Leadership for Personalised Care Case Study: Helen, Senior Project Manager and Clinical Lead
Background and context
Helen is a Senior Project Manager and Clinical Lead for a small company that specialises in improving residential nursing care in the East of England. The organisation assists local authorities and the Integrated Care Board (ICB) to implement a care framework that moves towards proactive, personalised support that is centred on the needs of individual residents, their families and care home staff. They also run the Trusted Assessor scheme, a nationwide initiative that supports safe and timely discharge from hospitals for care home residents.
Helen was motivated to participate in the National Leadership for Personalised Care programme to advocate for her talented colleagues in social care and drive forward the personalised care agenda, particularly in acute trusts. While personalisation is an intrinsic part of social care, forming part of the Care Quality Commission’s (CQC's) inspection protocol, it is not the case for acute care.
‘We work within acute hospitals. And we felt as a team that actually personalised care… still wasn't seen as important. The care wasn't personalised, so it was an opportunity again to really push forward the personalised care agenda within the acute trusts… but also just as a sort of refresher for social care.’
Impact of the programme
Helen thought that the programme was fantastic, motivating and empowering. She gained more knowledge about personalisation and developed some tools and techniques that supported her to get her voice heard in a large and noisy system. It provided her with a ‘safe space’ to network with like-minded people working toward delivering personalised support in their system. These new connections gave her the encouragement to ‘go out and do it and give it a try’. Overall, her confidence and knowledge have increased, which has enabled her to take more risks and push boundaries.
‘There was lots of opportunity to discuss and go “I've got this issue” and “Yeah, right. Let's just go and do it”. And it was very confidence building for me as a person.’
Since her time on the programme, Helen has made significant changes to the Trusted Assessor operating procedures. During Covid, the approach to patient assessments inadvertently became more medicalised and depersonalised due to system pressures. Her time on the programme reinforced for Helen that she was not comfortable with the direction of change, so she gathered her team together to overhaul their approach.
‘I had the opportunity and was lucky enough to get a place on the leadership programme and from that, it reinforced in my mind that I'm not happy with this. So as a team we got together and again sort of really looked at what personalised care meant to us as a team and completely overhauled the assessment, so it was very much written from the patient's perspective. So it was as simple as starting with “My name” instead of just “name”.’
Despite being a comprehensive assessment document, they completely redesigned the paperwork to ensure that it was personalised at its core. All questions were rewritten to start with ‘I’ and the assessments now include detailed conversations with the next of kin. These changes were made in collaboration with care providers, who were ‘over the moon’, despite the fact assessments would take a little bit longer. There was a lot of enthusiasm from care staff, and the CQC were ‘really positive’ about the new approach. The new assessment procedure was piloted, and anecdotal data suggest that the changes have had a real impact on the mindsets of nursing staff. Patients are no longer seen as just ‘beds’, but as people with names, families, needs and wants.
Helen was also invited to manage the ICB personalised care agenda, which has introduced her to contacts involved in the delivery of personalised support. With support from these new contacts, she established a project working group that meets fortnightly, which brings together colleagues from the ICS, local authorities, care homes and voluntary organisations. Helen and the project group organised and delivered a personalised care conference aimed at anyone delivering health and social care in the local community. The goal of the conference was for stakeholders to collectively develop a shared personalised care plan that will inform their practice across the community. Helen shared that the conference was well received by attendees, and provided her with more confidence to follow the personalised care agenda.
‘So what a personalised care plan looks for from a GP perspective or district nurse compared to care providers again is a vast difference. So it's all about trying to bring them together.’
The project group is also looking at opportunities for training and development for colleagues within the Primary Care Network to develop knowledge about personalisation and integrate it into business as usual. Helen has been instrumental in pushing the personalisation agenda through networking.
‘I do a lot of visits around my care homes and with domiciliary care and it's, you know, how you're getting on with sort of looking at the personalised care agenda…It's just getting out there and getting yourself known. And yeah, listening, networking, finding out what everyone else is doing.’
It has been difficult, as someone outside of healthcare, for Helen to influence mindsets in acute care. However, she continues to advocate for a different approach by role modelling and having ongoing authentic conversations.
‘I'm not in a position within an acute trust to be able to say this is what should be happening. All I can do is kind of lead from role modelling, “this is what we're doing, we're not changing it because of time frames”. It doesn't take that much longer, I'd say perhaps 15-20 minutes, but obviously, that does add up during the day.’
Helen believes that it is critical to engage acute trusts in personalised care, as it has the opportunity to prevent negative events such as unsafe failed discharges, complaints and safeguarding concerns. Therefore, Helen has organised an additional conference, targeted to acute settings, to build momentum in this area. This will be a one-off event, aimed at engaging acute trusts in the conversation surrounding personalisation by sharing the benefits of a personalised way of working.
Despite the challenges, Helen is proud of her and her team’s work so far, which has put personalisation firmly on the ICS’s agenda.