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Supporting the personalisation of services in Health and Social Care

David Griffiths

What do you think I mean when I say, “I support the personalisation of services in Health and Social Care”?

People who know about these things have explained the history of personal budgets and Direct Payments. How disabled people campaigned for the payments themselves and for the support that can be needed to make sure everything is delivered, paid for and accounted for properly.

I think this must be a work in progress because I read that the number of people using Direct Payments has gone down every year since 2015 and it has never been a big part of our work in Community Equipment or Technology Enabled Care.

However, I do see a lot written about choice and control, personalisation and outcomes, in the specifications that cross my desk for Community Equipment and Technology Enabled Care services, so I am guessing that these are still required.

And I have seen examples of Direct Payments working, or working well-enough, so that people do have some choice and control in how their care and support is arranged.

But what does any of that mean when Local Authorities and the NHS are strapped for cash and struggling, or failing, to keep afloat. Especially when that means there is pressure on managers, clinicians, and prescribers to restrict funding or gate-keep services.

As a long-term fan of Newcastle United, I am used to not getting what I want, and in my mind “personalisation” does not mean anyone who would benefit from some support, having whatever they want, whenever they want it.

To me, it starts with an honest and open conversation between people who draw on care and support, and the people and organisations that make a living arranging and providing that care and support, including Local Authorities and NHS organisations.

That’s what is happening across the Medequip depots and services. We are not experts in engaging with communities, so we have organisations like Community Catalysts and Healthwatch helping us, the Think Local, Act Personal Making it Real framework to guide us and the Social Care Future movement to inspire us.

Through them, and from people who have used our services or the services of other organisations, we have learned many things about how we can make our service better and how people want to live their lives.

Where there are other people responsible for making decisions, we have helped make introductions, for example, on the sorts of equipment we can provide, or the timescales for collecting things.

Where there are things we can change directly, we get on with it, and where there is more of a culture change involved, we look outside our organisation for support, and for challenge.

I won’t stray into the legal area, some might call it a quagmire, of how a Local Authority decides how much money to allow someone to have, for example to pay for Home Care or other services that can also be provided through contracts with various provider organisations.

But let’s just say it gets difficult to unravel the costs of sourcing, delivering, maintaining, repairing and collecting equipment to support people in their own home. Especially if you have a unit cost based on a large company loaning equipment on behalf of the Local Authority to lots of people in an area.

But I do believe in personalisation, if it means seeing people as people first, and in working with them to understand how they want their care and support, and maybe community equipment and Technology Enabled Care provided.

Does this mean starting with a more hopeful view of what people want to achieve for themselves? Yes, it must do.

Does this mean starting with a realistic view of the funding and other sorts of support available in a community? A big yes to this too.

But, it also has to mean that we all take a long hard look at the way we do things. Things that we have got used to and see as part of the way we have always done things. Like who does assessments and reviews, how much choice people have over types of equipment, and the balance of convenience and speed.

I take heart from the increasing number of contracts that require organisations to be innovation partners and that commit commissioners and service providers to work together alongside people who use services.

And I am inspired by the positive and negative feedback we receive from people and the continual efforts of the Medequip team to do their best.

So yes, I support Newcastle, and yes I support personalisation, both are fundamental to me, but I make sense of both of them by believing in and supporting people.

Money and systems may have to move around and evolve for personalisation to work the way the original campaigners hoped for, but if you believe in that, and the people involved, there is a better chance of this happening.

If you are ready to ask different questions about how Community Equipment and Technology Enabled Care services can play a part in the personalisation journey in your area, get in touch, Medequip is ready to help you think of some different answers.

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