C4CC’s co-chair Anna Severwright, blogs about the NHS Long Term Plan and why the incusion of personalised care matters to her.
As someone living with multiple long term conditions, there’s a lot in the newly published NHS Long Term Plan that is important to me but nothing quite as much as this statement in chapter 1: “People will get more control over their health and more personalised care when they need it”.
I am very grateful for all the great clinical care that I receive from the NHS. But I find I am seen by multiple different professionals, focussed on either a specific condition or a particular part of my body. Many of them don’t see me as a ‘whole person’ or take the time to understand how my conditions affect my life.
I recently had an appointment with one of my consultants who I have seen for a few years. He treats one of my conditions, but he doesn’t know about my role with the Coalition for Collaborative Care (C4CC) or anything about my life. This is because I am never asked about anything other than my clinical symptoms. (He also referred to me as Emma not Anna in his last letter…)
The reality for me is that my consultant can’t fully treat my condition without knowing how my condition limits me, my priorities for treatment and about my life. Living with a long term condition is not just about clinical indicators and blood test results – but also about getting my quality of life to be the best it can be.
The Long Term Plan states the need to shift from ‘what’s the matter with someone’ to ‘what matters to someone’. C4CC has championed better conversations between people and professionals since we formed and it’s great the plan says it will support and train staff to have these conversations in a more person-centred way.
The plan also talks about ‘creating genuine partnerships’ between patients and staff. If healthcare professionals acknowledge that people and their carers are experts in their own lives and conditions, then a joint plan, using both the patient’s and professional’s respective knowledge can be agreed. I know that if I co-create a plan – one that actually works with my life – I’m much more likely to follow it and for it to positively impact my health.
‘A shared responsibility for health’ is also referenced in the plan and this will only be achieved with a shift from ‘doing to’ to ‘doing with’. The reality is that every day I manage my long term conditions and it’s hard work. It is welcome that the plan says it will ‘ramp up support for people to manage their own health’ but this support needs to be individually tailored to people.
The increase in personal heath budgets will allow more people with higher support needs to have greater control over what care they receive, from who and how. This choice and flexibility is so important to allow people the flexibility to live the life they want.
Last year C4CC and Think Local Act Personal (TLAP) published Making it Real a framework which was co-produced with people with lived experience. It includes a series of statements that describe what good personalised care and support looks like from the perspective of individuals and organisations. The first ‘I’ statement begins with “I can live the life I want…” and for me that sums up why personalised care matters.
A key factor in people being able to live the life they want is community. We all need to feel connected to others in some way and loneliness has a massive detrimental effect on a person’s health and wellbeing. The expansion of social prescribing is a welcome shift, from seeing medication as the answer, to thinking more holistically about someone’s life and what else might improve their health. For social prescribing to be successful we need to continue working with communities and the voluntary, community and social enterprise (VCSE) sector to ensure strong communities and that there are welcoming places for people to form connections and feel a part of.
For these approaches to make positive improvements to people’s lives and health however, services need to be co-produced with the local community, workforce, patients and carers. Otherwise they won’t be what people need or want and will be less effective, wasting both time and money.
Inevitably there are challenges in delivering the roll-out of personalised care. The workforce needs training and staff need to feel confident in working more collaboratively with patients. There are many already doing it, but for a lot it’s a new way of working and a culture shift. Also working closely and in partnership with social care and the VCSE sector is vital to this being successful, and health must not try to ‘go it alone’.
The numbers in the Long Term Plan – 2.5 million people benefiting from personalised care in the next five years with this doubling to 5 million in the next decade – are undoubtedly ambitious. In my role as co-chair of C4CC I will be not only be working with partners to harness the collective power of our partnership to help make this a reality but will also be ensuring that as we scale up we focus on quality of personalised care as well as numbers.
This is the largest commitment to personalised care in the NHS that we have ever seen and a great move forward towards the ultimate goal of personalised care becoming ‘business as usual’.