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The Department of Health (DH) has launched new guidance to help commissioners of healthcare and social care services ensure that individuals with long-term conditions are more involved in decisions about their illness and treatment.¹ The document—Supporting people with long term conditions: commissioning personalised care planning—supports the Government’s aim to offer a personalised care plan to every person with a long-term condition by 2010.

The guidance explains how personalised care can be provided through:

• sharing information with people so that they can be involved in decisions about their care
• promoting choice and control by placing the patient at the centre of the care planning process
• providing support for people to self manage their conditions
• focusing on the achievement of goals, such as returning to work or living independently
• integrating healthcare and social care agencies for more joined-up working
• improving patient and staff satisfaction
• reducing health inequalities, complaints, and inefficiency.

Also highlighted by the guidance is the importance of taking into account a person’s health, personal, family, social, economic, educational, ethnic, and cultural background and circumstances, and addressing their specific needs accordingly.

It is recommended that a care plan should be written following a care planning discussion between the healthcare professional and the patient with a long-term condition. This should record the discussion, all patient information, any goal setting, and shared decision-making, and should be accessible to both patients and staff.

Commenting on this DH guidance, Douglas Smallwood, Chief Executive of Diabetes UK, said, ‘Care planning is key to delivering the services and support needed by people with long-term conditions, such as diabetes, to self-manage their condition in partnership with their care teams.’ To help professionals develop the skills required to carry our personalised care planning, the DH is planning to launch a practical guide later this year.

In this month’s Guidelines in Practice, Koon Lan Chan, Public Health Developmental Manager at NHS Sefton, reports on their local initiative to improve care of patients with diabetes who are housebound or in residential homes. This successful initiative follows some of the underlying principles of personalised care planning, aiming to provide education and support for patients and carers to increase perceived empowerment, satisfaction, and quality of life. Results from a successful pilot programme showed that all identified patients underwent an annual review and had a management plan developed. Further details can be found on pages 29–34.

References

1. Department of Health. Supporting people with long term conditions. Commissioning personalised care planning: a guide for commissioners. London: DH, 2009.

Julia Morris, Editor
julia.morris@mgp.ltd.ukG