The Clinical Transformation Lead for the Personalised Care Programme at Hertfordshire and West Essex CCG outlines how embedding personalised care in practice across health, social care and beyond doesn’t just give people more choice and control – it makes the teams and individuals supporting them feel valued, engaged and supported:
Within Hertfordshire and West Essex, we see the Personalised Care programme as the key for the residents of our Sustainability and Transformation Partnership (STP) to have greater choice and control over their health and wellbeing.
Personalised care means changing the conversation we have with people, and that this altered conversation is consistent regardless of who they come in to contact with.
If we collectively have a personalised approach, we will ensure that those who need support access the right services or support at the right time. We also see this as a key opportunity to empower our workforce to feel valued, engaged and supported.
We use the term ‘workforce’ loosely, as we feel all local people – such as hairdressers, volunteer car drivers and postmen – have a vital role to play within the Personalised Care programme, not just people who may typically be thought of as a workforce such as nurses or therapists.
As an employee of the NHS, I see how the increasing demands on an ever-dwindling health and social care workforce is pushing people to breaking point. Staff feel they do not have the headspace to take on board something new or different. We have a large number of people working within commissioned services, who interact with many people on a daily basis. It would be easy to think if we enhance the skills of staff working within these services we could greatly improve the experience for all people receiving care. Simple!
The truth, however, is the ethos of the programme needs to apply to the workforce as well as the people they support. We need to work with staff to truly understand the challenges they face and how they feel in order to support them to personalise the care they provide.
In Hertfordshire and West Essex, we’ve held a series of workshops with representatives from across the STP. So far, we have:
- Co-produced a set of values for those delivering personalised care to demonstrate, such as empowerment, sincerity and being dynamic. We think these values will help people working in health and social care understand what is meant by personalised care and gives people the opportunity to assess their current practice against the values.
- Worked with NHS England colleagues and representatives from across the STP to design a ‘train the trainer’ programme on personalised care and support planning. This coincides with the creation of a single personalised care and support plan, ‘MyPlan’, co-produced by people with lived experience and staff across the STP. Initially, we heard feedback from staff that it was another piece of paper to fill in, which they didn’t have time for. During the delivery of the training, however, we saw the lightbulb moments when they truly understood its value, purpose and, most importantly, that the conversation is the essential part – not the paperwork.
- Acknowledged the current culture and climate and how this impacts on the delivery of personalised care. Staff need to feel valued and supported at work and we are exploring how the programme can enhance this. Within the STP, we have a fantastic wellbeing college that co-produces courses for people such as sleeping well, managing anxiety and daring to dream. We are exploring whether this approach can help staff to better manage their day to day work life. It is early days, but we are excited by the multi-organisational approach and the opportunity to empower staff to create something meaningful for them.
- Explored the role of shared decision making in increasing staff resilience. This is a key element of the personalised care programme and we are taking this a step further. With an ageing population and advances in medicine, teams are supporting people who have increasingly complex needs and can make decisions regarding their care. As a clinician, it can be difficult if a person’s decision goes against evidence-based guidelines; there is also a risk of deeming people non-compliant rather than embracing shared decision making. We are exploring multi-organisational approaches to such cases to make the experience more positive for all, building resilience and reducing the need for people to repeat their story several times. One current offer is a Multi-Specialty Team to discuss those with complex needs across systems. Staff explain that this meeting offers a ‘supportive, safe environment to share your concerns and problem solve’.
The approaches we have taken so far aim to make everyone feel valued, engaged and supported. We recognise a cultural change is required to truly enhance the personalisation of care. Within current working climates, this will be really challenging, but by sharing learning and experience between our local teams over time, we are hopeful for the future.