Month: December 2021

PRSB’s 2021 achievements

We entered 2021 in lockdown at the height of the second wave of the pandemic, with the health and social care sector working tirelessly to keep us safe. Despite these difficulties, we’ve also had notable successes this year with the mass rollout of the vaccination programme and at PRSB we are immensely proud that our […]

A great inaugural year for PRSB’s Partnership Scheme

2021 saw the introduction of PRSB’s new Standards Partnership Scheme, which recognises the good work of software suppliers that integrate standards into their digital products and supports interoperability as an enabler of integrated care. Throughout the year, PRSB has delivered several Partner-exclusive masterclasses and given insights into the pivotal role of standards in advancing the […]

An introduction to PRSB’s Head of Marketing: Andy Hall

What made you want to join the PRSB? For me it feels like a very exciting time to be joining the organisation. The acceleration of digital transformation and the burgeoning demand for accurate, real-time data in the sector means the PRSB has a critical and leading role to play in the collaborative effort to implement […]

2022: Standards in the pipeline

Although the end of 2021 is nearly here, PRSB is working hard on developing the first batch of standards to be published in 2022. Have a read of what’s to come. Diabetes Standards: We are developing two standards for diabetes care for adults and children, for remote monitoring and information sharing between anyone involved in […]

Personalised care and support plan standard wins Information Standards Notice (ISN)

The Personalised care and support plan (PCSP) standard has achieved ISN status following rigorous quality assurance by the NHS Data Alliance Partnership Board. ISN status ensures that health and care organisations and system suppliers adopt information standards, so that data can be shared and compared across the sector. The ISN sets out details of the […]

PRSB welcomes the government response to the Paterson Inquiry

By Professor Maureen Baker CBE Openness is critical for safe healthcare and all consultants should be writing directly to you to ensure that you have the right information to make informed decisions about your health, treatment options and care. This is one of the recommendations made by the Paterson Inquiry, accepted by the government today, […]

PRSB responds to The Paterson Inquiry recommendations 2021

The government have accepted the recommendations of the Paterson Inquiry following the actions of former surgeon, Ian Paterson, who was sentenced to 20 years in jail after performing unsafe and sometimes unnecessary operations on hundreds of women.

The PRSB welcomes all of the Inquiry’s recommendations which include a national framework for managing patient recall procedures, a multi-disciplinary meeting where everyone has access to the patient’s results and treatment options and the introduction of a short period into consenting procedures to allow patients time to reflect on their diagnosis and options.

PRSB responds to the ‘People at the Heart of Care: adult social care reform white paper’

The PRSB welcomes the Government’s pledge in the new White Paper for adult social care to speed up adoption of digital tools and make better use of data to promote safe, sustainable, high quality social care.

‘People at the Heart of Care’ commits to £150 million new funds for technology; it recognises the role of information standards for advancing interoperability across social care, sees the importance of linking health service and local authority data and promises that 80% of social care providers will have a digital care record in place that can connect to a shared care record by 2024. Its proposed digital hub and skills passport for staff is a welcome idea.

The Royal College of GPs’ James Mackenzie Lecture 2021

PRSB Chair, Professor Maureen Baker, gave the annual James Mackenzie lecture at the RCGP’s AGM in November. If you looked at your phone right now, you would be able to monitor your BPM, sleep schedule and daily step count in little more than two clicks. In this sense, we are all already self-directed patients, meaning […]

Personalised care and support planning for people with severe mental illness

A review of a sample of current care plans, and the way they have been developed, may be helpful in identifying the priorities for this improvement. The PRSB Implementation Guide provides more detailed explanations about each element of the plan, including advice on how the planning process might be best conducted.
These questions might form a checklist for current plans to be compared with. 

1. Does the plan include an About Me section in which the service user, in their own words, can indicate the information they want to be available about their lives, their values, their interests, and priorities, available for all those who may care for them?
2. Is the approach to developing a care plan patient centred and engaging, allowing plans to be based on patient priorities goals, and aspirations, along with the actions they plan to take and the support that they will receive?
3. Is there space for a “formulation” to be recorded in which the person receiving care and the professionals who provide it, share and record the personal meaning and the origins of the person’s difficulties?
4. Are relevant procedures and therapies recorded?
5. Where relevant, are one or more contingency plans included for anticipatable disruptions, exacerbations, or deterioration, and do they include advice on what to do and points of contact for those called upon to respond?
6. Where relevant are additional supporting plans incorporated, (an example being an “educational and health plan” for someone with a neurodevelopment disorder)
7. Is a version of the plan available to a service user (if they wish to have it) in a form and format that they can understand and find to be of value?
8. How is a version of the plan available to the GP and other key parts of the health and care system?

Work conducted by PRSB and partners recently has looked specifically at the suitability of this approach to the development and documentation of care and support plans for people with Severe Mental Illness. This resulted in an updated version of the standard (v1.4), for use by any service and for any group of service users, but with some modifications to ensure that it meets the needs of this community. The approach to a patient centred process of identifying goals, hopes, and values, and the support needed to achieve them, is fully compatible with and can be conducted using, specific tools in use in mental health, such as DIALOG, DIALOG+, and ReQoL, for example. 

Where analysis indicates the need for improvement in the content and process of personalised care and support planning for patients with Severe Mental Illness, specific improvement projects should be instituted to co-design with service users and their representatives, and the relevant staff groups, new approaches, and documentation that would be of value in delivering improvement. The toolkit includes a range of existing resources that could be used to engage in this improvement work, including signposting to relevant existing approaches informed by patient experience-based design.

Moving to a single holistic plan

A review of a sample of current care plans, and the way they have been developed, may be helpful in identifying the priorities for this improvement. The PRSB Implementation Guide provides A key development, consistent with national policy on support for Personalised Care across all health and care sectors, is the move towards an individual with complex needs having a single, integrated, care plan, rather than a series of plans developed by different parts of the health and social care system in isolation of one another. For a patient with severe mental illness, the related concerns and challenges might form a very prominent part of such an integrated plan; many will also have concurrent health challenges and needs. The intention is that the relevant services work together to plan and wrap support around the patient and their family in an integrated way, rather than as a series of sequential or disconnected encounters in which the service user or their friends and family have to adopt the role of the integrator.

A starting point would be to agree priority groups of service users who may already have more than one care plan because they need care from more than one part of the system of health and social care. This could be initiated by looking at service users registered with some sentinel practices or PCNs. Alternatively, the approach might focus initially on people with defined co-morbidity or risk that entails collaborative care with agencies beyond specialist mental health services.

The focus here is on the process of care planning and agreement on what should be shared, rather than solely on the technology used;

1. What is the process to agree which professional will initiate care planning and act as the “lead point of contact” for the service user?
2. Will initial plans be agreed with the service user in joint consultations or sequentially? Where and how will they be conducted?
3. What will be the process to agree the elements of the plans which should be available to professionals and potential authorised users beyond the immediate care teams, (A&E services, Ambulance Services, Social services, etc.) with the service user’s consent?
4. How will elements of the plan be updated following consultations in a way which is proportionate, to allow contact and progress notes to be maintained by the service conducting the consultation, whilst avoiding unnecessary work for partners in care if there is no significant change to the personalised care and support plan?
5. What are the implications for workload, logistics, and administration arising out of these decisions?

The answers to these questions and others will best be elicited through focused joint working, grounded in real, or at least realistic examples. This will entail process mapping, and co-design with a range of professionals, service users, and families. Resources from the toolkit and outputs from the Simulation element of this project will be valuable. Some organisations would adopt an approach such as a Rapid Process Improvement Workshop, planned over several weeks and conducted over a number of sequential days, to develop prototype ways of working that could be tested in the field.