Using digital to bridge the gap between person and place
Across these sessions, two ideas were consistently raised: the importance of delivering person-centred care, and the exciting possibilities presented by a shift to a place-based approach that focuses on population health.
According to Health Education England, person-centred care is about focussing on the needs of the individual, ensuring that people’s needs and values guide clinical decisions. In turn, a place-based system of care is one in which providers of services work together to improve health and care for the populations they serve, often focussing on tackling the social determinants of health and prevention.
Whilst these two approaches are not necessarily in opposition, one could argue that there is a need to bridge the gap between them, bringing these methodologies into alignment. Integrated Care Systems, now empowered to establish Provider Collaboratives, present an opportunity to do this. Using digital to bring together these two approaches will be critical to tackling the problems challenging modern health systems: an ageing population, the increasing prevalence of multiple comorbidities, and a lack of human resources across the health and care sector.
One public sector stakeholder present at a techUK regional roundtable in 2021 noted that when NHS providers invest resources into their locality, benefits are often felt more widely and as patient/citizen outcomes improve, the provider is then able to reap the rewards of enhanced population health. However, when resources are focussed on the individual, this can result in people moving away from less prosperous areas, meaning that the NHS provider does not experience the benefits of improving the health outcomes of people in that region. This can lead to a circle of investment without return, often meaning performance targets are missed.
A report published in 2018 by the Local Government Association (LGA), ‘Making place-based, person-centred health and care a reality’, looked for examples of how partners are making real progress in improving outcomes for individuals and populations, examining how to bring together a person-centred approach and a wider focus on prevention.
One example of how technology has been used to pull together place-based and person-centred approaches, used in the LGA report, is the pan-London smoking cessation transformation programme. London councils worked together on interventions at scale to tackle smoking on a pan-London basis. This successful programme involved a new model of smoking cessation in primary care, pooling resources to fund a digital platform that provides virtual smoking cessation advice and resources, a helpline to provide telephone-based support, and a series of London-wide campaigns.
In its ‘Integration Checklist’, the report included: “Proactively deploying new technology, including innovations such as robotics and personal digital devices for selfcare. Joining provision of assistive technology, community equipment and adaptations. Wherever possible, technology should result in more cost-effective and sustainable support.”
The technologies referenced here have exciting and profound potential to enable a new approach to health and care provision. However, also crucial to answering the question of how the UK’s health and care system can be both person-centred and place-based, is the safe, secure, and efficient sharing of data, including facilitating easy access to citizens to their own data.
Empowering people to take ownership over their own health and ensuring that staff, not only across the NHS and social care but in multiple settings (local authorities, housing, education), can access the information they need to provide care, is central to enabling integration and joined-up services. Many of the recommendations to come out of the Goldacre Review and subsequently included in the Data Saves Lives strategy, will go a long way to enable this if implemented correctly.
To truly make the most of the opportunity presented by Integrated Care Systems, place-based partnerships must make urgent use of the wealth of innovation that is coming out of the UK’s technology sector. Underpinned by digital, this approach will ensure that collaboration that drives person-centred care sets the foundation for the most significant health and care organisational change in a decade.
To find out more about techUK’s thoughts on Integrated Care Systems, read our latest report.
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