It's all about people: Reimagining the Continuing Health Care journey in Lincolnshire

Continuing Health Care and Adult Social Care have joined forces to develop a pathway with people at the heart.

Earlier this year, Helen Sands, Head of All-age Continuing Healthcare (CHC), reached out to the It's All About People team with a bold ambition: to make the CHC journey better for everyone - the individuals receiving care, their families, and the staff who support them.

The CHC process can be complicated and, at times, overwhelming. It provides fully NHS-funded care for people with complex, long-term health needs, but the way it’s delivered can sometimes feel impersonal and full of red tape. For many, the assessment experience can feel clinical and detached, at a time when compassion and understanding matter most.

Helen and her team wanted to change that - see Helen's comment below.

They wanted to reimagine CHC to make it more personal, more compassionate, and more connected, putting people, not processes, at the heart of every decision.

In describing the project, Helen said:

"I’m committed to ensuring that the changes and insights emerging from this project translate into real and lasting improvements across the Continuing Healthcare journey for everyone involved.

My sincere thanks go to everyone who is contributing to this important work for their time, input, and honest reflections, which are proving invaluable.

It’s through this shared commitment that we can create meaningful change for both the people we support and the teams who support them."

What we're doing

The It’s All About People team worked together with the CHC and Lincolnshire County Council Adult Social Care teams to explore how we could embed personalised and strength-based approaches into the CHC journey, making it more personal, holistic, and focused on people’s abilities, not just their needs.

We started by talking to the CHC team...and listening. 

Through conversations with team members, surveys, and attending team meetings, we heard honest reflections about what is working well and where things are more challenging across the CHC process. Some clear themes emerged:

• Our approach can sometimes feel too task-driven and focused on ticking boxes, which means the person’s voice and story can get lost.

• Team members have different understandings of what personalised care really is, and what it can offer and help to achieve. 

• We want to build closer, more collaborative relationships with external partners.

• National policies can sometimes limit how flexibly we’re able to work.

• Limited time makes it hard to build the trust and rapport that person-centred care depends on.

• Communication gaps exist between services along the pathway.

• Strengthening communication within and across teams will help us work as one, united by a shared purpose.

These insights helped shape our next steps, focusing on how to make the CHC experience more person-centred, connected, and driven by a shared purpose. 

What the insights are telling us

From those conversations, some clear priorities emerged:

• Make time for meaningful conversations, focused on “What matters to you?” rather than “What’s the matter with you?”

• Explore people’s strengths and support networks to build on what already works well for them.

• Embed shared decision-making so individuals and families can make informed choices about their care.

• Strengthen collaboration and communication across teams and with partners.

• Work proactively to reduce complaints and disputes by improving clarity, empathy, and consistency.

• Use resources wisely — reducing waste while increasing our overall impact and effectiveness.

These insights, along with feedback from the CHC Quality Assurance Team, are now helping to shape the future of the service.

Embracing the process

This isn’t just a paper exercise. The CHC team has jumped in with energy and commitment. They’ve already set up working groups focused on:

• Improving communication within the team and with partners.
• Gathering feedback from people and families about their CHC experience.
• Reviewing and simplifying internal processes.

This is a team not afraid to challenge the status quo, and they’re doing it with a real passion and commitment.

Mapping the Continuing Healthcare journey

Recognising the need for a whole-system approach, the CHC and Adult Social Care teams have begun mapping the entire CHC person's journey - or pathway - from the initial mention of CHC by a health or care professional to the review and disputes process.

This 10-week mapping process has been led and supported by Paul Holmes, Innovation Lead at Health Innovation East Midlands, with enthusiastic backing from Helen Sands and Vicky Lee, Head of Service, Adult Social Care, Lincolnshire County Council.

The mapping sessions have been eye-opening. Staff from CHC, Adult Care, and system partners have shared, challenged, and reflected on current practices.

One pivotal moment came 3 hours into a session to map the current decision-making process, when the question was asked, “We've not mapped the touch points with people in this process - where are they?” That question is now guiding the design of a future state that truly centres people.

Other work happening now

In parallel with the process mapping work, we’re launching two new surveys - one for the public and one for the workforce - created with support from the NHS Lincolnshire Integrated Care Board Engagement Team.

Access each survey via the links below:

Continuing Healthcare Services in Lincolnshire - PUBLIC SURVEY

Continuing Healthcare Services in Lincolnshire - STAFF SURVEY

These surveys will help us understand what the CHC journey really feels like, both for the people going through it and for the staff who support that journey every day.

What's next?

As we head towards 2026, we’re excited about what’s next with this work.

With all this insight, feedback, collaboration, and co-production - people with lived experience are already part of the team, and will continue to provide essential insight and ideas as we move forward together - we’re working towards a Continuing Healthcare service that truly puts people at the heart of everything it does.

Yes, national policy might limit some changes, but the passion and commitment from the CHC and Adult Social Care teams, and partners across the wider Lincolnshire health and care system, is unstoppable.

If you’re reading this and thinking, “I’d love to be part of this work,” please get in touch.

Whether you want to join a session or share your thoughts, we’d love to hear from you. Pop an email across to lhnt.itsallaboutpeople@nhs.net ​