People powered health: health for people, by people and with people

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This report outlines the changes needed to help the health system make the most of the skills and commitment of employees, patients and communities, in addressing the biggest strategic challenge for health: the rising importance of long–term conditions. 

The report argues that this challenge requires a new balance between health provision for people, active health management by people, and mutual support with people.  It sets the framework for a series of related learning reports on People Powered Health published by NESTA.

The report sets out the case for changing the ways in which healthcare is organised and describes in detail how healthcare can better combine the very best scientific and clinical knowledge with the expertise and commitment of patients themselves, as well as the families, communities and networks that they are part of.

It describes a vision for a health service in which:

  • the health and social care system mobilises people and recognises their assets – personal strengths and abilities as well as family, friends, communities and peer networks that can work alongside healthcare professionals and the community and voluntary sector to support patients to live well with long–term conditions.
  • the ability to live well with long–term conditions is powered by a redefined relationship, a partnership of equals between people and health care professionals. These relationships are trusting, purposeful and oriented to the needs of the individual and not the system.
  • the health and care system organises care around the patient in ways that blur the multiple boundaries within and between health, public health and social care; and with community and voluntary organisations; and the boundaries between formal and informal support.

The report advocates changing three vital components of the current system:

  • Changing consultations  to create purposeful, structured conversations that combine clinical expertise with patient–driven goals of well–being and which connect to interventions that change behaviour and build networks of support.
  • Commissioning new services  that provide ‘more than medicine’ to complement clinical care by supporting long–term behaviour change, improving well–being and building social networks of support. Services are co–designed to configure and commission services around patients’ needs.
  • Co–designing pathways  between patients and professionals to focus on long–term outcomes, recovery and prevention.  These pathways include services commissioned from a range of providers including the voluntary and community sector.

Finally it sets out how the vision can be realised by:

  • Changing the way services are commissioned
  • Making the most of new structures
  • Encouraging people to take part in People powered Health
  • Mobilising clinical leadership
  • Changing financial incentives
  • Changing what gets measured
  • Shifting investment in technology towards technologies that enable collaboration, self-management and effective communication
  • Transforming organisational workforce culture
  • Creating a cadre of system leaders
  • Strengthening the business case

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