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.