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‘People-centred service design’ – what is it and how do we implement it?

On a rainy and windy evening in London, the latest Cambridge Health Network event, People centred service design, took place at the Royal Society of Medicine. Speaking about the challenges of conceptualising and implementing truly person-centred care were Dr Matthew Dolman from Somerset CCG, Betsy Fields from IDEO and Dr James Featherstone from Healthcare at Home.

The session kicked off with Dr Dolman promising a PechaKucha style presentation of the exciting developments occurring in the Southwest’s first vanguard site. We all wished him luck, sat back and listened to him deliver an impressive talk about how collaboration between different system actors, from GPs, hospitals, community staff and social workers has made person-centred care possible. He spoke frankly about how the region is tackling its particular challenges – Somerset’s  population is significantly older than the national average and how the local system is meeting these by planning and reacting to local needs together through shared resources and expertise.

The key message from Dr Dolman was that the future is all about networks. In order to achieve truly people-centred care, the system, communities and people will have to forge partnerships; moreover, design and commissioning will have to be outcome based and value driven. One significant component of this is to mobilise the personalisation agenda. Dolman was keen to highlight how self-management is actually the normal mode of care. On average a person only spends 5 – 10 hours a year with a NHS or social care professional, the rest of the time it is down to the individual. Somerset has started to use the Patient Activation Measure (PAM), which measures an individual’s knowledge, skill, and confidence for self-management. People who are more activated are significantly more likely to attend screenings and check-ups, and to adopt positive behaviours. Good news for prevention.

Betsy Fields from IDEO continued on this theme, highlighting that to generate healthier people, we need to design for health services where life happens. Using examples from designing accessible housing for disabled veterans, to designing and building a health system from scratch in Latin America, to a ‘give to get’ programme in the US, she argued that ‘we can’t leave our health up to healthcare’. Indeed, the shift from viewing health as receiving care to a more holistic approach of wellbeing is exactly what the NHS needs to promulgate. Betsy joined the call for the need to find radical new partners to enable this new form of care to exist.

Dr James Featherstone of Healthcare at Home was the final presenter and spoke compellingly about his organisation’s latest report, Bringing the Hospital Home; an innovative piece of work on how virtual wards can support integrated care models, contribute to admission avoidance, and fit care around where patients feel most comfortable and happy; in their home. For the audience, it seemed like the logical conclusion to the talks. It offered a pragmatic, evidence-based programme to implement care around people. Dr Featherstone spoke of how virtual wards have the potential to contribute to the delivery of the Five Year Forward View through building services around patients, making treatment one part of a person’s life, not the focal point.

The golden thread running through the three presentations was the need to engage people in their own care and to build systems around the individual. The voice of the patient is not loud enough yet, but we are getting there. Meanwhile providers and commissioners will have to continue to be creative and build the partnerships that are needed to support truly person-centred care.

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