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A momentous year for transforming health and care Bevan Commission: 2018 in review

2018 has been a momentous year for the Bevan Commission, as we celebrated 10 years of expert thinking and radical action in health and care. It was also the year we marked 70 years of the National Health Service, serving as an important reminder of the founding principles set out by Aneurin Bevan, and of our collective responsibility to safeguard and transform its future.

Making the case for prudent healthcare

The year kicked off with the publication of 'The Parliamentary Review of Health and Social Care in Wales', authored by a group of international experts including our Chair, Professor Sir Mansel Aylward, and Bevan Commissioner Professor Dame Carol Black. The report called for a revolution in NHS Wales, building on the principles of prudent healthcare, and its recommendations included strengthening individual and community involvement.
In January we launched the second publication in the prudent healthcare series, 'A New Way of Planning: Working Towards A Prudent Model of Health & Care', at Caerphilly Miners Hospital.
We must stop investing in secondary care to keep trying do the same role - it is clearly not working. We need to do more work at the primary and community care levels and also ensure we are joining up primary care with social care and the third sector. This will require a change in the direction of NHS investment – and also courage and a real passion to see it through and make it succeed. - Nygaire Bevan, Bevan Commissioner and great niece of NHS founder Aneurin Bevan
Helen Howson wrote for the Western Mail on how a Prudent Healthcare approach has informed the Welsh Government’s long-term plan for health and social care and can, in the 70th year of the NHS, empower communities, organisations, professionals and patients to take greater responsibility for their health and care and those around them.
We need more GPs, with enhanced training to help them meet the changing requirements of patients and health service delivery, if the Welsh Government’s vision for a world-class healthcare service, delivered in or near patients’ homes, is to be realised. - Professor Kamila Hawthorne MBE

Professor Kamila Hawthorne wrote for BJGP on the need to transform primary care in Wales.

There is no denying that the challenges of the future of healthcare look very different to its past. However we can continue to learn from giants like Julian Tudor-Hart and pioneer new, innovative ways to embed a culture of commitment and empathy in our services. The benefits of a reciprocal relationship between people, patients and healthcare professionals are clear; the only limiting factor is whether we will be bold enough to invest fully in redrawing this relationship. - Professor Sir Mansel Aylward

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Transforming the health and care workforce

In June, we launched a Bevan Commission publication on 'A Workforce fit for future health and care: aligned to a prudent social model of health' which recommended that traditional roles must undergo a rapid transformation to keep pace with the needs of patients and communities.

The report suggested that different roles encompassing core skills in problem solving, digital expertise and communications will become increasingly vital - such as lifestyle coaches and health technologists. It also reinforced the need to embrace the potential of the ‘unseen’ workforce, including the public, patients, carers and volunteers.

The publication tasked the new special health authority, Health Education and Improvement Wales (HEIW), with implementing its recommendations in collaboration with local Health Boards, NHS Trusts, professional organisations and regional planning boards in Wales.

Bevan Commission International Conference 2018

In July, we held the Bevan Commission International Conference 2018 at the Celtic Manor, Newport, marking 70 years of the NHS and 10 years of the Bevan Commission.

We collaborated with NHS at 70: The Story of our Lives to capture stories and memories from people in Wales. We heard about life-changing treatments, memorable hospital stays, career achievements, and the health service's significant impact on communities across the nation.

Attended by over 500 health and care professionals, policy makers, academics, community members and more, the event was a focal point for discussion in a week of NHS 70 celebrations taking place across Wales.
We should celebrate the social and cooperative traditions in Wales... The NHS is an amazing achievement. - Vaughan Gething AM, Cabinet Secretary for Health and Social Services
We need organisations to act as critical friends to the government... the Bevan Commission is an independent source of fresh thinking. - Rt Hon Carwyn Jones AM, Former First Minister of Wales
We launched the final installment of our prudent healthcare series at our conference, 'A New Way of Doing: Delivering a Prudent Model of Health and Care'.

We also launched a commemorative book, comprising of a collection of personal reflections on the NHS in Wales from internationally renowned experts, the Bevan Commissioners. The book charts the progress of the NHS from its roots in Aneurin Bevan’s Tredegar to its technology-driven tomorrow. It addresses challenges such as health inequalities and deprivation, and explore opportunities such as arts and health collaborations and emerging technologies.

Motivational, inspirational, celebratory... The Bevan Commission team did a great job and produced a world-class event. Back to the day job tomorrow with an extra spring in my step. - Conference Attendee

Developing a nation of health and care innovators

In April, a Bevan Exemplar sepsis awareness and management programme published findings that demonstrated overall success in terms of improved sepsis detection, but led to an increase in the number of E. coli blood stream infection cases presented, calling into question the targets used by Health Boards and set by the Welsh Government.

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We published an independent evaluation of the Bevan Commission second cohort, authored by Professor Nick Rich, Swansea University, which described the programme as a powerful force for change in Wales. The evaluation found that the programme had achieved an overall success rate of 79%, with each project generating £196,000 on average in economic benefits and 32% eligible for immediate adoption or scale-up.

A Bevan Exemplar scheme which made it quicker and easier for cancer patients to access radiotherapy treatment won a national patient safety award for 'Palliative Care'. The initiative, which was trialled at Velindre Cancer Centre at Cardiff, significantly improved the quality of life for patients by embedding radiographers within the palliative care function, relieving outpatient doctors and ensuring patients can access radiotherapy treatment more rapidly. The scheme won the ‘Palliative Care’ category, as well as being shortlisted under the ‘Cancer Care’ category, at the UK-wide Patient Safety Awards.

An innovative Bevan Health Technology Exemplar and Hywel Dda University Health Board project, VIPAR (Virtual Pulmonary Rehabilitation), won the ‘Improving Health and Wellbeing and Reducing Inequalities’ award at the NHS Wales Awards 2018.

In Autumn we welcomed the Bevan Exemplar Class of 2019 from Health Boards and Trusts across Wales, armed with innovative ideas that they will trial and test out in their own hospitals, GP surgeries, palliative care units and ambulances.

Some of the new Bevan Exemplar initiatives include:

  • Implementing a virtual clinic for people with Parkinson’s with the aid of wearable technology, which will monitor motor symptoms.
  • ‘Digital companions’ who will help to get those who have never used the internet online and connected up with peers with similar interests, to explore how this could improve health and well-being.
  • A collaborative approach to reducing antimicrobial resistance by engaging and informing prescribers at all levels.
  • Buzzard Café: a Virtual Reality (VR) space where those with cystic fibrosis can ‘meet’ to provide support to each other and undertake group therapy led by a trained psychologist.
  • The 'Staying Steady Schools' project which uses Primary School ambassadors to raise falls prevention awareness with elderly people. Watch below.

In October we led the Welsh Health Gadget Hack, which took place in Wrexham, North Wales and awarded three collaborative projects with funding for further development, with a further runner-up project receiving special recognition.

The two-day event, which was a collaboration between the Bevan Commission, AgorIP and MediWales, brought together over 50 health and care professionals, technologists, academics and supporting agencies to tackle NHS challenges through innovative technology or gadgets.

Driving forward social movements for change

We announced our partnership with the WI in Wales to engage their support on prudent healthcare. Women’s Institute (WI) members across Wales are being encouraged to take action for better health and care following the 70th anniversary of the NHS.
The Our Health in Our Hands project will inspire the strong network of 16,000 WI members in Wales to help work towards achieving a more prudent social model which recognises the shared responsibility of society starting with the individual. During the coming months we will be encouraging our members to start a conversation with their family, friends and community members about the importance of taking care of themselves and making prudent health and care decisions. - Mair Stephens, Chair of the National Federation of Women’s Institutes-Wales

Patients in Wales want a more equal role in managing their own health and care. We worked with partners in Swansea University Medical School, Gwent Association of Voluntary Organisations (GAVO) and 1000 Lives Improvement to analyse 1,400 patient responses to Education Programmes for Patients (EPP), which provides courses for people with chronic health issues to help them develop the skills and confidence to self-manage their conditions.

The report found that patients identified significant challenges around communication with healthcare professionals, understanding the healthcare system and accessing services. Solutions suggested by patients included developing health literacy for all, giving patients access to their own health records and improving communication with frontline staff by reducing jargon and managing patient expectations.

It is my belief that the NHS cannot continue to just keep fixing people, but that it must help people to help themselves and each other and it also must listen to people about what is important to them... I hope our mission to save patient solutions in Wales inspires others around the UK to look afresh at the way they collect and analyse patient feedback. Our voices are too valuable to lose! - Jules Horton, Bevan Advocate

Jules Horton, Bevan Advocate and EPP Co-ordinator for Caerphilly, Torfaen & Newport, writes for BMJ Opinion on her experience of being a patient and how it inspired her to capture patient-generated solutions.

Bevan Exemplar award success

Several Bevan Exemplar projects and industry partners were recognised at MediWales Innovation Awards.

The VIPAR (Virtual Pulmonary Rehabilitation) initiative, based at Hywel Dda University Health Board, scooped the prize for ‘NHS Wales Collaboration with Industry’, sponsored by Life Sciences Hub Wales.

Debbie Thomas, IBS Dietitian from Abertawe Bro Morgannwg University Health Board, won the ‘Innovation in the NHS’ award, sponsored by 1000 Lives Improvement, for her ground-breaking work which improves symptoms of irritable bowel syndrome in over 75 per cent of sufferers.

SymlConnect took home the award for ‘Partnership with the NHS’, sponsored by Nutricia, for their Bevan Exemplar partnership with midwives at Powys Teaching Health Board, led by Marie Lewis, Assistant Director for Innovation and Improvement.

The award for ‘Start up’, sponsored by Geldards Law Firm, was won by QR Info Pod. The Bevan Exemplar industry partner produces patient information hubs linking patients to health information through encrypted QR codes.

2018: a year to remember for the Bevan Commission

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