Rick O'Brien and Dr David Paynton
Person centred commissioning across health and social care
The afternoon session was chaired by Professor Mayur
Lakhani, Chair of the Dying Matters Coalition and the
National Council for Palliative Care.
This plenary began with perspectives on
person-centred commissioning across health and social care.
Rick O'Brien, Social Care Lead at the National End
of Life Care Programme, reflected on the benefits of collaborative
working between health and social care organisations, within the
framework of local democracy.
He outlined the dynamic nature of social care, with thousands of
providers delivering services, including at the end of life. 28% of
people require some form of local authority funded social care in
the last 12 months of life - this amounts to over 150,000
"Social care works best when embedded in local
community and primary care systems. In their role as both providers
and now commissioners of care, GPs are advocates of person-centred
care delivery," he said.
Rick believes integration and personalisation of care will
influence the future shape of eolc, as individuals take control of
their care budgets and expect well-integrated service delivery.
Dr David Paynton,
National Clinical lead at the of the RCGP Centre for Commissioning
outlined the opportunity for transformational change in end of life
care that the current NHS reforms offer.
"Commissioning isn't just a procurement and
contracting process. It's about redesigning systems to
support local populations, based on the individual, and so
making these systems sustainable in the long
Dr Paynton is keen to see this change enabled from the top but
delivered locally by GPs working with social care partners and the
wider commissioning community. With RCGP colleagues, he is helping
to develop end of life care commissioning guidelines for GPs,
establishing the key principles and encouraging new
approaches. These include the innovative 'out of hospital'
care model which is being used successfully in his own community in
"We're identifying people who may be at risk of
dying in the coming months, and empowering these patients and their
carers to put in place the care they require. Multidisciplinary
community teams then support GP practice clusters in delivering
He emphasised that end of life care is not a end in itself,
sitting in isolation, but part of the much wider drive to deliver
community-based care, keeping people out of hospital when they
don't need or want to be there.