Leadership for Personalised Care Case Study: Melanie, Social Prescriber Link Worker
Background and context
Melanie is a Social Prescriber Link Worker working for Arun & Chichester Citizens Advice in the South-East of England. She helps people take control of their health and wellbeing by supporting them to decide which organisations, services, charities, or groups they wish to engage with to move forward. She encourages her clients to make authentic changes at their own pace. Many of her clients have felt ‘let down’ by their local community as they often have ‘doors shut’ on them when trying to access services.
Melanie participated in the Leadership for Personalised Care programme in 2021. While she was already working with a ‘personalised approach’, she sought something ‘structured’ to enable her to delve further into personalisation. She was the only one from her organisation to attend, but she saw it as an opportunity to learn how to improve the services they offer clients.
The impact of the programme
Melanie thought the programme was ‘inspirational’ and provided her with a ‘safe space’ to learn from her peers. She has gained more confidence as a practitioner and, while she always had a personalised philosophy, the programme allowed it to develop and deepen. Since the programme, Melanie has felt ‘empowered’ to ‘disrupt’ in a way that she believes will bring meaningful change to practice from the ground up.
‘The personalisation programme gave me confidence in to be radical in my approach…it gave me permission to be radical.’
She sees herself as an agent for change in her local system, influencing mindsets and wider practices in a non-directive and gentle way.
‘If services aren’t at the place of fully embracing personalisation it is my role to support, challenge and disrupt, but gently so, and to support the change.’
Her colleagues see Melanie as a vocal advocate of personalisation, both within and outside their organisation.
The personalisation journey
Melanie’s approach to influencing change centres around her practice; she relies on her ‘steadfast’ approach to personalisation as a lever to provoke curiosity and conversation. She seeks out ways in which she can improve processes to make them person-centred, such as changing her approach to writing client case notes to ensure they focus on the person and their journey. She has also reframed what is thought of as a client ‘outcome’, by documenting actions that may be considered ‘small’ but are significant personal achievements.
‘The outcomes weren't personalised [in case notes]…They [the client] can choose not to do anything, but if a client made a decision and it might seem small, this decision, but it was a big decision and the client made that decision and the client hadn't made any decision before.’
These changes have been noticed by managers and peers within the organisation. It has sparked conversation and interest about how she practices in a personalised way, which Melanie hopes will result in changes to how her colleagues work with their clients. Although she is aware that this is a ‘slower’ approach to change, her organisation does not put any barriers in her way. As well as internally, she has also driven change in the wider community. She has worked with local charity partners to personalise the routes to engage with services.
‘One of the big issues that we were finding was supporting individuals to engage. Now they wanted to engage. So, it's not that we're forcing anybody to engage, but there’s a big space between an individual wishing to engage and that point of engagement.’
Melanie worked with a charity to design a gentle, personalised way of transitioning into the service. They removed the need for a client to self-refer, and instead, the service reaches out to the individual to support them in the transition. However, Melanie believes it is more difficult to influence the local community as stakeholders are less likely to have a ‘personalised mindset’. Despite these challenges, Melanie remains clear that the best way to influence change is to focus on herself and role model personalised practice.
The future impact of personalisation
For Melanie, embedding personalisation can have an immediate impact on the individual but a slower impact on wider health and social care outcomes. She acknowledges that by changing practice on the ground, the system is unlikely to see an immediate ‘big impact’, but gradually she believes the system will become ‘more human’. However, she is clear that personalisation must be ‘authentic’ to each individual and not become ‘controlled’ and ‘dictated by the system’.
‘You can't dictate what personalisation is. As long as it stays authentically personalised. Not developed into some entity.’
To take the personalisation agenda forward, Melanie will continue to take ‘responsibility for her practice’ and fully personalise the experience for her clients. She believes that changing practice will slowly influence change from the ground up. So, she calls upon other practitioners to be an advocate by embedding personalisation in their approach and challenging any barriers that prevent personalised practice.
‘Resist and challenge pressure or demand from external influences which may interfere or hinder with the provision of a personalised approach.’