In Bologna in Italy, the ‘home-based hospital’ has become a cheaper and better alternative to treatment for people with cancer, offering all of the healthcare provided by a traditional hospital in the comfort of patients’ own homes. This is made possible by harnessing the aspirations of the 3300 patients in the hospital to self manage, while combining this with support from 200 healthcare professionals, 1300 volunteers, and the personal contribution from families and friends.
For Italy’s National Tumour Association, which established the hospital, this approach is based on the belief that by integrating patients’ treatment with their everyday lives, the quality of care will improve and cost will be reduced. Indeed, the hospital has already brought about impressive cost savings, reducing the cost of hospitalisation by 90%. The next step will be for ANT to scale up the programme.
One of the biggest barriers to this distributed healthcare model has been the significant logistical issues that inevitably arise when people are treated in disparate locations and the care they receive comes from mixed teams.
As part of the solution to this challenge, the ANT Foundation developed Vitaever, a sophisticated ‘Software as a Service’. Based on an inexpensive cloud computing model, Vitaever is a tool that enables communication, knowledge and data sharing, together with the management, tracking and optimization of personnel, assets and scheduling. Already the winner of several awards, Vitaever is the kind of cutting edge technology that could support the development of more healthcare that deconstructs the traditional binaries – patient versus professional, hospital versus home - that currently characterise healthcare services
In the end, though, it is not technology but people that are at the heart of ANT Foundation’s successful approach to cancer treatment. By leveraging the ability of patients to help themselves, allowing them to remain in an environment within which they are comfortable and connected to a willing network of friends, families and volunteers, as well as making efficient use of professional capacity, the ANT Foundation have created a winning formula. We call this approach to healthcare coproduction.
Coproduction is not a new idea. Local examples of coproduction in the delivery of healthcare services have proliferated in the developed and developing world alike. This is partly a response to ageing populations that are experiencing a rise in long term health conditions such as diabetes and cancer, thus placing unprecedented pressures on healthcare systems. With more than 15 million people currently living with a long-term health condition in the UK, it is estimated that by 2025 this number will rise to 18 million. Shifting to a more people-centred provision will represent a vital step in ensuring that the NHS is equipped to deal with increasing demand for services.
The People Powered Health programme, delivered by NESTA and Innovation Unit, is concerned with embedding coproduction solutions that tackle the rise of long term health conditions in our health system.
Over eighteen months, People Powered Health will support six localities that are already working in the health and co-production space to improve, build upon and learn from their practice, with the aim of taking them to scale. In providing an opportunity for these projects to prove their worth, we also hope to encourage the open discussion and debate – at both local and national level - of the benefits and barriers of co-production, in order to raise awareness about this apporach amongst public services and share knowledge and understanding about how it might become an integral aspect of healthcare delivery. In other words, we want to ‘make co-production mainstream’, by identifying the means to make it scalable and sustainable as well as communicating its merits to both professional and public audiences in clear and appropriate ways.
Our learning and evaluation will focus on four main areas that we have identified as potential barriers to making coproduction mainstream: models of measurement and accounting for value, workforce culture and professional resistance, commissioning practice and decommissioning, and constructing appropriate businesses cases and measuring value.
We aim to have the final six localities selected by August 2011. You can stay in touch with the People Powered Health via this link, or follow us on twitter via #PPHealth. If you are interested in doing coproduction in public services, why not join NESTA’s coproduction practitioner’s network.