9 November 2023

Community Appointment Days: What makes them tick?


Jamie Tulley

Common sense innovation is one of our by-words at Here – we believe in innovation, and doing things differently – we also believe in simple ideas that have great impact.

Community Appointment Days (CADs) are a simple idea, built on a bedrock of partnership, personalised care and devolved decision making. With all eyes on the growing NHS waiting lists, anything that serves to get people quickly to the care they need is gathering attention.

But what makes them work? Could this happen anywhere?  

These are my reflections on the story so far:

Partnership is key

As a social enterprise, we’ve been working hand in hand with our Sussex Community Foundation Trust (SCFT) colleagues for over ten years. At the CAD you can tell. Everyone introduces themselves as MSK Partnership staff. One team, not several. Everyone pulling together.

We draw on the agility and creativity of a small social enterprise and join forces with the expertise and credibility of the NHS. A perfect example of the whole becoming more than the sum of its parts.

Photograph: Jenny Handy

MSK practitioners at a Community Appointment Day (CAD)

Personalisation is the difference

As an organisation our calling card is exceptional care for everyone. We specialise in personalised care approaches to long term conditions. We constantly ask the question – is this care exceptional – both in terms of the standard of care, and our ability to make an exception to respond to a particular set of needs.

The MSK partnership has a mission too – putting patients at the centre of their healthcare journey. Why does this help? It means we focus only on understanding what really matters to someone, and this has been the beating heart of the CAD.

Making sure we understand, and quickly respond to the things that are going to make a difference, and not wasting any time offering or pursuing pathways that just don’t suit.

I liked the atmosphere and behaviour of staff. Everyone was lovely and anxious to help me. I liked both areas I was sent to, especially rehab because the lady there was extremely kind and went above and beyond with trying to help me.

Photograph: Jenny Handy

Devolved decision making

If you are going to really be person-centred, and allow for shared decision making with people, your clinical team will need the autonomy and independence to enact creative thinking every day. By baking in clear vision and values in every part of the system, you can trust teams to do what matters. 

As a clinician you know that so long as you are holding true to the values, you have a great deal you can offer. Good for managers, good to staff, good for people.

Simple rules let you work with complex problems – and when it comes to caring for people, each and everyone of us arrives with our own complexities to understand.  

I found each area really helpful, every member of staff I saw was sympathetic, understanding and amazing. I felt listened to and not judged.

A learning culture

You know the saying, ‘Culture eats strategy for breakfast?’ If we’d set out two years ago with a strategic plan to reduce our wait list, it’s unlikely we’d have come up with this. If we’d had board sign off from all our partners, this idea would still be sitting on a table waiting for final governance sign off or a pilot.

By creating a culture of working in teams to solve day to day problems together, guided by principle but supported by robust data and learning, we have teams who are unusually used to trying out new things.  This ability to quickly learn, try and fail, change tack means we are improving all the time.

The CAD days evolved from a clinical validation approach that wasn’t working well. Our approach to learning meant we identified the piece that was working – the what matters to you conversation – sowed the seed for a whole day focused around this one conversation.

Find out what people had to say after attending a Community Appointment Day here.

Download the Community Appointment Day Essential Ingredients.

Download the Community Appointment Day Information Sheet.

Photograph: Jenny Handy

About Sussex MSK Partnership Central

Sussex MSK Partnership Central is a joint venture between Here, & Sussex Community NHS Foundation Trust. This is a prime contracting model supporting musculoskeletal (MSK) health for a population of 650,000 covering physiotherapy, orthopaedics, rheumatology and chronic pain. The service operates across central Sussex; including Brighton & Hove, Horsham and mid Sussex and Crawley.

Website: www.sussexmskpartnershipcentral.co.uk

Interested in finding out more about the Community Appointment Days?

Email collab@hereweare.org.uk or use the form below.

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