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Making the case for the personalised approach

Two of the speakers at today’s Long Term Conditions (LTC) Summit at the QEII in London explain how the event provides a stark reminder about the critical challenges facing people with LTCs:

There are over 26 million people in the UK who live with at least one LTC and 10 million who have two or more. Their ongoing and complex needs are currently met by an already overstretched health and social care system.

One of the challenges facing the NHS is the fact that more people are living longer but not necessarily healthier lives. Advances in healthcare have brought greater life expectancy, and as people age they are more likely to have one or more LTC.

Recent figures also suggest around 41% of people attending A&E do not need to be there. There are many reasons for this but it is clear that we need to divert people to more appropriate support and then service them better when they do arrive.

People with LTCs are particularly relevant here as they account for 50% of all GP appointments and 70% of hospital beds. In addition, 70% of each health and social care pound is spent on supporting people with LTCs.

These are staggering figures to comprehend.

The Five Year Forward View also makes our focus abundantly clear that  ‘long term conditions are now a central task of the NHS; caring for these needs requires a partnership with patients over the longer term rather than providing single, unconnected “episodes” of care.’

So what can change?

For people with a LTC, we have strong evidence that self-care can play a key role in improving their health and wellbeing outcomes. Yet 45% of people with a LTC are not confident self-managers and tend to make more use of both elective and urgent services than the 55% who are confident self-managers.

In addition we know that there is a growing general demand for health empowerment, both from patients, who rightly demand increased choice and control over their health and care, and from system leaders, clinicians and commissioners, who recognise the opportunities that come from tapping into the renewable assets that individuals and communities can bring to the table.

We also need to focus on prevention and prioritise our efforts on both premature morbidity and mortality. Prevention is often considered ‘longer term’ for both investment and outcomes, and there are many measures that we can put into place that can have a quick impact.

Therefore, supporting people with LTCs on a journey of activation will help them feel more in control; live a better life; and ensure they make more informed and, therefore, less use of elective and urgent care services.

This is where a universal approach to Personalised Care and Support comes in.  It is an approach that fundamentally changes the relationship for patients and the system – a change that moves from an agenda of ‘what’s wrong with you?’ to one that asks ‘what matters to you?

Personalised Care is about providing a more balance relationship, one in which the person in need of care and support is put at the centre of that support. Services are then designed around the individual, rather than being rigid in approach, and in a way that the individual person understands and can truly engage with.

Personal Health Budgets are good example of this approach and already 22,846 people with complex, long term needs are now benefitting from this new way of working.

One good example of how this works is how digital services and tools can help people to better manage their LTCs. Digital services are convenient for patients, efficient for the NHS and can get people the right care as quickly as possible.

GP online services enable people to book appointments, order repeat prescriptions and access their records online. David is a patient with diabetes and having ongoing access to his online test results and health records has helped him to better manage his condition.

Paul uses an online app called myCOPD which helps him to manage his chronic obstructive pulmonary disease (COPD). The app includes a complete pulmonary rehabilitation programme delivered in his home and evidence is emerging that this app is having a real and positive impact on COPD patients.

But this is just the beginning, and these connected apps and online tools are just one example of how a personalised approach can revolutionise care and support people better.

It’s time to start working differently by making new health and care partnerships with patients themselves but also making the most of social and community-based services that are already available.

Together we can provide better health outcomes for people with LTCs as well as building a stronger, more efficient NHS.

James Sanderson

James Sanderson is the Director of Personalised Care at NHS England, working within the Strategy and Innovation Directorate to oversee the strategy and delivery for a range of programmes that are helping to empower people to have greater choice and control over their care. This includes the Personal Health Budgets programme, Integrated Personal Commissioning (IPC), Shared Decision Making, Person-Centred Care, Maternity Pioneers and developing and implementing new models of delivering patient choice.

James joined NHS England in November 2015, and was formerly Chief Executive and Accounting Officer for the Independent Living Fund (ILF). The ILF was used to support disabled people across the whole of the UK to live independent lives through the provision of direct payments enabling the purchase of personal assistance support.

After graduating, James embarked on a career in the private sector before joining the ILF in 2002 to undertake a number of senior roles including Operations Director with responsibility for front line service delivery, and Business Development Director with responsibility for performance development, change management and information governance.

Jacquie White, Deputy Director for Long Term Conditions, Older People and End of Life Care

Jacquie White is NHS England’s Head of Clinical Policy with responsibility for improving the quality of life for people with Long Term Conditions, Older people and those at End of Life.

Jacquie has over 15 years’ experience of working in and supporting health and social care teams to improve the quality of services for and with their local population.

Having started her career in fund holding in a small rural general practice, Jacquie has worked across the public sector at a local, regional and national level.

She has significant experience of both commissioning and provider development and of supporting teams to integrate care across organisational boundaries.

2 comments

  1. Sandra Hartley says:

    I think these figures make it very clear for the need for focus more on health promotion and prevention strategies.

    Is it possible to provide a reference for the 26 million people in the UK who live with at least one LTC and 10 million who have two or more, as I would like to cite.

    • NHS England says:

      Hi Sandra,

      The statistic came from the Office for National Statistics (ONS), 2011 Household Consensus Data.

      Kind Regards
      NHS England