Digital care and support planning standard

Care and support plans are fundamental to high-quality person-centred care and this month the PRSB held a workshop to develop a standard for digital care and support planning.

The workshop was well-attended with nearly 60 professionals, patients, carers and suppliers engaging in lively discussions about what should be included in a care and support plan based on their lived experience and professional perspective.

The PRSB is working in partnership with North West London Collaboration of Clinical Commissioning Groups (CCGs) to develop the digital care and support planning standard so that care plans can be effectively shared between patients, carers and all the health and care professionals involved in a person’s care.

Developing a standard for generic care planning, including end-of-life treatment, will contribute towards the creation of a more joined-up health and care system. Standards will also help to enable people to manage their own care, with the support of a wide range of services including GPs, hospitals, occupational therapy and social care, among others.

The workshop gave people the opportunity to discuss the suggested headings for each section of the standard. Feedback and advice will be taken onboard, before we develop a survey which will be issued to a wider group of professionals. We are expecting the final report to be issued at the end of 2017 or early 2018.

For more information contact info@theprsb.org

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CHAT theory also explicitly addresses five areas which if addressed systematically will help overcome stakeholder differences in pursuit of the common goal:

1. Understanding the artefacts that characterise the group and its activity.
• The artefacts might be clinical settings or the forms and templates used to capture and share information. During the pilot we heard about hard copy Dialog response forms; locally generated templates for collating information from different systems; letters and emails to GPs; images, poems or other non-text artefacts that service users might want to include in their ‘about me’ or care plan.

2. Understanding the multi-views of the group. Such groups are always a community of multiple points of view, traditions and interests. 
• Different participants in the group will have different roles and will bring to the group and their roles their own histories, language, and ‘rules’. During our Stocktake preparations and workshops we worked with psychiatrists, mental health nurses, occupational therapists, social workers, transformation leads and voluntary sector representatives, all professions and interests with their own language, approaches professional ‘rules’ but united in their interest in care plans, care planning.

3. Activity systems (like the ICSs) take shape and get transformed over periods of time. ‘Historicity’ is a term coined to express how the group’s problems and potentials can only be understood against their own history. 

 

• ‘We’ve always done it this way’, ‘that didn’t work before’, ‘it’s always like this’, ‘it wasn’t always like this’, ‘they are changing things again’, are all typical statements that often frustrate those charged with overseeing change initiatives. Without addressing the experiences that lie behind such comments you risk repeating mistakes of the past, alienating your stakeholders or just not understanding the real starting point for your transformation project. This is particularly the case for the implementation of the PCSP standard, the success of which will be largely reliant on point-of-care practices and information protocols as well as having systems which are user friendly and appropriately configured.

4. The central role of contradictions as sources of change and development. Contradictions are not the same as problems or conflicts. Contradictions are historically accumulating structural tensions within and between activity systems. Collectively addressing contradictions in how policy, practice, culture and technology interact will empower teams to find genuinely novel solutions for apparently intractable challenges, like interoperability and shared care plan/planning. 

This links to the fifth principle that:

5. the possibility of expansive transformations in activity systems. As the contradictions of an activity system are aggravated, some individual participants begin to question and deviate from its established norms. In some cases, this escalates into collaborative envisioning and a deliberate collective change effort. “An expansive transformation is accomplished when the object and motive of the activity are re-conceptualised to embrace a radically wider horizon of possibilities than in the previous mode of the activity.”