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Using P-D-S-A, patients can take control of their own health & wellbeing trajectories

 

Blog headlines

  • Reading Well for young people consultation
    14 October 2021

    The blog this week is from Reading Well. They support people to understand and manage their health and wellbeing using helpful reading.

  • Special school eye care service
    7 October 2021

    This week we are sharing an article on improving eyecare services for children and young people with learning disabilities and/or autism who are 28 times more likely to have a sight problem. This piece explores how a service has been developed to improve outcomes for these children.

  • Using P-D-S-A, patients can take control of their own health & wellbeing trajectories
    30 September 2021

    This week we are sharing how patients in partnership with the NHS can self-manage long term conditions. Improvement science methodology has enabled Julian Simcox, a patient leader in North Somerset to develop a personalised care approach to support him to manage his long term conditions.

  • Chronic Low Back Pain Phase I (FIH) Clinical Trial at NHS sites
    23 September 2021

    For networks this week we are sharing information about a clinical trial at NHS sites, the first part of the trial has just been completed – at two NHS sites during the pandemic.

  • ‘There is nothing so practical as a good theory’
    16 September 2021

    The Networks blog this week comes from the Staff College: Leadership in Healthcare (Staff College) is a national charity dedicated to promoting great leadership for the public good.

  • Reflections on a ‘new’ NHS and its impact on general practice
    10 September 2021

    This week’s blog we are sharing reflections by William Greenwood on the direction for the health service and potential impact on general practice.

  • When facilitation could turn into mediation
    3 September 2021

    Requests to attend a meeting, to help find a way forward, to help with planning, to redesign a care pathway, and numerous other reasons are not always what they seem. Sometimes you will be asked to facilitate, or just asked to attend. What then happens in the room may not be the meeting that you are expecting. Other situations, such as tensions between practices, departments or teams may give a more obvious sign that what is needed goes beyond just attending or facilitating a little.

  • Population Health Management?
    26 August 2021

    One of the frequently heard phrases of the moment is population health management – but what is it and does it work. The blog is from a longer article by Monica Duncan exploring the topic.

  • The future must be primary care
    19 August 2021

    The blog this week is by Professor David Colin-Thomé, chair of PCC.

  • Preparing for winter 2021/22
    13 August 2021

    One of the hottest days of the year saw people from practices, primary care networks (PCNs) and federations gather to start to think creatively about managing their winter pressures in this session hosted by PCC and the NHS Confederation PCN Network.

  • Building the collaboration
    5 August 2021

    Prior to COVID-19 primary care network (PCN) community pharmacy leads (representing a group of pharmacy contractors in their locality) were starting to contact the clinical director for their allocated PCN to discuss how pharmacy services could develop and adapt to help address community health needs.

  • Audit into action… with a pandemic thrown into the mix!
    29 July 2021

    A blog from the Clinical Leads for the National Audit of Care at the End of Life (NACEL).

  • GP partnership uses new video to highlight benefits of its merger-led transformation
    23 July 2021

    An East Cheshire-based GP practice, the Middlewood Partnership, which formally merged in order to successfully transform its clinical and business models, is sharing insights, via a new video, with colleagues across the health and social care sector.

  • Early evaluation of the Children and Young People’s Mental Health Trailblazer
    15 July 2021

    The Birmingham, RAND and Cambridge Evaluation Centre (BRACE) is funded by the National Institute for Health Research to conduct rapid evaluation of promising new services and innovations in health and social care. The BRACE Rapid Evaluation Centre and Policy Innovation and Evaluation Research Unit have published findings from the early evaluation of the Children and Young People’s Mental Health Trailblazer programme.

  • Learn from reflection
    8 July 2021

    We are sharing an article by Helen Northall, chief executive, PCC this week on learning from reflection.

  • Link of the week: National Thank You Day
    1 July 2021

    This week we are featuring National Thank You Day.

  • North East Essex integrated discharge single point of access - implementing the Coronavirus Act 2020 and Covid-19 hospital discharge service requirements
    24 June 2021

    The blog this week is from Frank Sims, chief executive of Anglian Community Enterprise and shares learning on collaboration and redesign to support hospital discharge.

  • Helping your patients making an informed choice: Medical or Surgical abortion?
    17 June 2021

    This week the blog has been submitted by MSI Reproductive Choices UK and is about supporting patients to make an informed choice based on NICE guidance.

  • The potential for case finding patients with cardiovascular disease in a dental setting
    10 June 2021

    The blog this week is by Wendy Crew, PCC adviser, considering the opportunity to case find patients with cardiovascular disease in a dental setting.

  • Using population health data to inform ARRS recruitment
    3 June 2021

    Funding for the additional role reimbursement scheme (ARRS) has increased nationally from £430m (2020-21) to £746m max. (2021-22) with an allocation available for each primary care network (PCN) depending on the size of the population it covers. Clinical commissioning groups (CCGs) draw down the funds but only as new roles are recruited within PCNs. PCNs are therefore being strongly encouraged to make use of their ARRS allocation to ensure people in their neighbourhoods benefit from the funding available.

 
 
Thursday, 30 September 2021

Using P-D-S-A, patients can take control of their own health & wellbeing trajectories

This week we are sharing how patients in partnership with the NHS can self-manage long term conditions. Improvement science methodology has enabled Julian Simcox, a patient leader in North Somerset to develop a personalised care approach to support him to manage his long term conditions.

This week we are sharing how patients in partnership with the NHS can self-manage long term conditions. Improvement science methodology has enabled Julian Simcox, a patient leader in North Somerset to develop a personalised care approach to support him to manage his long term conditions.

Continue to share your news, case studies and articles, sending them to maria.axford@pcc.nhs.uk Scroll down to vote in this week’s poll where we ask what will help stop violence against health and care staff.

Using P-D-S-A, patients can take control of their own health & wellbeing trajectories

Julian Simcox is a patient leader in North Somerset and when last year confronted by a sixth Long Term Condition, he decided to use P-D-S-A to learn as much as he could about his mind-body system as a whole in order to self-manage his own outcomes.

A year and a half later, two of his conditions are verifiably in remission, and the other four are evidenced as firmly under control. Now in his 70th year, his all-round health and wellbeing have improved so radically he is now largely medication free.

Julian has written-up his story to demonstrate how by using ‘improvement science’ (P-D-S-A) to develop an ability to track and systemically interpret one’s personal outcomes over time, any patient – in partnership with the NHS – can self-manage most any long term condition.

For many years P-D-S-A has been used by NHS professionals to gauge improvement, and now Julian raises the possibility that by recruiting as many of his fellow patients as are willing to use exactly the same method, ‘shared-decision making’ can become more of a practical reality. Commissioners for example might now sponsor interventions such as PAM® Level 4 workshops, led perhaps by the ‘Supported Self-Management’ coaches currently being appointed by PCNs?

Not all patients of course will be up for such an approach, some will be too fatalistic or will simply default to denial, but for those naturally intrinsically motivated, or indeed anyone confronted by an adverse diagnosis, the possibility of connecting to reality over time could become such a powerful driver for change. The early adopters no doubt would then spread the word, even to the disaffected.

As a patient leader in his own community Julian is now exploring the application of P-D-S-A with the handful of patients bold enough to seek his help. His papers are shortly to be published in the Journal of improvement Science https://www.improvementscience.co.uk/jois/ and meanwhile a pre-publication version of “An Invitation to Practise Personalised Self-Care” can be had by contacting him directly: julian@cohear.com.

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Improving Population Health by personalising self-care

A strategic challenge for every ICS is to actualise the Long Term Plan’s notion of ‘person-centred care’ in a way that promotes ‘agency’ in patients. Essentially this has to mean equipping and supporting patients to take control of their own outcomes – so they each can get a grip of what causes those outcomes.

Past efforts to enable patients to be their own ‘expert’ have been destined to fail – due to what BJ Fogg calls the “Information-Action Fallacy”: an assumption that giving people the right information is on its own sufficient to change attitudes and behaviours. The Expert Patient Programme would have petered out for other reasons too, and Julian Simcox offers nine more. He also ponders just what the new ‘Personalised Care Institute’ might now do differently to succeed where EPP couldn’t?

Nowadays ‘lifestyle change’ is seen as the magic bullet, but behaviour change workshops appeal mostly to only those seeking affirmation for what they already do, leaving everyone else feeling stigmatised for ‘bad’ behaviour, or just overly patronised. This time something smarter is needed. By inviting segmented patient groupings to improve their own health outcomes, commissioners for example could tackle ‘inequity’ more directly via purposely ‘unequal’ interventions designed to meet patients and sub-cultures where they are. With timely support genuine agency can take root.

The new ‘Personalised Care Institute’ https://www.england.nhs.uk/wp-content/uploads/2018/10/personalised-care-operating-model-2021.pdf makes it clear that to truly personalise health trajectories, interventions need to be rooted in supporting patient self-empowerment and choice. This is such a massive cultural ask for the Health & Social Care system that almost every assumption ought now to be up for revaluation.

Julian Simcox points for example to the vital difference between inequality and inequity: that ‘inequality’ pertains mostly to the ‘one-size-fits-all’ paradigm, whereas tackling ‘inequity’ necessitates more of a mass-customisation paradigm. A range of intervention strategies are needed so each may be tested in different population sub-group contexts – the goal: to discover just what connects with the motivational energy that latently exists in each cultural context.

Covid has hit us all hard, and few have been stretched more than Primary Care workers, but resilience is being revealed in surprising places, including the most underutilised resource in health and social care: patients.

Julian’s paper is shortly to be published in the Journal of improvement Science https://www.improvementscience.co.uk/jois/ and a pre-publication version: “How to invite Patients to Practise Personalised Self-Care” can be had by contacting Julian directly: julian@cohear.com.

 
Harry Muzart
Harry Muzart says:
Oct 18, 2021 01:52 PM

Thank you for this article, it's very informative and useful. I myself have been involved in related work, and I have been thinking about this for many years, from my many interactions with people spanning the whole range of neurological and psychiatric spectrums.