In my clinic this week, I saw a woman experiencing back pain. We covered the clinical aspects of her back pain and ruled out red flags but, more importantly, we had a ‘what matters to you?’ conversation.
It transpired that 18 months ago she suddenly lost her husband of over 35 years. She talked about how her world had shrunk and the impact this had on her. Her social connections had weakened, along with her love of nature – walking on the South Downs had been one of the couple’s shared hobbies. Working together, we partnered up and ‘danced’ through our professional/patient relationship with a mutual respect for what the other one could bring, the therapeutic alliance. We talked about how she could connect with a weekly pilates group and start volunteering again – simple self-management steps to improve her health, wellbeing and pain. None of this mutual understanding and potential would have been unlocked without a personalised conversation.
A simple reframing of the intent and opening of my interactions, with the question – ‘what matters to you?’, has had more impact on outcomes than any of my other clinical training. I am not only talking about how this manifests with people seeking care, but also for people I work alongside. One of the most frequently overlooked elements of personalised care, is that it should not be limited to patients. I have found that the real magic – for it does elicit magic – came when I began to use this model universally with everyone. I can provide just as many examples of how this has shifted the conversation for me as a colleague, or manager, as it has for me as a clinician.
At Sussex MSK Partnership Central, we have embedded ‘what matters to you?’ into all care over the last two years. For example, we recently held two Community Appointment Days providing in-person, musculoskeletal (MSK) assessment and rehab in local leisure centres to around 600 people on waiting lists for MSK services. No squeezed appointment slots, no fixed timings, no closed doors, no fear of the growing queue of people. Just a de-medicalised space of understanding and focusing on what is important. We supported most people to self-manage and gave them open access to us through patient-initiated follow up. Skilful ‘what matters to you?’ conversations with everyone who attended, set the course for everything that followed, it was magic! We provided immediate access to assessment, rehab, a nurse-led health hub and local community and voluntary services all in one place. And as colleagues we worked together, managed flow, delivered excellent personalised care to our local community and created a sense of solidarity.
So where next for us and how are we continuing to embed personalised care in all we do? This week marks global What matters to you? Day. At Sussex MSK Central, we will be celebrating the incredible impact of human and unhurried care, throughout the whole month of June. We have developed a programme to hear from inspiring speakers from health and social care and education, who have seen the difference made by embedding a ‘what matters to you?’ approach in their work. Clinical teams and Health Builders, our partners with lived experience, have co-created a Personalised Care Observation Tool to focus peer supervision, and surveys to measure the impact of this approach for our patients. Colleagues will reaffirm their commitment to this important work that enables people to have a voice and be really heard by making pledges on our ‘what matters to you’ pledge trees.
The value of ‘what matters to you?’ is more than just the words. I have found that so much of what follows is dependent on my tone, pace, and authenticity. Shoehorning ‘what matters to you?’ somewhere in a conversation, without making it your raison d’etre, will not yield results. But when done well, it has transformed my practice and discussions with people.
So, consider this your personal prompt to have a different type of conversation this ‘what matters to you? day’. Change one thing; shift the focus from what’s wrong with someone to what’s important to them and see the difference first hand. And if you don’t know where to start you can access training and learn new skills, or hear other experiences by following the conversation #WMTY23 – see what magic you can conjure!