It's All About People - Strategic Plans

Personalisation is rooted in the belief that individuals want to have a life, not a service. 

It’s a way of working that changes the conversation from ‘what’s the matter with you?’ to ‘what matters to you?’  and is seen as a significant cultural and behavioural transformation for Lincolnshire’s health and care system and population.

Personalisation and a new relationship with the public are two key enablers in Lincolnshire’s Integrated Care Partnership Strategy and the local NHS Joint Forward Plan.

With people with lived experience we aim to evolve the relationship and conversations between people, professionals and the health and care system to one which focuses on people’s strengths and assets and ‘what matters to them’ - providing a positive shift in power and decision making that enables people and those who are important to them to have more choice and control to be able to live their best life.

Personalisation is a critical enabler and a generational behaviour change, that will help to transform the way we work with and improve outcomes for people and carers of all ages in Lincolnshire.

Collaboration with Population Health Management intelligence is enabling us to identify where we can have the biggest impact on improving Health Inequalities for our population using personalised and strength-based approaches.

Embedding these new ways of working together with people and carers should be considered an integral way to how we deliver services.

Such as,

  • Embedding the five foundations of the ‘Our Shared Agreement’.

  • Including people in any service redesign through Co - Production.

  • Through exploring and understanding what’s important to people and their carers through ‘what Matters to You’ conversations

  • Proactively planning for now and into the future through personalised care and support and advanced care planning which are owned by the person and shareable to all relevant parties.

  • Ensuring that people and carers have meaningful information that enables them to make a shared decision with health and care professionals about their treatment, care, health, and wellbeing.

  • Working together to understand people’s knowledge and skills and confidence to look after their own health and wellbeing and remain as independent as possible for as long as possible, through coaching and strength-based conversations and tailoring the intervention accordingly.

  • Supporting people to feel connected and engaged in their local communities.

IAAP brick wall characters.pngOver the last few years, and during the constraints imposed by the pandemic, the It’s all about people programme has focused on working with partners, stakeholders, and people with lived experience to develop and co-produce the building blocks around Personalised Strength based approaches that can be used to transform how we work together with people and how we deliver services.

What are national drivers and the emerging evidence telling us about where we need to focus?

The Long-Term Plan mandates that personalised care will become business as usual across the health and care system and Personalisation will contribute to national priorities (reducing occupancy rates, unnecessary appointments, AARS roles delivery, proactive support and enhanced community response).

Personalisation is explicit in the Fuller stocktake recommendations and implicit in the recent Hewitt report. Personalisation contributes to delivery of Network Contract Directed Enhanced Services and Quality and Outcomes Framework and will be a key element of the anticipated NHSE ‘Proactive Care’ framework.

The Adult social Care white paper, People at the Heart of Care, sets out an ambitious 10-year vision for how support and care will be transformed in England. The vision puts people at its heart and revolves around 3 objectives:

  1. People have choice, control, and support to live independent lives.
  2. People can access outstanding quality and tailored care and support.
  3. People find adult social care fair and accessible.

Emerging evidence base is demonstrating the impact personalised approaches can have on the outcomes for people and reducing demand on the system.

 

1. What Matters to you conversations, supported Self-Care and Self-Management

If people and carers are more informed, better activated, and have a clear plan they are likely to have; 

  • 18% fewer GP contacts
  • 38% fewer emergency admissions
  • 32% fewer attendances to A&E

People most able to manage a mental health condition, as well as any physical health conditions, experienced 49% fewer emergency admissions than those who were least able

Providing better personalised support to those least able to manage, can reduce A&E attendances by 6% & emergency admissions by 7%

(Health Foundation, 2018)

2. Shared Decision Making / Strength Based Approaches

People have long been saying that they want to be more involved than they currently are in making decisions about their own health and health care (Care Quality Commission Inpatient Survey 2020; GP Patient Survey 2022; Community Mental Health Survey 2021).

In all three surveys on average 50% of people state they are not as involved in the decision making about their care and treatment as they would like to be.

 Cochrane Review 2017 states; optimal shared decision-making improved communication, information sharing and risk assessment, thereby helping patients feel more satisfied with their choices, knowledge base, and decisions. Optimal shared decision making also helps to reduce repeat appointments, therefore, saving time in the long run.   

3. non-medical interventions

  • 20% GP consultations are for non-medical interventions such as psycho, social, and economic issues.
  • 4% of GP appointments could be dealt with by Social Prescribing link worker

NHS Alliance & Primary Care Foundation

Recent study has shown that Social Prescribing

  • Improved people’s mental health and wellbeing
  • Reduced levels of loneliness
  • People feel more connected to their local communities.
  • Reduced the need for a GP appointment by 28%
  • Reduced the need for A&E by 24%

(Dr Richard Pile – The dangers of loneliness)​​​​​​​

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