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Can we really personalise health care?

Last week we welcomed the launch of NHS England’s new personalisation vision, which aims to give everybody choice and control over their health and care. In Nesta’s Health Lab we have witnessed the powerful benefits of providing truly personalised care, extending far beyond satisfaction ratings. We know that personalisation can help people to feel more motivated and confident about their health, which translates to better health outcomes.

Some people may doubt that personalisation can be delivered at scale and it won't be without its challenges. But our Good Help programme exemplifies how subtle shifts in conversations and interactions can help to transform formulaic and impersonal care experiences, into something much more meaningful and motivating.

A core Good Help characteristic highlighted in the personalisation vision is that of power - the need for professionals to relinquish power in order for people to genuinely feel in control. Power can be shifted by changing the conversation. For example, rather than focusing on symptoms and deficits (which turns professionals into experts and people into recipients), conversations should explore what is unique about a person – the way they experience a condition, what they are striving for with their health, and the influence of social and environmental stressors. If wider determinants of health are ignored, then interactions become oversimplified and will leave people feeling ‘done to’ and less committed to changing health behaviours. The Foundation for Change embeds personalisation in their approach to helping people who have experienced addiction, trauma and inequality. They do not ‘do’ interventions to people – instead they provide teaching opportunities to help people learn new skills such as critical thinking, problem-solving and personal responsibility.

Key to relinquishing power is the ability to ask questions rather than provide answers. This is tricky in a culture of ‘telling’, but asking a question (especially an open-ended one) automatically places power in the hands of the person answering - they hold information the other does not have. If health and care services genuinely value such information, they will be better understand individual motivations and circumstances, and together make choices based on what matters to each person. For example, Scottish charity Cornerstone supports people with disabilities to articulate their dreams and aspirations, and to identify their own purpose, which subsequently shapes the type of support offered (not the other way around).

The personalisation vision also acknowledges the benefits of social connectedness and peer support. Whilst health is something that is experienced at an individual level, it is strongly influenced by a range of social factors. We know that having access to peer support (being helped by people with similar experiences to yourself) inspires people to make changes in their own lives because they feel an emotional connection, they feel understood and have a sense of what might be possible for them. For example, Groundswell’s Homeless Health Peer Advocacy programme employs people who have experienced homelessness themselves to encourage others to access healthcare services.

In a large and stretched healthcare system like the NHS, some may see personalisation as a ‘nice to have’. But it is much more than that – it is is key to sustained behaviour change and to people leading healthier happier lives. The Good Help programme will be exploring practical opportunities for public services to embed a more personalised approach to helping.

If you have any ideas or questions please connect with [email protected]

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Good Help Award

Author

Esther Flanagan

Esther Flanagan

Esther Flanagan

Senior Programme Manager, Social Health

Esther joined the Health Lab in January 2017 and is working in the social health team on a range of projects.

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