Professor Helen Jayne Stokes-Lampard PhD FRCGP is a general practitioner and Chair of the Royal College of General Practitioners. Here she reflects on the recent commitment to make personalised care ‘business as usual’ for 2.5 million people by 2024.
It’s been a particularly hectic start to 2019 with the announcement of the NHS long term plan, and confirmation of the next five-year GP contract – both of which promise to be positive for general practice, and in turn the care we can deliver to our patients.
A key element of the long-term plan is a commitment to delivering Universal Personalised Care to 2.5 million people by 2024. This approach aims to support people to make informed decisions about managing their health, so they can live the life they want to live, based on what matters to them, as well as the evidence-based, good quality information from the health and care professionals who support them.
As GPs of course we already aspire to deliver holistic care, but this even more personalised approach along with additional resources should help us to better co-ordinate care around a patient’s individual circumstances, as well as support them to connect with digital and/or community resources.
One part of this is ‘social prescribing’ – and whilst the term itself is recent, it’s just a natural evolution of something that good GPs have always done in one form or another.
Often, as we all know too well, the underlying reason for someone visiting their GP is not medical, and for these patients a recommendation or encouragement to join an exercise class or community group or learn a new skill can be hugely beneficial – more so than a traditional prescription for medication.
I’ve spoken before about Enid: my 84-year-old patient who suffers from hypertension and type 2 diabetes and has intermittent flares of osteoarthritis pain in both her hips, and who was recently widowed.
I noticed that Enid was visiting the surgery more often, and becoming irritable with the team, but whilst she did have health problems, they really weren’t the reason for her behaviour: she was lonely and lacking purpose. I was able to connect her to a local social programme that worked for her and led to a massive improvement in her wellbeing.
We hear wonderful stories – like Enid’s – about how social prescribing is transforming people’s lives, and whilst we recognise that we need more robust, systematic review into the efficacy of formal social prescribing initiatives, there is some evidence that they can free up GPs’ time for patients with complex health needs who really need our medical expertise. A College survey also found that 59% of GPs believe that social prescribing can help reduce their workload, and therefore alleviate pressures across the NHS.
This is why we are supporting NHS England plans to introduce 1,000 ‘link workers’ as part of the NHS long-term plan. Ensuring GPs have access to social prescribers is something the RCGP has called for, and something that is being received well in Scotland, particularly in terms of reducing health inequalities.
Social prescribing is just one of five ‘components’ that make up the Universal Personalised Care – and together they signal the intention to forge a fundamental new relationship between people, professionals and the health and care system. The other five components are shared decision making; personalised care and support planning; supported self-management<>; enabling choice and personal health budgets.
Evidence shows that people will have better experiences and improved health and wellbeing if they can actively shape their care and support in this way. We know that a one-size fits all health and care system simply cannot meet the increasing complexity of people’s needs and expectations.
Many of you have been using good collaborative care and support planning for some time and the recent developments will help others to also start implementing some of these ways of working.
The RCGP recently hosted a briefing about UPC where I heard first-hand experiences about the impact that a more personalised care approach can have on clinicians and patients. These are often simple things like being able to order a wheelchair that comfortably fits the person; having ongoing carers who you trust knowing about your condition coming into your home; patients having a better understanding about their condition; and patients – like Enid – connecting with local community groups to help them manage and improve the conditions that are affecting their long-term health and wellbeing.
Personalised care is part of the essence of good general practice. The ability to deliver holistic care is one of the main reasons why we choose this profession – taking into account the physical, psychological and social factors potentially impacting on a patient’s health when making a diagnosis and formulating a treatment plan.
We look forward to working closely with our colleagues right across the NHS to help realise the ambitions of Universal Personalised Care.