Personalisation and the National Health Service - shut up and listen

Paul Rackham, ex-commissioner, speaks his mind about the challenges to personalisation in the NHS.

Spoiler alert, this is not the last word on personalisation in the NHS.

It’s a contribution to the debate. Three challenges from a bloke who has worked in the social care and health system for the last 26 years and who, thanks to an accident of genetics and bad luck, has been a heavy user of NHS services since May 2012.

If you read TLAP blogs you may know that personalised care is one of the five priorities in the NHS Long Term Plan 2019. (opens new window) However, my observation is that once I step outside of my social media echo chamber, and leave behind the political, policy, academic and campaigning voices, very few of my family, friends, neighbours and the wider community realise there is any work going on in this area at all. I wouldn’t say they don’t care about it, just that it’s not their main concern. ‘Personalisation’. Most people never use the word. Of those who use it as a search term, the biggest group are looking to have a name engraved on jewelry, or printed on a mug.

My first challenge – keeping personalisation in the NHS at the top of the agenda

Let’s all talk more about personalised care in the NHS. Most people aren’t interested in whether it’s a Clinical Commissioning Group or Integrated Care System that controls the budget. So, let’s keep personalised care in the NHS at the top of the political and media agenda. Anyone know who does the bookings for Good Morning Britain?

In a recent webinar hosted by Social Care Institute for Excellence, Webinar: ICSs and people empowerment – how can we effectively give service users better control over their own health and care? (opens new window) James Sanderson, NHS Director of Personalised Care said something like “success for the personalised care programme would mean that the NHS no longer needs a personalised care programme”.

Rather, he thought, the mainstream work of the NHS would be built on the six elements agreed as the core of Personalised Care and on the agreed model, referred to as the “Comprehensive model for Personalised Care”. The people involved in the work can tell you more. It looks like a great programme doing important work. It has been co-produced with people and other organisations, and it’s used evidence-based and evaluated methods.

But we have to remember that the NHS is a “mahoosive” thing. Employing 1.3 million people, there are almost as many specialities, functions, and departments and it is in constant state of re-organisation. We need to keep focused on the priority for personalisation.

So, my second challenge – putting people at the heart of the organisation

Let’s not underestimate the size of the challenge. Remember, the NHS was the organisation that needed a campaign to get staff to introduce themselves to people.

Thanks to the efforts of the families of disabled and ill children, disabled people, people experiencing poor mental health, people with long-term health conditions, older people and family carers and friends, there is something happening in health that we can all benefit from. There are people who are prepared to give up their time to help make things better.

In social care, various voices championed a collection of initiatives. One of them was called “nothing about us without us”. Person-centred planning, circles of support, asset-based based commissioning, and co-production are all held up as organisations and practices that put people at the centre of things. To me there are e two common elements of behaviour for organisations and the people they employ - be curious and shut-up and listen.

My final challenge then – culture change

Whether you are a public, private or voluntary sector organisation. Whether you are organising a national conference #oursocialcare – Social Care Future (opens new window) or your regular team meeting, but especially if you have an NHS lanyard, please make space in your week, and in your head to listen to the people that matter most – the people that use your services.

Read TLAP's response to the NHS white paper

Read the white paper 'Working together to improve health and social care for all'.  (opens new window)


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