LTP Priority: Personalised Care
Population Intervention Triangle: Segments (link to Section 1 PHE PBA): Service
Type of Interventions: Personalised Care – Supported Self-Management – Health Coaching
Major driver of health inequalities in your area of work
Chapter one of the Long Term Plan sets out personalised care as one of the five major changes that will establish the new service model for the NHS. 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 supports people to stay well for longer and makes the most of the expertise, capacity and potential of people, families and communities in delivering better health and wellbeing outcomes and experiences. As a result of personalised care, healthcare is tailored to what matters to the individual, in the context of their whole life, such that personalised care can support programmes and systems to address inequalities in access, experience and outcomes.
Personalised care is listed as part of one of the five major, practical changes to the NHS Service Model over the next 5 years: People will get more control over their own health, and more personalised care when they need it.
The LTP sets out that 2.5 million people will benefit from the Comprehensive Model for Personalised Care. This includes the following commitments across six components of personalised care (in addition to a number of other commitments that rely on personalised care):
- Accelerate roll out of Personal Health Budgets… Up to 200,000 people will benefit from a PHB by 2023/24 (para 1.41)
- Over 1,000 trained social prescribing link workers by 2020/21 and 900,000 people referred to social prescribing link workers by 2023/24 (para 1.40)
- Ramp up support for people to self-manage their own health (para 1.38)
- People have choice of options for quick elective care, including choice at point of referral and proactively for people waiting for six months (para 3.109
- Support and help train staff to have personalised care conversations (para 1.37)
- Use decision-support tools (para 3.106) and ensure the least effective interventions are not routinely performed… potentially avoiding needless harm (para 6.17viii))
Below we expand on how each of these commitments can support the approach to reducing health inequalities.
People living in deprived areas
Details of the recommended intervention.
Supported Self-Management – Health Coaching
Health coaching means helping people gain and use the knowledge, skills and confidence to become active participants in their care so that they can reach their self-identified health and wellbeing goals. A health coaching role can take may different forms. It can be:
- built into existing healthcare professional roles, i.e. existing staff are trained to use these techniques and tools within routine NHS consultations
- dedicated health coach role – usually delivered in a primary or community care setting.
The Supported self-management summary guide is a best practice guide aimed at people and organisations leading local implementation of supported self-management. It provides advice and resources to support the implementation of supported self-management approaches.
In 2019/20 NHS England will be publishing a quality standard for commissioning of health coaching services that will be available on the NHS England website. This health coaching quality standard will provide a national standard against which health coaching provision can be measured and benchmarked.
Health coaching can improve patient activation levels (unpublished data available from KYOH – Know Your Own Health), and socioeconomic deprivation is associated with lower levels of engagement and activation (Coulter). Raising patient activation levels benefits patients. (Barker, I. et al. (2017), Patient activation is associated with fewer visits to both general practice and emergency departments: a cross-sectional study of patients with long-term conditions, Clinical Medicine, 17(3), p.15) (Deeny, S., Thorlby, R., Steventon, A. (2018), Briefing: Reducing emergency admissions: unlocking the potential of people to better manage their long-term conditions. London: Health Foundation).
Guidance for Commissioners:
Guidance will be available from the futureNHS collaboration platform from July 2019 as part of the Supported Self-Management summary guide.