Leadership for Personalised Care Case Study: Karen, ICS Programme Lead

Background and context

Karen is the ICS Programme Lead for the Community Deal within the Frimley ICS. The Community Deal is one of Frimley’s six key ambitions and aims to build relationships with communities to co-produce solutions to local issues. Karen oversees Frimley’s approach to the Personalised Care model set out in the NHS long-term plan. She hopes that embedding personalisation in the system will empower residents to vocalise what matters to them and what they want from local services.

‘It’s that shift of power, of how we make our patients understand and think about what matters to them, for us to be able to deliver what they need to achieve their outcomes.’

Karen joined the regional Leadership for Personalised Care programme in 2021 with colleagues from across the ICS. Although personalisation was underway within Frimley through the Community Deal, the programme came at a time when place-based teams were accelerating their local personalisation journeys. Place-based teams are tailoring their approach to personalisation to meet the needs of their residents while collaborating with other teams across the ICS to share best practices and innovation.

‘[Different place teams] are all doing different things so part of that has also been about us... having that coordinating role to try and align us to get us into a situation where we then… have a system wide view of how we deliver…’

The impact of the programme

The programme provided Karen with the time and space to reflect and take stock of Frimley’s progress towards personalisation. This protected time to reflect motivated Karen to continue to change mindsets and practices in a range of health, social care, and voluntary organisations.

Karen also learned the importance of holistic thinking and not viewing elements of personalisation in silos. She feels that by taking part she can identify opportunities for different aspects of personalisation more frequently, setting the groundwork for personalisation to efficiently be embedded into the ICS’ practice.

Frimley’s personalisation journey

Following the programme, Karen led on the establishment of the ICS personalisation steering group, which is responsible for overseeing both the place-based and system wide personalisation journeys. Involved in the steering group there are representatives from the Local Authority, Primary and Secondary Care, and the community sector. The group collaborated to deliver a set of principles outlining Frimley’s personalisation goals, and the steps to be taken to embed personalisation.

‘We’ve developed a set of core principles for the system as a focus on how we deliver personalised care and for our population’

Co-production is high on the agenda for Karen. With the personalisation steering group, she convened a group of people with lived experience to review the principles and share their experiences of the health and social care system. Working with this group of people, Karen and the steering group have tested these core principles, ensuring that they are understood by the local population and that personalisation is properly embedded into practice. Their insight was also used to inform similar changes in different elements of the system.

‘We kind of wanted to get us some footing as a system of work, that means we’ve always wanted to go and talk to people with lived experience.’

Karen also identified that generally, personal health budgets were an underutilised resource. She challenged the system to expand their use. By doing so, she hopes to increase the level of freedom residents have in improving their health and wellbeing. The ICS has begun to source personal health budgets for individuals at the point of entry to services and Between April 2021 and March 2022, the number of personal health budgets increased from 74 to almost 1200.

‘[With] new cases coming on, we automatically think what we can do as part of a personal budget with a personalised care support plan… When we started counting in April [2021], we were starting at a point of 74… at the end of [March 2022] we were 63 off our 1200 target.’

Karen feels that before tackling systemic practice change, mindsets toward personalisation must change. To help others understand the importance of personalisation, Karen has delivered presentations and workshops to organisations providing support to Frimley residents. Through these, she hopes to influence individual mindsets and organisational cultures and support the development of personalised practices.

‘So hopefully [spreading awareness and keeping up the conversation] will then get people to change their mindset and their thinking.’

Frimley’s journey benefits from having strategic system-wide oversight, alongside operational place-based teams that can respond to community needs, and pilot initiatives in the local setting. Karen and other ICS representatives can use insights and data from these pilots to show the impact of personalisation initiatives in different places, highlighting any practices that can be rolled out across the ICS.

The future

As the personalisation journey across Frimley continues, Karen’s priority is to continue work to change the mindsets of organisations involved in the delivery of services across Frimley. She hopes doing this will instil belief in the principles of personalisation, encouraging as many people engage in the journey as possible. This, Karen feels, will support the adoption of a shared, personalised vision across the ICS and further support the delivery of the Community Deal and the ICS’ personalisation strategy.

She also intends for people with lived experience to play an even bigger role in the design and delivery of the journey as it progresses. This will continue to be through their involvement in the personalisation steering group meetings, work with the voluntary and community sector which Karen hopes will grow in size and influence as the community begins to see change in the system and support they receive.