How community-based care is putting patients in control
Transforming Healthcare Moving healthcare out of hospitals and into the home is bolstering patient empowerment and breaking down barriers between individuals and healthcare professionals.
The health and care system is changing:
Gradually, the focus is shifting away from hospital-based care and onto community-based care. This means increased home healthcare visits from GPs and nurses, but also therapists, social care services and pastoral care services where necessary. The idea? To take a more rounded view of healthcare, empower the patient, put their requirements first and break down barriers between NHS users and healthcare professionals.
"...benefit individuals by giving them more control over the way they receive healthcare."
This new way of delivering healthcare recognises that everyone, at some time in their lives, will be a patient, and deserves — and needs — the healthcare that is right for them. It's also designed to benefit individuals by giving them more control over the way they receive healthcare. By being more proactive, everyone can be treated in the location that suits them best, whether they require chemotherapy or physiotherapy. It's a win-win situation. The system wins because the pressure on it is relieved. The patient wins because they have a more flexible healthcare experience.
The value of person-centred care:
This emphasis on community-based care has been recommended by the Industry Coalition Group (ICG), which represents organisations across the health sector. The first step in its implementation is for health professionals to fundamentally reassess the way they view patients. “We need to see people in the wider context of their families and communities and recognise them as individuals who have their own needs and aspirations,” explains Mike Bell, Chairman of Croydon Health Services NHS Trust and Chair of the ICG.
The ICG also sees the value of a people-centred care system which gives individuals more say in the way their own healthcare is delivered. “When people go into a hospital or healthcare setting, they tend to quickly become a passive recipient of care,” says Jane Milligan, ICG member and Chief Officer of NHS Tower Hamlets CCG. “That's because there's an entrenched idea that 'the doctor knows best'. We now have to make it easier for people to navigate the system more effectively so that they can access better information and support, and feel more in control of what is happening to them.”
Yet individuals also need to take more responsibility for their own health, says Natalie Douglas, Chief Executive Officer of Healthcare at Home — which is another reason they need to be better educated about their condition and the medication or treatment they may require. “We think there is a real opportunity to get patients involved in managing their own wellness,” she says. “For example, elderly people — or their carers — should properly understand the importance of their medication or the physical care they need.” Technology can help in this regard, such as giving people access to their own records and results.
Relieving pressure on the system:
It's not just patients who would benefit from a redesigned health and care system insists Douglas. It would transform the lives of staff, too. “Delivering clinical homecare can be a more satisfying and flexible experience for healthcare professionals,” she says. “Naturally, not every person can be cared for in the community, and some nurses will prefer the cut-and-thrust pressure of a hospital ward. Yet if there was more of a focus on clinical homecare it would take some of the stress out of an overburdened system.”
"Homecare can be a more satisfying and flexible experience for healthcare professionals."
Milligan agrees and stresses the importance of collaborative working throughout the system. “We're starting to think about the value of healthcare in terms of wastage,” she says. “That includes wasting the time of patients and carers, as well as wasting clinical time.
The system operates in a rather 'siloed' way at present. Generally, many of the frustrations felt by patients and staff are because of a mismatch between different healthcare services: an X-ray might not come back in time for a clinician's appointment, for example. This serves to highlight the importance of person-centred care so that all services meet the needs of patients, rather than feeding the needs of the system.”
Implementing change that works:
Yet, the only sure-fire way to ensure lasting change is to release the talent and creativity of staff. “If we don't have an empowered staff who look forward to coming to work, then we will always struggle to make any sort of change,” says Mike Bell. “So the people working in the system have to be right at the heart of this transformation. We need to value them, give them the space to innovate and work with their ideas. In Croydon, for example, we started a programme called Listening Into Action which is a structured process for gathering staff ideas about improving services — then working with staff members to implement the changes. That's made a massive difference to us.”
"...empowered staff who look forward to coming to work."
The report brings together a mix of current examples which were instigated in the Five-Year Forward View and new ideas which will collectively form this new principal care system, says Milligan. “But, of course, there is immense financial effect on the health system — and when money is tight it makes it harder to keep transformation on track. The aim of the ICG is to keep the conversation going.”
Healthcare at Home is proud to be a member of the Industry Coalition Group. As the UK’s leading full service, clinical provider of healthcare out-of-hospital, we partner with publicly funded, pharmaceutical and private providers to deliver services for patients that are essential for sustainable healthcare.
Read the full report here: insights.hah.co.uk/2000days