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Why Personalised Care and Support Planning?

Published: 1 October, 2015

Improving care for the 30% of the population living with long term conditions (LTCs), and who account for 70% of NHS costs, is a priority.

Individuals spend just a few hours per year with healthcare professionals and more than 99% of their lives managing their conditions themselves.  People involved in CSP  – personalised Care and Support Planning – are supported to develop the knowledge, skills and confidence they need to do this successfully. CSP is described as ”the key that unlocks person centred, coordinated care“ (National Voices).  It leads to better outcomes in terms of physical health, less depression and improved confidence and skills for self-management, especially when this is part of a formalised process integrated into routine care. Despite this, only 5% of people with LTCs have a care plan.

Patients say –

“I love this new way of knowing my results before the Clinic, I now feel as though we are working together“

 “I now feel that I am included in my care of my diabetes and can make a contribution to the discussions about my care to improve my results“

 “To be actively involved in my diabetes care is motivational”

The good news is that through the work of diverse primary care teams we already have the tools and resources needed to introduce care and support planning as normal care for all patients with LTCs.  The Year of Care Programme  helped build the evidence base, case for change, theory of change and a reproducible whole system implementation framework known as the House of Care.

Clinicians say-

“The care planning process has resulted in me changing my consultation style; it has brought me back to the way we consulted pre-QOF. By putting the patient at the centre I have found the consultation is far more pleasurable and the evidence indicates far better outcomes.  So it’s a win-win all round“. GP and Commissioning Director

“Care planning has made me look at patients differently. I focus less on the disease and take a more holistic perspective” . Practice Nurse,

Contact me directly to find out more about local opportunities for training in care and support planning to practices and integrated care teams. This is offered by the Strategic Clinical Network LTC programme in conjunction with Health Education Thames Valley. Delivered locally, this course (one  day with a follow-up half day) gives health care professionals  the knowledge, skills and resources to adopt this way of working. Follow-up support for implementation post training is also available to teams/practices.

Julia Coles
Senior Clinical Network Manager
Mobile: 07825 448208
Twitter: @ThamesValleySCN

Last updated: 21 May, 2018

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