Alice Hopkinson, Principal Consultant at PPL, discusses how to find a way to describe what integrated care might mean for a patient or service-user
I went to an interesting meeting today. So interesting that I entered with half a croissant and left with half a croissant. Normally that only happens in the really senior ones! There were health and social care representatives in the room, and we were trying to find a way to describe in a meaningful way what integrated care might actually mean for a patient or service user.
My initial reaction was that we don’t have enough information to be able to do so – local areas are still puzzling through the details of a new, integrated model of care. We don’t have enough to be able to say to an individual that in practice, once implemented, it means calling this person and going to this building to do this. We do, however, have a common vision, despite the fact that at a granular level this might look different at a local level. For example, individuals will be empowered to manage their own condition(s). But what does that actually mean for an 86-year-old with multiple long-term conditions? “Empowerment” becomes hard to visualise, let alone make a reality.
What it means, in the context of whole systems integrated care, is that individuals will decide and own their own goals. Maybe they want to get out of their basement flat, or go to a football match, or hold their granddaughter in their arms. (I should say at this point that this definition came from a lay partner in the room – and I could wax lyrical about the depth of understanding that they brought and why the conversation was so much richer because of this, but that’s a topic for another time).
It got me thinking about goals, and how diverse they can be. How they really only need to resonate with you in order to be powerful, and how important they are to living a fulfilled life and experiencing things to maximum potential. A lot of us have career goals; these are both fulfilling, and, to some extent, expected. But what I think you can forget, in the context of that paradigm, is the value of setting personal goals that are outside your comfort zone and in a sense outside of the “daily grind”.
For example, the experience of satisfaction and sense of achievement from essentially coming last in a 5k run recently, is very different to anything that I’ve achieved at work in the past few months. This is because I thought I couldn’t do it, I worked really hard at it, and on the day I kept going (I realise this sounds ridiculous but I guess that’s kind of the point – goals only really have to be a big deal to you, and not measured against others’).
So what did I get out of that? Am I going to continue my “running regime”? Probably not. Has it made a material difference to my fitness and the way I choose to live my life? Probably not. Did I win the race? Definitely not! Am I still buoyed by that high of achieving something? Not really, but I remember how it felt, and I remember the significance of applying myself in that way, and I am trying to translate that into other areas of my life (including my work!) And what I hope to get from that is not just better outcomes, but improved wellbeing.
I guess, for me, that means that the concepts behind whole systems integrated are not just for a particular cohort of patients/service users, but are applicable to the way that all of us live our lives. And do I feel “empowered” by that knowledge? I think I do, yes.