PRIMARY CARE

Personalised Care

Personalised care represents a new relationship between people, professionals and the system. It happens when we make the most of the expertise, capacity and potential of people, families and communities.

See December 2023’s Personalised Care Bulletin here.
What's happening

Opportunities and Offers

2-Day Health Coaching Core Skills Programme

Health coaching is a supported self-management intervention and is part of the NHS Long Term Plan’s commitment to make personalised care business as usual across the health and care system.

Find out more here.
Contact [email protected] to apply.

 

Make Every Contact Count 1-Day Chat to Change Train the Trainer Course – Face to Face

Making Every Contact Count (MECC) is the opportunistic delivery of consistent and concise healthy lifestyle information via brief or very brief behaviour change interventions, enabling individuals to engage in conversations about their health at scale across organisations and populations.

Contact [email protected] to apply.

PAM (Patient Activation Measure ) Workshop

It is widely acknowledged that people who have the knowledge, skills and confidence to manage their own health tend to have better health outcomes than those who may have a more passive approach. Patients/clients with high levels of activation usually understand their role in the care process and feel capable of fulfilling that role.

Contact [email protected] to apply.

An Introduction to personal health budgets eLearning

The introduction to personal health budgets eLearning module has been updated. This online training is intended to support all staff who are involved in the delivery of personal health budgets (PHBs). The module covers a variety of topics including: the legal right to have a PHB, budget management options, and what a PHB can and cannot be spent on. It also offers guidance on the steps involved in implementing and maintaining a PHB, and the key features that ensure people experience the best outcomes possible.

The Leadership for Personalised Care programme

The Leadership for Personalised Care programme is suite of cutting-edge learning and development programmes aimed at leaders at all levels in health, social care and beyond, to help them champion personalised care, community development and co-production and lead system transformation from the ground up. Leadership for personalised care requires a paradigm shift from seeing public services as simply ‘providing’ a solution to focusing on what matters to people and families, in the context of their whole lives and communities. It is a person- and community-centred complex adaptive approach to leadership. It involves specific actions around individual care – ensuring approaches like care and support planning, social prescribing and proactive support for self-management are in place, but also creating the conditions for these things to happen, an in the most effective and asset-based way.

Find out more on their website. 

Introduction to Leadership for Personalised Care Course

New free online course: NHSE have created an ’Introduction to Leadership for Personalised Care’ course, that takes their high-quality content and makes it easily accessible via the FutureLearn platform. 

This 3-week online course is free, easy to access and open to anyone who wants to find out more about leading a person-centred approach, offering you the same high-quality content as their other programmes. 

Learning online means you can be self-directed and take advantage of the flexible, accessible, and bite-sized content, providing you with a foundation in leadership for personalised care practice. It will help you take the first step in being a leader in this field and develop the skills and confidence to go further. 

Enrolment is now open.

further information

Roles

Social prescribing link workers, health and wellbeing coaches, and care coordinators (non-medical roles) are all included in the Additional Roles Reimbursement Scheme, with a specific aim of supporting people based on what matters to them, and helping address their holistic needs through advice, guidance, and connection to wider support services, including social, practical and financial support.

These roles can help identify and address unmet social needs and health inequalities through targeted work with specific groups identified through proactive approaches.

Social Prescribing Link Worker

Social prescribing link workers connect people with local community activities and services that can help.

Find out more about the role on the NHS Health Careers website.

If you have any questions please email [email protected]

Public Health England has advice and guidance for healthcare practitioners on the health needs of migrant patients, including a summary of findings from a recent evidence review that PHE completed on social prescribing for migrants in the UK. It also provides a series of recommendations for referrers to social prescribing services, link workers, social prescribing monitoring and evaluation, and future research. Doctors of the World have also recently launched a toolkit for link workers to support migrants to access healthcare.

This programme is open to clinical and non-clinical NHS colleagues who are passionate about raising the profile of social prescribing and sharing good practice.

Applications are now closed. If you would like to enquire about the programme, please visit the NASP website.

This guide provides additional information to help PCNs introduce the social prescribing link worker role into their multi-disciplinary teams (MDTs) as part of the expansion of the primary care workforce introduced through the Network Contract Directed Enhanced Service (DES) 2022/23 Additional Roles Reimbursement Scheme. It also provides information to deliver the proactive social prescribing element of the Network Contract DES Personalised Care service specification

Social prescribing services and link workers have the potential to make a big difference to the lives of people with musculoskeletal conditions such as arthritis or back pain. This webinar aims to help you understand musculoskeletal (MSK) conditions, their prevention, their impact, and how to consider this when you meet clients. Watch the recording on Arthritis and Musculoskeletal Alliance (AMRA) website

Health Coach

Health coaching is a patient-centred process that is based upon behaviour change theory and is delivered by health professionals with diverse backgrounds.

Working closely with Osca and the Tavistock Institute and in consultation with health coaching commissioners, providers, champions and experts locally and around the country, three products have emerged from this strategic review that address this need:

  • A Quality Framework to help in the commissioning of high quality health coaching staff development programmes, giving examples of projects from across the country
  • A Quality Framework Summary with the main strategies and approaches from the full framework, but without the examples); and
  • The Area Delivery Template which provides ideas on ways in which a health coaching approach can be developed and sustained across a geographical area.

Care Co-ordinator

Care coordinators provide extra time, capacity, and expertise to support patients in preparing for clinical conversations or in following up discussions with primary care professionals. They focus on the delivery of personalised care to reflect local PCN priorities, health inequalities or at risk groups of patients. They can also support PCNs in the delivery of Enhanced Health in Care Homes. 

Tools to implement supported self-management

The Care Coordinators’ welcome pack is designed for newly appointed care coordinators in primary care networks.

Designed to support the delivery of a care coordinator and provide an introduction in the role. The document will also point the reader in the direction of more detailed information that will be useful to their role.

Appointed care coordinators may also find this document helpful as a reference guide to their role.

further information

Resources & Videos

Frameworks, Reports and Guides

This brief summary guide will support integrated care systems to understand and create the conditions for sustainable implementation of personalised care and support planning in line with the essential delivery of personalised care within systems. It is intended to support those involved in the leadership, design, development and delivery of personalised care and support planning across all sectors. It provides best practice advice, not statutory guidance. However, it can be used to self-assess and self-assure the quality of local systems implementation of personalised care and support planning.

This new framework provides guidance for people employed as a link worker and those employing them. It will help increase the understanding of the role and where link workers can have most impact in supporting and empowering people to improve their health and wellbeing. It also sets professional standards and competencies, gives guidance on supervision, training, and continuous professional development. 

Social Prescribing Link Worker Framework

Health and Wellbeing Coaches Framework

Care Coordinators Framework

Addressing palliative and end of life care needs for people living with heart failure: a revised framework for integrated care systems has been published replacing ‘End of life care in heart failure: a framework for implementation’ (2014). Its purpose is to raise awareness of the supportive, palliative and end of life care needs of people living or dying with progressive heart failure, to help in commissioning services to meet their needs. It covers care for adults and refers to anyone aged 18 or over.

The National Academy for Social Prescribing worked with National Association for Voluntary and Community Action (NAVCA) and Spirit of 2012 to develop a new toolkit for social prescribing link worker host organisations, with a particular focus on hosting in the Voluntary, Community and Social Enterprise (VCSE) sector.

The resource aims to help primary care networks (PCNs) and host organisations establish, develop and maintain a sustainable and effective social prescribing scheme in their local area.

The data visualisations for the individual employers and personal assistants report 2023 are now available. The report provides information about direct payment recipients and their personal assistants in England

This toolkit has been designed to help NHS organisations reduce the risk of suicide in their workforce. It will assist organisations to embed suicide prevention strategies in the organisation’s health and wellbeing policies and guide the approach to supporting those at risk of suicide within the workforce.

The general practice team has expanded significantly to include a wide range of healthcare professionals working together to support patients. These teams are already delivering care for patients across the country, and we know it is important that patients understand what all members of the general practice team do and how they support their care.

A range of resources about the general practice team are available to download from the Campaign Resource CentreThe materials aim to support general practice teams to share information about the different professionals working in their practice and explain how they enable patients to receive the most appropriate care as quickly as possible. These include social prescribing link workers, health and wellbeing coaches and care co-ordinators.

NHS England has published three case study films which give an insight into how social prescribing and the non-clinical additional roles reimbursement scheme (ARRS) roles can help people to better manage their health and well-being.

These members of the general practice workforce can particularly support people who are experiencing the current ‘cost of living’ issues and NHS winter pressures through pro-actively identifying certain groups of people that need more intensive support.

Find out more about how these roles can help people this winter in the recently published guidance. Supporting High Frequency Users (HFU) through proactive personalised care, delivered by Social Prescribing Link Workers, Health and Wellbeing Coaches and Care Coordinators sets out the principles and recommended approach for offering proactive, personalised care for those at higher risk of hospital admissions due to psychosocial needs, as part of a broader strategy for integrated care boards and primary care networks to tackle winter pressures and reduce unplanned admissions.