An NHS England scheme to transform care for millions of disabled people and those with long term conditions is being rolled out to six new areas across England. James Sanderson, Director of Personalisation and Choice, explains what today’s new announcement means for patients.
Not long after I came into post I set out some of my ambitions for expanding personalisation and choice in the NHS, and I’m pleased to say that significant progress has been made.
Our Integrated Personal Commissioning (IPC) programme has continued to develop as a mainstream care model for people with long term conditions. I’m delighted to announce we have recently added ‘Early Adopter’ sites to the programme, giving us 18 IPC footprints across 33 CCGs. We saw significant interest from Sustainability and Transformation Plans (STPs) who have incorporated the IPC model into their local plans as a means of transforming care and creating a sustainable health economy.
IPC, coupled with personal health budgets (PHBs), empowers disabled people and those with the most complex health needs to use their own expertise to generate innovative solutions for their care. It’s a practical, quality model, of personalisation which enables the delivery of person centred and integrated care at scale. This not only improves outcomes for individuals, but can also significantly reduce cost to the system.
Alongside colleagues from the Local Government Association (LGA) and other IPC board members I have recently been touring the country to visit our demonstrator sites and have been inspired and encouraged by the amount of progressive and life changing work that is being delivered – really innovation and creative disruption happening now.
We have seen excellent examples of local systems working together, health and social care boundaries being made obsolete, multidisciplinary teams working together around the needs of an individual, and powerful examples of people taking control of their lives through personalised support.
The principles of coproduction are central to the model and we have introduced a peer leadership academy which has developed the skills and confidence of people with lived experience to support every level of our work – from system design and delivery, through to being active members of our board.
That isn’t to say that making any of this happen has been easy. Processes in some areas remain complex and lasting culture change takes time to embed, but as we get to a point where the system is delivering at scale, we are confident that we will see greater efficiencies for the administration of PHBs and more effective partnerships across health, social care and the voluntary sector.
Equally IPC isn’t a standalone model, it fits coherently into the landscape of the Five Year Forward View, for example, it will be a crucial component of the multispecialty community provider (MCP) and integrated primary and acute care systems (PACS) new care models, enabling precision commissioning and ensuring that as health systems develop we will still retain real choice and control for patients. We are looking forward to providing the system with replicable delivery focussed models in the New Year to support the further expansion of the programme.
Beyond the IPC sites, our PHB Delivery Team continue to support CCGs across the country as they rapidly expand their local offer of personal health budgets in ways which meet the needs of their populations, in line with the ambitions set out in the NHS mandate to reach 50-100k PHBs by 2020.
Momentum is really gathering behind the opportunity to transform support, and we have seen an increase of 130% in the number of PHBs being delivered over the past year, taking the number of people who are now benefitting to just under 11,000.
We’re supporting CCGs to focus on specific areas where PHBs could work well, including for people with multiple long term conditions, mental health needs, for people with a learning disability and in the provision of wheelchairs.
We are also trialling PHBs for end of life care in five areas, looking at mechanisms to change the conversation around death and enable more effective person centred care. Earlier this year the Department of Health published a EoL commitment to improve patient choice, and evidence shows PHBs provide a great opportunity to make the commitment a reality for people. We are currently working alongside Professor Bee Wee, the LTC team and regional NHS colleagues to deliver a series of EoL roadshows across the country exploring how we can improve care and support at this crucial time.
Looking even further beyond innovative models for people with long term conditions we are also working to improve maternity choice for women through the development of personal maternity care budgets and we were delighted that last week Cheshire & Merseyside become our first Maternity Choice & Personalisation Pioneer site to launch this new initiative as my colleague Jennie Walker recently wrote about.
Overall, what I have seen over the past year is a real commitment from commissioners and clinicians to improve choice and control for patients within the healthcare system. The Personalisation and Choice programmes are at the heart of chapter two of the the Five year Forward View, which calls for a shift in patient power and provide the system with clear delivery models that turn this philosophy into a reality. We have more work to do, but the signs are there of a real shift beginning to happen!