approach via the exemplar of heart and circulatory conditions and other long-term conditions.
This programme has built upon work by the Year of Care Partnerships to identify critical success factors for implementing the House of Care. The lessons learnt from this programme are as follows.
Clinical leads are important
It was vital for clinicians to articulate the vision for care and support planning to facilitate practice buy-in and for staff to receive tailored training from healthcare professionals they respect and trust.
Involve people with LTCs
Patient reference groups played a significant part in championing this approach. In Gateshead they designed leaflets, engaged with receptionist groups, and developed and promoted the OurGateshead community website, which connects people with follow-up services.
Equip the workforce with ongoing training
In addition to initial Year of Care Partnerships training, short tailored ‘top-up’ training, Learning Sets and Train the Trainer approaches to support practices were highly successful in equipping professionals to have effective collaborative conversations. Practices need time to learn about how to adopt a care and support planning approach in addition to developing systems and tools.
Include the whole team
This helps to establish new processes and culture from the start and reduces the impact of staff changes. It includes practice management and administrative staff, as well as practice nurses, GPs, pharmacists and healthcare assistants.
Allow time for building the roof
Teams said it was essential to ensure infrastructure changes are in place before extending the approach to additional practices or sites. It can take at least six months to put systems in place before care and support planning can start, and two to three years before it is fully embedded.
Project management and practice facilitation are important
This can be combined with training and practice facilitation roles. Project managers at the different sites were trained and became involved in different ways. All project managers responded to emerging needs and encouraged practices to include more LTCs. They have been kept in post to support the spread and adoption of care and support planning.
Flex the framework to meet local needs
While maintaining the core components, some practices tailored these to meet their practice and patient needs. Nurses visited the housebound or included telephone conversations, while others developed a picture format and colour coding system in the results letter to help those with poor health literacy.