As Jeremy Hunt sets out plans for social care reform, NHS England’s Director of Personalised Care takes a look at the pivotal role of joint health and social care assessments and integrated personal budgets for securing transformation:
There is a widespread consensus that joint working across health and social care is vital to improving people’s health and wellbeing outcomes and reforming the health and social care system.
But our attempts have often failed to recognise the pivotal role people themselves can play in integrating their own care.
At the British Association of Social Workers conference earlier this week, the Secretary of State for Health and Social Care, Jeremy Hunt, set out the key principles for social care reform, which included recognition of the fundamental importance of people feeling in control of their care and having confidence in the care and support system, as part of a true “partnership between the state and individuals”.
This call for a more personalised approach to care, with people at the centre, is a welcome endorsement of the work we are leading in the Personalised Care Group at NHS England.
Also announced by the Health Secretary was a new consultation on personal health budgets in order to achieve better integration for those with the greatest ongoing social and health care needs; and a new £1million Integrated Health and Care Pilot in Gloucestershire, Lincolnshire and Nottinghamshire.
Using the Integrated Personal Commissioning (IPC) model, this pilot will specifically examine the impact of providing an integrated and holistic ‘care needs assessment’ and a ‘personalised care and support plan’ for people with both health and social care needs. It will involve an entirely new proactive and joined-up way to care assessment and planning for those that need it most.
Both these moves are seen as key to securing vital transformation, ensuring that people are recognised as experts in their own condition and partners in their care, rather than passive recipients of services.
The IPC model is about providing a systematic framework for the NHS and local Government to deliver care in a way that is proactive, asset based, personalised and integrated. Over the last two years, we’ve been working with areas across the country to embed this model and we are now starting seeing the real and positive impact where IPC and personal health budgets are helping people to have a much more joined up experience of health and social care.
The Integrated Health and Care pilot will further build on this success and provide an important next step towards enabling a truly integrated service which is built around the needs of the individual.
Importantly, this approach is part of a wider drive to personalise health and care which dates back to the 1970s, when disabled people rightly campaigned to have more choice and control over their care. Growing evidence shows that choice and control over decisions made about care can lead to people accessing more appropriate services, improve the coordination of people’s care, improve outcomes and experience, and reduce costs for the NHS.
As people are now living longer, and with more complex needs, the advent of new approaches to managing care will help ensure our system responds effectively to people’s individual needs, however complex these may be. The stats show this is no small task, with 15 million people living with long term conditions, accounting for 50 per cent of all GP appointments, and occupying 70 per cent of hospital beds.
In the new pilot areas, people will receive holistic care plans, tailored to their individual needs and based on the health and wellbeing outcomes they wish to achieve. The process should be integrated, with a single, named coordinator working in partnership with each individual.
This work will draw on learning from IPC and work across the country to offer personal health budgets, and stories such as Jackie’s, someone who was left disabled following an attack whilst on duty as a Metropolitan police officer, demonstrate the positive impact of personalised care, both for Jackie’s wellbeing and in terms of the impact on the NHS. Having saved the NHS 60 ambulance trips in one year alone, Jackie’s assistance dog alerts her when she is going to have an epileptic seizure, can predict her hypo and hyperglycaemic attacks, sound an alarm, and open the door to paramedics.
These types of approaches remain true to the NHS constitution, providing free health care at the point of need, but crucially enable this care to be tailored more specifically to individual need, ensuring that resources are deployed more precisely.
There is still much to do, so I warmly welcome the launch of the consultation to extend the legal rights to have integrated personal budgets and the integrated health and social care pilots.
These are timely opportunities to help expand personalised care and I look forward to seeing the outcomes of the consultation and pilots, and working closely with our partners across the country to delivering this radical and necessary change.
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