Rob Webster and Pritti Mehta are self-confessed ‘rubbish runners’, parkrun volunteers and health and care leaders. Here they argue that taking control of health and wellbeing is a personal, community and system issue.
We all make choices that impact on our health and wellbeing.
These choices operate in our personal lives, and are reflected in our communities and in what professionals call the “systems” we operate in.
Making conscious choices and doing so together can lead to greater control over our health and wellbeing. Doing so is a personal, community, system and strategic issue. Put simply, this is already everyone’s business and getting serious about it could impact at all levels of health and care.
On a personal level, it is the steps we take to manage our own mental and physical health and wellbeing. Both Rob and I try to run. It can be a real struggle to start, ‘the steps from the sofa to the front door are the hardest’, but we never regret going for a run and always feel better for it. How we feel is important and research on the benefits of activity and health are well evidenced. If exercise were a drug, it would be hailed as a miracle cure.
On a community level, it is volunteering at our local Woodhouse Moor parkrun. Every week, up to 500 people come together to walk, jog, run and volunteer. The benefits of volunteering are also well evidenced for social, physical and mental wellbeing. This low tech innovation is the biggest social movement of its kind, building health, happiness and community connections.
At a system level, it is the work we are doing to embed personalised care across local health and care systems, building on new care models and integrated personal commissioning programmes. These policy shifts are important if we are to recognise that we need more conscious approaches to making this everyone’s business.
The comprehensive model of personalised care is part of the answer. It aims to:
- help people stay well through social prescribing, by connecting them to community based approaches such as parkrun
- support people with long term conditions to develop the confidence and skills to better understand and manage their own condition, which includes patient activation measurement (PAM®) and support for self-management
- support people with more complex care needs to have better quality of life and care through personalised care and support planning and personal health budgets.
These approaches are all underpinned by informed choice and shared decision making.
In West Yorkshire and Harrogate, where we both live and work, we are actively supporting its six ‘local places’ to systematically embed these approaches, by building on excellent work that has already taken place. Social prescribing is fully embedded in four of the six places. PAM and support for self-management is available in two of the six places, with plans to extend. And training is being delivered to support the implementation of personalised care and support planning and personal health budgets across the patch.
As the lead for the West Yorkshire & Harrogate Integrated Care System, Rob is delighted that all six places have signed up to this approach. It is part of a shift in emphasis towards a true partnership with local people. One where we each bring something at a personal level to communities to benefit the system.
Over the Pennines, in Lancashire and South Cumbria, work is being championed by local system leaders, including Amanda Doyle and Sakthi Karunanithi to implement the comprehensive model. Digital approaches to enable social prescribing are being developed alongside the implementation and spread of PAM and health coaching, building on the work of the Fylde Coast vanguard. At the heart of this is ‘community based, personalised care’, where ‘primary care networks’ and local authorities are playing a key role in supporting communities to be fully engaged in their own health and wellbeing.
The next steps will be to ensure that personalised care is implemented alongside population health management approaches. They are pieces of the same jigsaw in a future picture of health and care – one where we maximise the impact of these approaches and fully track the outcomes at individual, population and system level.
In the 21 Century we know that most of the people we work with will have enduring issues and multiple morbidity. We need new and better partnerships with people who will never be “cured” of the long term conditions they live with but have huge amounts to offer each other, communities and the NHS.
Population health management and personalised care need to move from being the latest jargon to meaningful interventions at scale. They must become business as usual at regional and national levels, so that more people are able to take control of their own health and wellbeing.
This is our ambition in West Yorkshire and Harrogate and we hope to see this as a centre piece of the long term strategic plan.
If you doubt that people-powered health can make a difference, just ask Sarah Hewitt. This month, she became the 5 millionth person to sign up to parkrun and she ran at Woodhouse Moor.