How can person-centred approaches help people make decisions about their healthcare?

The Secretary of State for Health Andrew Lansley has announced that from 2014, all people will have the right to ask for a personal health budget. Early findings from the evaluation are showing improved health outcomes for people. But there is a risk this important work will be distracted by critics fuelled on a diet of media stories about severe financial restrictions, cutbacks to services and "bad" use of public money. We are starting to witness an increasing climate of "fear" that creative solutions to managing people's long term health conditions must be continually justified - and in the worst case scenario, severely restricted.

Some work needs to be done to allay the anxieties of some of our health colleagues, the media and others that creative, person-centred solutions that combine both the clinician and individual's expertise is a good long-term investment that improves people's lives.

We have been doing some thinking around this with colleagues from the Department of Health's personal health budget pilot and amongst our own team. We also hosted a well-attended and earnest discussion at the Gathering in October about how we take what has been learnt from social care and apply it to health.

Rita Brewis from In Control said at The Gathering that we can't simply pick up a system from one working context (social care) and drop it into another (health). We must instead acknowledge that there are different legislative frameworks and cultures, as well as a vast amount of clinical expertise to treasure and cherish.  We of course want to keep hold of best practice and the research-based advice about best treatment options. But we also want to bring in an individual's view of what matters most in their life and shift some of the power and decision making to change the relationship between the NHS and individuals.

I agree that our goal should be improving the conversations between clinicians and people (I blogged about this back in September http://bit.ly/tBThLQ). Our work in this area must lead to a personal care plan that includes options and advice from the health service, but also understands the personal impact of the long term health condition, an individual's preference, the options they have in their local communities and the real wealth and capacity they can bring to managing their condition.

One of the factors central to the success of personal health budgets is the idea of co-production. This is where the person who is being supported, alongside their family members and friends, are considered equal partners while developing a package that will help them manage their long-term health condition.

Person-centred approaches have a vital contribution to make here. There are a whole range of tools and techniques available that can help people do this thinking, together with family and friends, and health practitioners. For many, the essence is a good conversation that focuses on what is really important to them, and what they want to change.

We have published a minibook - Person Centred Thinking & Health (http://bit.ly/vpaHMg) - which describes how to do this in more detail. For example, the "Circle of Influence" can help people disentangle the things they have control over with those they can't, so energy and time can be redirected to focus on what would help a person feel better and take more control. The "Helps and Hinders" tool helps a person think about their condition and build up a picture of what a person needs more and less of in their lives. The "Support to Confidence" tool looks at what a person wants to achieve and what support it would take to have more confidence to self-care.

We must all remember that personalisation is a movement of change that is about helping people get a better life. Let's take what we have learnt from social care and use it constructively within health.  And let's continue to get the message out that a great planning process taps into creativity, integrates what matters most for an individual's health with clinical best practice and importantly, innately makes public money work more effectively.