Personalised care gives people choice and control

A guest blog from James Sanderson, Director of Community Health and Personalised Care at NHS England.

When we look back over the years, it’s not difficult to see that the progress in medicine has been enormous. It seems unbelievable that it all started in Babylon; one of the first civilizations which introduced clean, running water and the idea of sanitation. Since then, we have witnessed advancements which have helped us, as a society, survive and live longer – for example, the development of penicillin by Alexander Fleming in 1928, the ability to transplant a heart, or being able to look into someone’s body using an MRI scanner.

However, there is still so much we can do to further improve the delivery of healthcare. One way is through person-centred care, which gives people more control and choice. This is why the NHS has developed the comprehensive model of personalised care.

It starts with shared decision-making – asking people what matters to them, not just what’s wrong with them. One of the most important tools that we have at the NHS is conversation, which sometimes gets overshadowed by different technologies, such as apps and wearables. However, only via conversations can we start looking at people as a whole person, rather than just their conditions. The Shared Decision-Making Standard created by the PRSB aims to address this by empowering people to make informed decisions about their care and treatment, based on the information that matters to them.

Choice is another element that builds our person-centred model. We need to ensure that we use medicine in the most effective way and through shared decision-making – and giving people choice is core to the shift to more personalised care. For example, the National Institute for Health and Care Excellence acknowledges that exercise is a key to managing arthritis – therefore, there’s no reason why people with this condition shouldn’t be recommended swimming or any other form of activity, as an alternative to taking steroid injections. Exploring such non-medical solutions can help us overcome one of the significant issues that we currently face – overmedicalisation.

Whether we are going through a significant condition, or whether we’re planning a baby, we need a plan to map our lives in the way that is meaningful to us. This leads us to personalised care and support planning – including palliative and end of life care, which all of us should consider at some point in our lives. Why? It is estimated that planning and preparing for this event will help us avoid nine unnecessary hospital transfers – and stress for ourselves and our loved ones. For this reason, I am delighted that the PRSB is currently working on an Implementation Toolkit to support adoption of their Palliative and End of Life Care Information Standard.

One in five people attending a GP appointment today, will be turning up with a non-medical need. Social prescribing is vitally important in addressing this – for example, using art and culture as a means to help people with dementia, or engaging in outdoor activities to support better mental health. Think about the last time you’ve spent time on your hobby, or simply connected with your like-minded community – how did it make you feel? The shift towards a more holistic approach to our health and wellbeing is already taking place, and I am glad that at least 900,000 people will be referred to social prescribing by 2023/24.

Furthermore, the PRSB’s Social Prescribing Information Standard has now received an Information Standards Notice, which makes its use a requirement in specific care settings. This is really pleasing for us, and it will help support the recording and sharing of information which will better support the care and outcomes for people using social prescribing services. Social prescribing helps people to focus on their social, emotional, and physical wellbeing, alongside their clinical needs. Social prescribers give people time to focus on ‘what matters to them’ and help connect them to a range of local groups and services for practical and emotional support.

Self-management of care and making people experts in their own conditions is also a major focus. Rather than handing another informational leaflet to a person with diabetes, why not help them connect with their peers at education classes, where they can learn from each other on how to successfully manage their condition?

And finally, a personal health budget is another way in which people can have more choice, control and flexibility over their care. For example, a paralysed person might decide to employ carers with similar interests to create a friendly environment, for both them and their caregivers. If we are to play our part in decision-making about our own care, then we should also be able to decide how we want to spend our resources on this matter.

The essence of personalised care has been successfully grasped in the Personalised Care and Support Plan and About Me standards, which set a person at the heart of their health and social care. Here, I would like to thank the PRSB for their work, which strongly aligns with the NHS focus on personalised care. We set ourselves a target of 2.5 million people benefiting from this distinct model by 2024 – and we actually hit our target by March this year. This should be the default setting in health and care circumstances – I strongly believe that people need to have this type of support for all the reasons that I’ve outlined.

James will be speaking on our webinar which will provide guidance to system suppliers and health and social care providers on how to implement the Personalised Care and Support Plan Standard successfully. Register for FREE and join us on 31 January, at 3pm.

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