24th April 2025
Conversations, not consultations - working towards a better relationship
A blog by Kirsteen Redmile, Lead for Personalisation, It’s All About People Personalisation Programme
The It’s All About People Personalisation Programme team talks to a lot of people - both those who deliver, and those who are supported by health and care services. And through these conversations, one message is clear: building better relationships between people and health and care services in Lincolnshire is essential.
Why? Because stronger relationships — built on conversations, not consultations, shared decision-making, and personalised care — help people better understand and trust health and care provision, and encourages greater involvement in their own care.
And this, in turn, leads to better outcomes for both the person, the workforce, and the wider health and care system.
This is a key opportunity of Lincolnshire’s Integrated Care System (ICS). ‘Integrated’ shouldn’t simply mean establishing closer links between existing health, care, and wellbeing providers.
Instead, the system needs to serve as a vehicle for fostering a more dynamic relationship between services, people, and communities — one that builds on civic participation and supporting people to shape the care they receive.
And this is happening in Lincolnshire - we ARE using the ICS to reshape how health and care services talk with, and work alongside, people and communities.
This work is called Our Shared Agreement, and it is driven by Five Foundations that provide guidance and inspiration to the health and care workforce and the people of Lincolnshire as we create this new relationship together:
Taking the time
The health and care staff we talk to recognise the value of this better relationship. But, as with all good relationships, it takes time to build understanding and trust – and the daily pressures and challenges they face can make it difficult to build and maintain those positive, trusting connections.
Yet when time is taken, and used well, it creates better outcomes for both people and the professionals that provide their care.
When the person-centred care champion, Tommy Whitelaw, returned to Lincolnshire a couple of weeks ago, he reiterated the powerful point that "it’s always the beautiful stuff we do less of when busyness gets in the way."
Where time has been taken to understand people’s needs and nurture trusting relationships, there is some truly beautiful and transformative work happening in Lincolnshire…and beyond.
I want to highlight two stories from outside of the county that show how this approach really works.
"It should be the individual who shapes the support they receive"
In Hull, the Jean Bishop Integrated Care Centre – a unique initiative of the City Health Care Partnership (CHCP), a social enterprise – has cut emergency admissions for the most severely frail people by 50%.
Led by two remarkable physicians, Anna Folwell and Daniel Harman, the CHCP has flipped the usual model of care on its head, with its workforce committed to the idea that "...it should be the individual who shapes the support they receive rather than the public sector body."
As such, when people visit the Jean Bishop Centre, their assessment begins with a very detailed conversation with the person to explore their experiences, hopes, and needs.
Armed with this understanding, the clinicians and others working at the Centre can work out exactly what is needed to maintain the health and well-being of someone with frailty and their care-givers and provide it in as effective and flexible a way as possible.
And that regularly involves bringing in wider community and voluntary sector support from organisations, often located in the Centre themselves, enabling immediate connection to the people looking for help.
Watch Ray’s story
Ray was one of the first patients at the Jean Bishop Integrated Care Centre. Prior to his appointment at the Centre, he had been housebound with a number of long-term health problems that had left him at a very low point in his life.
Conversations, not consultations
The Community Appointment Days (CADs) initiative in Sussex echoes Lincolnshire’s own ‘Pop-Up’ events, such as the Grantham Joint Aches and Pains Hub.
At the heart of the CADs is a simple yet powerful idea: understanding what truly matters to people and working alongside them to make that happen.
To bring this to life, the Sussex team brought together people seeking care, clinicians, voluntary sector services, and wider community organisations—all under one roof, often a leisure centre. This setup allows individuals to access a wide range of services in a single place, all in one day.
The vision for the initiative is to personalise care and remove barriers, focusing on what matters most to people and supporting them to take control of their own health.
Laura Finucane, Clinical Director for Sussex MSK Partnership Central: “I had the idea after COVID to do something radical. I wanted to strip away the traditional medical model and start having ‘what matters to you’ conversations, not consultations.” Ahead of the events, clinicians received training in how to have personalised, meaningful conversations.
“Our aim was to go beyond just MSK conditions and step out of our usual clinical environment into the community, where we could better support the whole person.
“We initially invited patients on our waiting list, gave them time and started by asking what they need now."
The Community Appointment Days, like our own Pop-Up Hubs, are a fundamental reimagining of how care can be delivered. And it works.
Throughout 2023, Sussex hosted six large-scale Community Appointment Days along with several smaller events. According to an evaluation report, the response from both people attending and healthcare providers was overwhelmingly positive.
One of the standout benefits of the CAD model was its impact on waiting times - 52% of participants received all the support they needed on the day and felt equipped to self-manage their care afterward.
Doing with, not doing to, gets results
Both of these incredible initiatives illustrate that when health and care providers take time to actively listen to what is important to people and their families – and ‘do with’ people rather than ‘do to’ them – wonderful things can happen.
If you’re working in a similar way in Lincolnshire, or have ideas about ways to develop and strengthen the relationship between people and health and care in the county, we’d love to hear from you.
Contact us at lhnt.itsallaboutpeople@nhs.net
