2. Analytic Philosophy and Values-based Practice

Bill Fulford, Ed Peile and Heidi Carroll. Essential Values-based Practice: clinical stories linking science with people. (2012, Cambridge University Press)

Derived as a philosophy-into-practice output from mid-Twentieth Century Oxford analytic philosophy (the so-called ‘Oxford School’), values-based practice is a partner to evidence-based practice in supporting shared clinical decision-making as the basis of contemporary science-led patient-centred clinical care.

On this page:
Founder Director of Oxford’s Collaborating Centre for Values-based Practice Ashok Handa
Founder Director of Oxford’s Collaborating Centre for Values-based Practice Bill Fulford

Introduction: The Collaborating Centre for Values-based Practice

Although  values-based practice was developed first in mental health, since the launch in 2015 of the Collaborating Centre for Values-based Practice at St Catherine’s College, University of Oxford, many key initiatives have been in areas of bodily medicine such as surgical care, radiology, occupational therapy, paramedic and emergency medicine, and clinical pharmacy. Additional urgency has been given to these initiatives with the recognition of shared decision-making drawing on evidence and values as the basis of consent to treatment (this was enshrined in UK law in 2015 by the Supreme Court Montgomery ruling.

Guided by an Advisory Board of senior National Health Service and political figures, the work of the Centre has been in three main areas, Education and Training, Regulation, Law  and Guidance, and Integration and Teamwork.   This work has been mediated in each case primarily by the Centre’s Collaborating partners through its Networks. We give examples of both (with apologies to those not shown) together with a sample of illustrative publications. Full details are available on the centre’s website – as follows

Education and Training

Examples of the work of the Centre on education and training as these relate to mental health are included in the  Index of Educational Resources

Regulation, Law and Guidance

The following tables give examples of work in values-based practice on Regulation, Law and Guidance respectively by individual partners in the Centre, by organisational partners, and by networks. The final section of the table gives a sample of related publications

Individual Partners
Last NameFirst NameBackgroundDescriptionVBP Profile
CoulterAngelaFreelance health services researcher and health policy analyst Oxford; Non-Executive Director of NICE; honorary professor at the University of Southern Denmark Working on a range of apps to support children and young people to bring what matters or is important to them into the design and delivery of mental health servicesAngela Coulter
Crepaz-KeayDavidHead of Empowerment and Social Inclusion Mental Health Foundation. Working with colleagues in genetics to bring mental health service users’ values into the design and delivery of genetics counselling services particularly as new technologies extend the range and detail of individual genomic informationDavid Crepaz-Keay
DudasRobertConsultant Psychiatrist and Work Stream Lead for Audit and Research for the Zero Suicide Programme at Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) Cambridge Work on Zero Suicide Programme reflects values-based perspective – developing this further with wider range of work on the values that psychiatrists bring to servicesRobert Dudas
GrayMuirProfessor Sir ‪Director Better Value Healthcare (BVHC) ‬‬Formerly a senior health service manager, now running a programme on ‘triple value healthcare’, ie service provision that combines economic, technical and personal values (see also entry for Better Value Healthcare)Professor Muir Gray
HaighRexFramework Lead Positive Environments Royal College of Psychiatrists Leading on work exploring the impact of environmental resources and constraints on service provisionRex Haigh
KintonMat National Mental Health Act Policy Advisor for the Care Quality Commission. In a former role as Research Officer for the Mental Health Act Commission (the functions of which have now been taken over by the Care Quality commission), Mat was among the first to introduce values-based principles into the monitoring of mental health service provisionMat Kinton
RichardsVeryan Lay participant contributing towards shaping the policy narrative and improving patient experience in mental healthcare. Leading on the incorporation of values and values-based practice into all aspects of the work of the Royal College of PsychiatristsVeryan Richards
RoegWaldoPeer Support Specialist/Peer Trainer Recovery & Wellbeing College CNWL (Central and North West London) NHS Foundation Trust Building on personal experience to develop and deliver values-based practice in the context of recovery training. Working also with the Bristol Co-production GroupWaldo Roeg
VenkatapuramSridharLecturer in Global Health & Philosophy King’s College London Senior Research Associate University of Johannesburg Philosophy Formerly a Lecturer in Moral Philosophy in the Department of Philosophy, University of Cambridge (UK), and recruited by the epidemiologist Sir Michael Marmot (an expert in economic health inequalities) to run an innovative practical programme promoting the principles of health justice in the development and delivery of services. In this context, prompted the extension of values-based practice to include social as well as individual values.Sridhar Venkatapuram
VillarmeaStellaAccredited Full Professor in Philosophy University of Alcalá Madrid Spain A philosopher working on values in childbirth including mental health aspectsStella Villarmea

Organisational Partners
NameLocation Description
The Critical Values Based Practice NetworkUKSchool of Health Sciences, The University of Nottingham, and Royal Derby Hospital, UK
-Organisational Partner
An interdisciplinary group of service providers and service users that has carried out a number of funded service development projects including a ‘values-based mental health ward round’
Commission for Values-based CAMHSUKChild and Adolescent Mental Health Services – Royal College of Psychiatrists, London, UK – Organisational Partner
Set up by former President of The Royal College of Psychiatrists, and VBP Collaborating Centre Advisory Board member, Professor Dame Sue Bailey, the commission carried out a programme of research and witness statements exploring the values of (what really mattered to) children and young people in the provision of mental health services. The Values-Based Child and Adolescent Mental Health system (VB CAMHs) Network is exploring practical approaches to implementing the Commission’s findings
National Survivor User Network (NSUN)UKOrganisational PartnerA service-user led organisation that researches and publishes policy documents on mental health service provision
Professional Standards Authority for Health and Social CareUKThe UK’s regulator of health and social care regulators. London UK
– Organisational Partner
Under its Chief Executive (and VBP Collaborating Centre Advisory Board member), Harry Cayton, the PSA supported a range of initiatives bringing values-based principles in the regulatory framework supporting health care
Networks
NameConvenerLocationDescription
Brazilian VBP NetworkGuilherme MessasBrazilAmong many other initiatives (see also Index of Educational Resources), working with the Co-production Addictive Behaviour (CAB) Research Network to develop values-based addiction services in Brazil and the UK
Educational Voice Hearing NetworkDr David Crepaz-KeayUKA service-user led group developing values-based support services for people who hear voices for example in employment contexts
Law and Ethics of Anorexia Nervosa – Values in Practice (LEAN ViP)Jacinta TanUKWorking closely with the VB CAMHs Network to develop values-based services particularly for young people with anorexia
Understanding Personality Disorders NetworkKonrad BanickiPolandA joint UK-Polish initiative working on phenomenologically-infornmed values-based service development and delivery for people diagnosed with personality disorders
The Values-Based Child and Adolescent Mental Health system (VB CAMHs) NetworkLeo KrollUKNetwork formed to take forward implementation of the Commission for Values-based CAHMs (see above organisational partner entry)
 Title AuthorDescription
Values-Based Child and Adolescent Mental Health System Commission, What Really Matters in Children and Young People’s Mental Health. (2016, London: Royal College of Psychiatrists)Royal College of PsychiatristsThe report of the Commission for Values-based CAHMs (Child and Adolescent Mental Health System Commission) was launched on November 7th at a reception at the House of Lords hosted by Commission Chair Baroness Tyler

Among other findings the Commission emphasised the importance of building closer links between education and healthcare in the provision of services supporting the mental health of children and young people.

To download a copy go to the VBP website to More about VBP/Full Text Downloads [link valuesbasedpractice.org/mor…] and scroll down to this entry.
Values-Based Commissioning of Health and Social Care (20xx, Cambridge University Press)Christopher HeginbothamAn experienced health services manager and academic Chris Heginbotham was the first to identify the importance of values-based commissioning and to develop a detailed model for effective implementation
The Dementia Manifesto: Putting Values-Based Practice to Work Toby Williamson and Julian HughesThis book represents a new turn in approaching dementia. It is a manifesto which sets out important principles about the nature of dementia both as a disease and as a disability and explores how a values-based, person-centred and rights-based approach can be applied to every aspect of the experience of dementia.
Values-based Decision-making Protocol for social work Reuben WOO, Yan-wahBased on his work at the Society of Rehabilitation and Crime Prevention, Hong Kong, Reuben Woo’s Decision Making Protocol provides a comprehensive guide for social workers in different areas of practice
The Values-Based Child and Adolescent Mental Health system (VB CAMHs) NetworkLeo KrollUKNetwork formed to take forward implementation of the Commission for Values-based CAHMs (see above organisational partner entry)

Integration and Teamwork

The following tables give examples of work in values-based practice on Integration and Teamwork respectively by individual partners in the Centre, by organisational partners, and by networks. The final section of the table gives a sample of related publications

Individual Partners
Last NameFirst NameBackgroundDescriptionVBP Profile
BergerSarahteaching and research in inter-professional education Medical Faculty University of Heidelberg Germany Sarah Berger
Bharatan IlaResearch Assistant Warwick Business School working with Rachel Manning on values and teamwork Ila S. Bharatan
BlytheAndrewWriter and Editor: Blythe Spirit: Communicating Diversity Writer and Expert by Experience – co-produced with Wendy Hawksworth Permission to Care – also author of values-based communication skills section of Essential CPE: depression and anxiety (for Pharmaceutical Society of Australia)Andrew Blythe
CarrSarahAssociate Professor of Mental Health Research Middlesex UniversityDirector of Sarah Carr and Associates mental health and social care knowledge consultancy Dr Sarah Carr
FetterolfEllianaPostdoctoral Research Fellow in Philosophy Working on the collaborative research project ‘Therapeutic Conflicts: Co-Producing Meaning in Mental Health’ (Principal Investigator: Edward Harcourt) Faculty of Philosophy University of Oxford; Research Associate Keble College Oxford, and the Bristol Co-production Group Dr Elianna Fetterolf
FisherPamela University of LeedsRan ESRC-funded Seminar Series on ‘Re-imagining professionalism: towards co-production’ Pamela Fisher
KingColinBlack and Asian Coaches Association; Lead for the Whiteness and Race Equality NetworkBringing together personal experience of services with philosophical insights (for example from Franz Fanon) into the impact of implicit values of whiteness on services and thereby to improve service provision for black and minority ethnic service users (see also entry for the Whiteness and Race Equality Network)Colin King
LobelPierre MA MD FACP FRCPsych Emeritus Clinical Professor Psychiatry and Behavioral Sciences University of Washington Seattle USA Psychiatrist supporting work by the Uehiro Centre for Practical Ethics on strengthening the impact of the biopsychosocial model in practiceJ. Pierre Loebel
ManningRachelResearch Fellow, Warwick University Business SchoolWorking with ILa Bharatan on values and teamwork; also leading on research on Housing First as a values-based response to homelessnessRachel Manning
MatitiMilikaCo-lead for Inter-professional Education University of Lincoln College of Social Science School of Health and Social CareLeading a Collaborative Inter-professional Education Undergraduate project between a health trust and university. Also a member of CAIPE and of the African Inter-professional Education NetworkMilika Matiti
SakakibaraEisukeM.D. Graduate School of Medicine The University of Tokyo/Department of Neuropsychiatry The University of Tokyo HospitalWorking on pathology and normalizationEisuke Sakakibara
ThistlethwaiteJill Professor health professional consultant; Adjunct professor University of Technology Sydney (UTS) SydneyAuthor of Values-based Interprofessional Collaborative Practice: Working Together in Health Care – see publications belowJill Thistlethwaite
 

 

Organisational Partners
NameLocationDescription
Action for Collaborative Transformation (ACT)UKAmong many other initiatives (see also Index of Educational Resources), working with the Co-production Addictive Behaviour (CAB) Research Network to develop values-based addiction services in Brazil and the UK
Black and Asian Coaches AssociationUKA service-user led group developing values-based support services for people who hear voices for example in employment contexts
The Bristol Co-Production GroupUKWorking closely with the VB CAMHs Network to develop values-based services particularly for young people with anorexia
Central North West London NHS Foundation Trust RecoverCentral North West London NHS Foundation Trust Recovery & Wellbeing College.y & Wellbeing College.UKRuns an educational programme to help support people in their recovery journey by finding the tools and skills to self-manage through partnership between expertise by experience and professional expertise. All aspects of the college are co-produced: the team is made up of 50% lived experience and 50% professional expertise, bringing that balance between evidenced based practice and lived experience together in a values based environment.
Centre for the Advancement of Interprofessional EducationUKPromotes and develops interprofessional education (IPE) in collaboration with like-minded organizations in the UK and overseas. The Values Based Interprofessional Education and Practice Network (see below) is convened by former CAIPE President, Dr Richard Gray
Centro de Humanidades, Facultad de Medicina Clínica Alemana Universidad del DesarrolloChileCreates an open and interdisciplinary dialogue between the humanities and the medical sciences through interdisciplinary humanistic projects in the medical and clinical campuses of the Faculty of Medicine (for example, “Buscando Sentido” (Searching for Meaning) explores through participatory workshops students’ identity, motivations, tastes, interpretation of the world and personal projections, through joint work between artists and other experts (sociologists, philosophers, psychologists, neurobiologists and anthropologists).
Collaborate CICUKWork with government, business and civil society, on the thinking, culture and practice of cross-sector collaboration in public services needed in the increasingly complex operating environment of contemporary society
Collaborate, the Collaborating Centre for VBP and London South Bank University’s joint program on ‘The Future of Collaboration in Services to the Public’ took the form of a series of Round Table Seminars hosted by Lord Adebowale in the House of Lords and resulted in the publication ‘The Anatomy of Collaboration’ (see below).
Mental Health, Health and Social Care (MH2aSC) research groupUKMental Health, Health and Social Care (MH2aSC) research group

Networks

NameConvenerLocationDescription
Interprofessional Education and Practice NetworkDr Richard GrayUKA spin-off from a conference jointly organised by CAIPE (see Organisational Partner, above) and the VBP Collaborating Centre, this network is developing values-based interprofessional models of healthcare education in support of collaboration and teamwork in the delivery of services
Co- Production Addictive Behaviour Research Network (CAB)Lucy WebbUKWorking with ,a href=”https://valuesbasedpractice.org/who-are-we-2/list-of-project-partners/list-of-individuals/dr-guilherme-messas/”> Guilherme Messas (Brazilian Lead for VBP) and the Brazilian VBP Network to develop values-based addiction services in Brazil and the UK
Whiteness and Race Equality NetworkColin KingUKCo-led by white colleagues (Simon King and Steve Gillard) the group is building on Colin King’s work (see his entry above) with the aim of moving collaboratively ‘beyond the colour bar’ in mental health service provision

Sample Publications

 Title AuthorDescription
Values-based Interprofessional Collaborative Practice: Working Together in Health Care (2012, Cambridge: Cambridge University Press)Jill Thistlethwaite Jill Thistlethwaite brings her extensive experience as a clinician and Professor of Medical Education to the way interprofessional collaborative practice supports the person-centred care that is at the heart of values-based practice.
Among other findings the Commission emphasised the importance of building closer links between education and healthcare in the provision of services supporting the mental health of children and young people.

To download a copy go to the VBP website to More about VBP/Full Text Downloads and scroll down to this entry.
The Anatomy of CollaborationHenry Kippin and Bill FulfordThe result of a partnership between the VBP Collaborating Centre for Values-based Practice and London South Bank University, this paper sets out the key facets of successful collaboration explored at our Collaborative Public Service roundtables . The roundtables were hosted at the House of Lords by Lord Adebowale (Chair, Collaborate, CEO Turning Point, and Advisory Board Member, Collaborating Centre for Values-based Practice), and engaged a wide range of expert speakers, including, Julia Unwin CBE (CEO, Joseph Rowntree Foundation), Rt Hon Stephen Dorrell (Chair, NHS Confederation) and David Behan CBE (CEO, Care Quality Commission).
3 Keys to a Shared Approach in Mental Health Assessment Laurie Bryant, Lu Duhig and Bill Fulford, for the National Institute for Mental Health in England (NIMHE) and the Care Services Improvement PartnershipThe 3 Keys is a values-based collaborative approach to assessment in mental health that came out of a wide-ranging consultation among mental health stakeholders sponsored by the UK’s Department of Health. The programme was co-led by Laurie Bryant, Lu Duhig and Bill Fulford, respectively Department Leads at the time for Service User engagement, Carer engagement, and Values-based Practice. The examples given in the report are the basis of on-going work by the Bristol Co-Production Group.

For a description of the 3 Keys Program and recent follow-up work building on its co-productive approach, see:
Fulford, K.W.M., Duhig, L., Hankin, J., Hicks, J., and Keeble, J.(forthcoming, 2015) Values-based Assessment in Mental Health: The 3 Keys to a Shared Approach between Service Users and Service Providers. Ch 73, in Sadler, J.Z., van Staden, W., and Fulford, K.W.M., (Eds) The Oxford Handbook of Psychiatric Ethics. Oxford: Oxford University Press
see Oxford Handbook of Psychiatric Ethics