How personalised care is delivering a pattern of positive patient results

Recently, I became an ambassador for the Personalised Care Institute (PCI), which is a role I felt enthused to take on after attending a personalised care training session which totally changed how I approach patient care. I have been a nurse for 38 years, working as a practice nurse for the last 20 of those; in 2017 I was proud to become a Queen’s Nurse.

In addition, I’m the practice nurse representative on our South Warwickshire Foundation Trust CCG diabetes forum and am passionate about connecting primary and secondary care. Underpinning all of these roles is my dedication to opening up access to high-quality resources and training to continually enhance and improve daily nursing practice.

The majority of my daily work involves supporting and treating patients with diabetes and coronary heart disease. I have always considered myself to be patient-centred, but, after attending the personalised care training, I realised I was still keenly ‘in charge’ of each consultation and there were things I could adapt to provide the very best quality of care. I’ve already seen numerous positive outcomes by implementing personalised care, which ultimately empowers people to have more control and choice about their care.

My role at the PCI gives me the opportunity to share how offering truly personalised nursing care helps us as individuals, as well as our colleagues and patients. We may already feel like we’re implementing some of the principles of personalised care in our daily practice but completing the PCI’s quality-assured training, which is available in bite-sized chunks, goes that step further to solidifying skills such as Shared Decision Making and Personalised Care and Support planning.

What is personalised care?

 Personalised care simply means that patients have more control and choice over the way their care is planned and delivered. It is about considering individual needs, preferences and circumstances, and helping people to choose what is right for them.

Sometimes referred to as patient-centred care or person-centred care, personalised care is a key part of the NHS Long Term Plan. It is a whole system approach that enables a variety of services across the health, social care, public health and community spectrum to be integrated around the individual, so that we can deliver better outcomes and experiences for patients.

Personalised care has also led to the creation of a range of new roles, such as social prescribing link worker and health and well-being coach, that further improve the quality of care that patients receive. 

Implementing personalised care in my own practice

Ensuring the patient is in control allows the patients and clinicians to gain so much more from each consultation and any subsequent treatment. I now start my consultations with the phrase “what is most important to you for us to discuss today?”

While I still need to explain the patient’s blood results to them, for example, and what that potentially means for their long-term risk; I don’t suggest or tell them what changes they need to make. When done well, the patient ends up telling me what I would have wanted to suggest to them. Because they suggested it, research shows they are more likely to do it and I have found this to be the case with the majority of my patients. They feel ownership of the outcome and are empowered to embrace it. It’s important to reflect as clinicians; sometimes what we think is most important is very far from what the patient believes to be, based upon what may or may not fit into their life.

What’s really pivotal is the positive results this approach is having on health outcomes. I’ve been able to report a pattern of results which show improved glucose control (lower HbA1c), weight loss and reduction in blood pressure across several of my patients; which is incredibly encouraging.  I completely recognise that time can be a challenge in a busy NHS and that there are worries about the time needed to adopt this approach; if I’m honest I definitely shared this concern too. But once you’ve embedded the right principles fully into your daily practice, delivering personalised care actually saves time. It also improves patient care and outcomes and results in a much more rewarding consultation.

One of our GP partners recently asked me what I was doing differently as he’d noticed an improvement in my patients’ results. The answer was simply ‘personalised care’. Feedback from my patients has been extremely positive too, with one gentleman calling the surgery back a few hours later to say it had been the most useful appointment he had ever had. It’s fair to say that I have become evangelistic about personalised patient care!

Personally, I think the results in many ways speak for themselves. It indicates to me that training in personalised care should be mandatory for every nurse, doctor, and anyone working in a healthcare discipline. I would love to see this happen in the future but for now, it is pleasing to know that quality assured training is available for free to all health and care professionals. I think that if Queen’s Nurses embrace these approaches and share with each other and colleagues how they benefit our daily practice, then we can make real headway.

Is there further evidence which supports personalised care?

 Beyond my own experiences, there is a growing body of evidence showing how personalised care improves the patient experience and quality of care. Research by the PCI, based on patient experiences from 4,410 appointments, showed there are many benefits when patients receive personalised care, including:

• Patients are more likely to understand the advice given and find it easier to follow. This is a really powerful reminder that while we all work hard to provide our patients with the best advice, if they don’t fully understand it then the chances of adherence are very low.
• Patients are much more likely to feel motivated to follow the advice and to feel in control of their recovery. A person’s state of mind is really important when dealing with a challenging health condition. Involving individuals in decisions about their care, and using personalised care training to ensure quality conversations, improves outcomes
• Patients are much more likely to feel listened to and valued. This is something that every patient deserves, and these human skills are a key part of our nursing practice. Nine out of ten people said they felt that a personalised care approach to healthcare would help them to manage their health issue more effectively.

Would you like to find out more?

You can access the PCI’s virtual hub to complete the range of peer-reviewed courses and I’d encourage you to familiarise yourself with what’s available to enhance your skills and knowledge. The quality-assured courses are all free and take between 30 and 60 minutes to complete; plus all learners get a certificate of learning once the evaluations are completed. Courses include: –

• Core Skills
• Shared Decision Making (SDM)
• Personalised Care Support Planning (PCSP)
• Personalised Care Support Planning (PCSP) – maternity

The PCI also curates a large collection of useful personalised care resources, including webinars and podcast topics. For more information and to register for free, visit https://www.personalisedcareinstitute.org.uk/

Karen Olorenshaw, Queen’s Nurse and Practice Nurse in Warwickshire