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As a nurse with over thirty years’ experience, and a champion of personalised care, I would like to take the opportunity of International Nurses Day 2021 to thank all my colleagues who practise personalised care in their daily professional life.
I am an ex-diabetes specialist nurse, and understand how important it is to get the balance right between the clinical and non-clinical aspects of care. For people with a long-term condition, managing it is just one aspect of day-to-day life, so supporting people to self-manage in a way that works for them is crucial.
Personalised care aims to support a more individualised approach to healthcare by reframing the relationship between people/patients and clinicians. It advocates more balance between ‘what’s the matter with you?’ (in a clinical sense) and ‘what matters to you?’, meaning their personal circumstances, values and preferences. It focuses on wellness as much as illness, to ensure the social determinants of health are considered.
Over the last year or so, the pandemic has challenged us all. Nurses have risen to the challenge of doing their best to provide personalised care and support to people in these difficult times. This makes me proud of my profession more than ever.
Although personalised care is not new, by drawing together shared decision making, personalised care and support planning and supported self-management, plus choice, social prescribing and community-based approaches and personal health budgets, the model seeks to fundamentally change the way that care is planned and delivered for people and communities.
It gives us the opportunity to help a range of individuals, from people with complex needs through to those managing long term conditions, mental health issues or struggling with social issues which affect their health and wellbeing. It helps them make decisions about managing their health and wellbeing, so they can live the life they want to live, based on what matters to them, helped by clinical information from the professionals who support them.
What does this mean for nurses in practice?
As well as delivering on the NHS Long Term Plan commitment to rolling out the comprehensive model for personalised care to reach 2.5 million people by 2023/24, nurses are professionally bound to deliver personalised care.
The Code that presents the professional standards for nurses, midwives and nursing associates states we should prioritise, listen and respond to people’s preferences and concerns and in doing so:
- work in partnership with people to make sure we deliver care effectively.
- recognise and respect the contribution that people can make to their own health and wellbeing.
- encourage and empower people to share decisions about their treatment and care.
- respect the level to which people receiving care want to be involved in decisions about their own health, wellbeing and care.
- make sure that people’s physical, social and psychological needs are assessed and responded to.
Many nurses strive to give great personalised care, but in some cases aren’t always able to do so. Barriers can include a lack of time or the way a pathway or service is structured. This past year it has also included managing the demands of a pandemic!
Evidence from national patient surveys, such as The General Practice Survey, 2019 would suggest people do not always feel as involved in their health care as they would like.
Evidence from The Kings Fund, 2012 also suggests that what people want in terms of health care, and what clinicians think they want, can be very different. Working in a health and care system that predominantly operates on a biomedical model of health, we can often slip into a pattern of treating the condition, not the person.
As nurses we need to have conversations that balance the power dynamic and address what is important to the individual, as well as what’s wrong with them. This requires knowledge, skills and confidence, which nurses are not always equipped to develop in pre-registration or post registration education and development.
The Personalised Care Institute has been established to provide exactly that: accessible, high quality training and development for health and care staff, and I would urge my colleagues to take advantage of all the excellent resources it has to offer.