Personalised services: getting the basics right
When you do your weekly shop, you might have a quick check through the cupboards and think about your meals for the week – with the click of a few buttons you’ve got your order done, delivery slot confirmed, and payment made. While I appreciate that online shopping might not be for everyone, there’s a lot to be said for the technology behind it and the ways this could be used to improve other types of services.
Many people already use similar technology to order a repeat prescription from their GP, or at the peak of the COVID-19 pandemic, review their vaccine status. With prescriptions, for example, if you try to re-order too early or order the wrong thing, the system will alert you – or you’ll have to call the surgery – so they not only save time and money, but also have these built-in safety nets to make sure you get just what you need.
My recent experience of requesting a replacement battery for my powerchair was far from satisfactory. The process from start to finish took six weeks and involved several attempted deliveries of incorrect items, and then a technician with no pliers. A six-week waiting time for something that affects one’s daily routine so directly could be massively improved by efficient use of technology. The involvement of people with lived experience in developing and commissioning services could help bring issues like this to light, as well as highlighting solutions.
Through my work on the National Co-production Advisory Group, I have experienced first-hand the difference that co-production can make, and this is something that I would like to see happening more throughout the commissioning process. But while co-production has the ability to lead to exciting innovations in care and support, incidents such as my experience with the battery show that there is still often a long way to go in just getting the essentials right. Although we might see exciting developments happen in areas like social prescribing or shared decision-making, all of these can be jeopardised if someone’s mobility is at risk. Letting such basics slide will result in undermining other well-meaning efforts and policies, for example the Care Act and Putting People at the Heart of Care.
Efficient running of key services has a direct impact on the lives of individuals. TLAP’s Making it Real framework, which sets out what good care and support looks like through its ‘I’ and ‘We’ Statements, makes this very clear. For example, I can’t drive when my powerchair is not working, so neither ‘living the life I want’ or ‘having appropriate aids and medical equipment’ would be achieved by my care and support. On these occasions my independence is hampered, and my husband has to secure my manual chair in the car and bring along the heavy add-ons. In addition to this, huge amounts of time are spent chasing up medical appointments and equipment providers. And once you do get through eventually to the right person, they can never give you a specific time, and you invariably have to stay in for a whole day.
So how do we move forward on the road to personalised services? The involvement of local people who use services, and their family and carers, can lead to well-informed, needs-led services when people are really listened to and concrete actions are taken based around their lived experiences. These voices, which otherwise often go unheard, can be the catalyst to moving forward and ensuring better, more personalised services. People with lived experience being involved in the whole process, from specification and commissioning through to delivery, will make it easier for organisations to discover issues and to solve them.
My suggestion of how to improve the ordering system for replacement parts is just one example of how lived experience could inform service improvements, benefitting those who both rely on the service and those who work there too. But even without a technological solution, the process of ordering and receiving a new battery could be improved. This would require the local authority to put pressure on their commissioned provider to meet acceptable standards. And this is why commissioners have such an important job – when it is done well, it can make such a tangible impact on people’s day-to-day lives. I encourage all commissioners to explore ways to embed the voice of lived experience in the way they work, so the most pressing issues are discovered, and solutions can be found, together.
TLAP’s ‘Making it Real’ is an approach to improving care and support. It centres around a framework developed in co-production with people with lived experience. You can learn more here.