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Putting people at the heart of the system

NHS England’s Director of Personalised Care discusses the growing movement for people to have control over their own health and care:

The concept of Personalised Care has been around for many years, in many different forms and with a myriad of terms and initiatives associated with it.

There exists an army of supporters right across the country that strives for people to have improved choice and control over their health and care, and for services to adapt to fit the needs of an individual.

The movement has been growing rapidly, with new approaches emerging, greater cohesion across sectors and, crucially, stronger evidence of the impact, both for individuals and the system.

However, approaches to personalised care have been far too fragmented in the past. Whilst there have been great pockets of activity around the country, these have on occasion been disconnected from the mainstream health and care system – existing as ‘nice to have’ programmes running alongside what many have seen as the ‘core’ service.

There has also been too much competition between approaches and, occasional distracting overly intellectual arguments concerning the language used to identify programmes, rather than a focus on building a consensus view and effective bridges linking initiatives together.

But we now have an opportunity to change this. The opportunity to make personalised care a reality for millions of people, moving beyond the talk, and creating a universal offer that becomes a core component of the system.

Personalised care means people have choice and control over the way their care is planned and delivered, based on ‘what matters to them’ and their individual strengths, needs and preferences. This happens within a system that makes the most of the expertise, capacity and potential of people, families and communities to deliver better health and wellbeing outcomes and experiences.

The Comprehensive Model for Personalised Care presents a game changer for the movement. It breaks down barriers between different approaches and provides a delivery framework that can achieve the scale necessary to emerge from the margins.

Crucially, the model has been co-produced, working alongside colleagues across health and social care, in the voluntary and statutory sectors, and with a significant number of people with lived experience involved right from the beginning. It brings together six core components – Shared Decision Making, Patient Choice, Personalised Care and Support Planning, Social Prescribing, Supported Self-Management and Patient Activation, and Personal Health Budgets.

On their own, each of these components are evidenced to work but, when used as a complementary set of interdependent enablers, the opportunities to transform experience, health and well-being outcomes and to ensure we use resources wisely are considerable.

Personalised Care will need to play a major role in the future of the NHS and set goals to scale the comprehensive model nationally. People are rightly demanding more choice and control over services, to be supported to manage their own health and wellbeing, and we are also increasingly recognising that new and innovative approaches to care are needed – especially in light of the increasing number of people who face psychological and social problems alongside their medical needs.

Let’s not forget that a model is a model. What it represents – and helps to deliver – is a clarion call to public services. It represents a shift from ‘what’s the matter with you?’  to ‘what matters to you?’. It signifies a shift from a deficit based system to an asset based system and it demonstrates how statutory services and communities can work together to co-produce health and wellbeing.

I hope that the publication of our model and the associated delivery mechanisms that we will be implementing across the system will provide a renewed opportunity for Personalised Care to finally emerge from the shadows and be accepted as a vital part of the NHS.

I also hope that the model enables different approaches and movement, to come together with a united goal of putting people at the heart of the system.

James Sanderson

James Sanderson is the Director of Personalised Care at NHS England and Improvement, 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 through the delivery of Universal Personalised Care. This includes the Personal Health Budgets programme, Social Prescribing, Shared Decision Making, Personalised Care and Support Planning, 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 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.

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6 comments

  1. Johanna Cleary says:

    Dear Mr. Sanderson,

    I am very interested in applying for a position as listening co-ordinator within your current recruitment drive for workers to assist in reducing the strain on our G.P.s. I have previous experience of work within the NHS and Social Services particularly in the area of Mental Health. I am currently enrolled on a NCFE Counselling course and I have personal experience of how to live a daily healthy lifestyle.
    I also have many qualifications in Alternative Health Treatments, including hands on treatments and good nutrition. I am also a qualified Personnel Officer through the Chartered Institute of Personnel and Development, (CIPD).

    Yours sincerely,
    Johanna.

    • NHS England says:

      Thank you for your interest.

      In the spring, we will be supporting areas to work together to recruit link workers locally. If you could email england.socialprescribing@nhs.net, they will log your request and will contact you again when further information is available.

      Kind Regards
      NHS England

  2. Sirinda Bhandal says:

    Hi James, Simply Connect have a wealth experience working with communities, helping to make services accessible to all. We’ve also worked to support people with personal budgets, have understanding of challenges faced in finding the right care and support, accessing services, etc We would be happy to share our experience and learning in any consultation that can support the work you are doing around implementing the plan, Sirinda

  3. Neeta Mehta says:

    The concept of personalisation, phb program and intergratea personal commissioning sounds so great if the ethos are accepted by the CCG’s. We have a long way to go before achieving the desired outcome which are benefits and improving outcome for patients. On a local level the outcomes are only desirable and weighed in with quantity and finance. My son is at the receiving end of this madness. He spent 16 months in a hospital, when there was no medical need for him to be in a hospital. He was detained due to my son’s desired to achieve personalisation and PHB. It took 16 months to receive incomplete care plan from the CCG. Many London CCG have imposed a cap on the phb, Regardless of patients needs. My local CCG reused to follow the framework and guidance, yet no one can hold them accountable for their appalling behaviour. We are dealing with very vulnerable patients, how long can we put their safety and well-being at risk, especially patients with short lives and needs very specialised

  4. Carol Morrison says:

    afternoon as some-one who is interested in the NHS and Services offered: do you have data that indicates for the country how far is it acceptable for one to travel to the nearest accident and emergency unit. I live in a rural area and have to travel over 50 miles to the nearest accident and emergency unit. is this the furthest. Is there anywhere else that has this travel ,or where can I get statistics.

    • NHS England says:

      Hi Carol,

      Thank you for your comment.

      I have passed the details of you comment on to our Freedom of Information team, who will be in touch to acknowledge your request.

      Kind Regards
      NHS England