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About the Author: Kim Ryley

Kim is Co-Chair of the Coalition for Personalised care and a cancer survivor with a complex history of multiple long term conditions. His experiences of treatment over almost 20 years have given him an insight and lived expertise into how health and care services can be reconfigured to provide a better quality of life for people.

8 November 2021

digital,health equity,health inequalities,inclusion,nhs @home,personalised care

Members of C4PC’s Health Inequalities Taskgroup shared insights recently with NHS @Home colleagues into how Personalised Care approaches can help transform health and care services, so that people are supported to keep well and manage their own health and well-being at home. There are already growing examples of where this is working well, but there is a need to join up the learning involved and to increase the pace of change, to give faster access to integrated, targeted care, which is based on personal choices.

Taking cues from some of the most effective responses to the Covid pandemic, the fascinating discussion explored a possible framework for a Health Inequalities Strategy for this vital, innovative work. Attention focused on concerns about digital exclusion as services migrate online, barriers to accessing healthcare particularly for some like people who are homeless and those from travelling communities; and how well-intended guidance and information giving can also be less than helpfully inclusive in the way it is communicated.

Challenging medical assumptions which are flawed and outdated, there was agreement that improved models of active participation and greater autonomy are needed, based on genuine co-production of solutions to individual needs. Acknowledging the gaps in current approaches which can be divisive, it was felt that a greater focus on ensuring Health Equity as the ultimate goal would be an effective way to challenge the status quo.

It was agreed that the key to the success of new approaches was better community engagement at every stage of the process of design and implementation, as well as a better understanding of the wider socio-economic and environmental determinants of health inequalities and exclusion.

There are significant implications too for workforce retraining, if the current power imbalance between medical practitioners and those needing treatment and support is to be redressed.

Following this rich dialogue, deeper analysis will be given to the ideas for change that were surfaced. This will inform the next steps for more extensive action in a growingly important field of effective healthcare.

NHS @Home

Although still a relatively new team, NHS @Home have already chalked up a growing roll call of fresh initiatives, which are reducing pressures on hard pressed GPs and hospitals, as well as empowering individuals to actively self-manage their own care.

These include:

  • 220, 000 blood pressures monitors issued with remote home monitoring BP@home, the majority of monitors are expected to be with patients by the end of December, with over 67, 00 currently with patients
  • Respiratory Clinical Networks to support Lung Health @home
  • 5 sites supporting the NHS move to a fundamentally different model of care for heart failure patients that makes the most of the significant shifts towards remote and home-based care – Managing Heart Failure @home
  • Proactive Care @home (which includes BP@home) long term CVD and respiratory conditions, including asthma and diabetes, in 4 early adopter Integrated Care Systems (ICSs) and currently scaled to just over a quarter of all ICSs.
  • Virtual Wards supporting patients, who would otherwise be in hospital, to get the acute care, remote monitoring and treatment they need in their own home or care home.

Find out more about NHS @Home.