Redefining place-based care: facilitating system change
Graham Brown, UK&I Marketing Director at Tunstall Healthcare, discusses what the future holds in regards to service transformation and place-based care, and how technology can facilitate access to care and reduce health inequalities.
In order to redefine care and achieve preventative services that reduce health inequalities, it’s important to approach healthcare services both holistically and through targeted resolutions to specific areas of care provision.
By starting with place-based care and the role of technology, it is possible to approach issues around prevention and proactivity and the tailoring of care to individual people and communities. This in turn will help care providers to combat health inequalities and improve access to health, social care and housing.
Defining place-based care
Place-based care presents multiple opportunities, as well as some intrinsic challenges. In order to capitalise on the opportunities that are presented, we must first define ‘the place’ and what this means to the people both providing and receiving health and social care services.
When defining place-based care it’s important to consider the different demographic regions across the UK. There are disparities in the health and wellness of communities with different population characteristics, with affluent areas tending to be more well and living longer than those in poorer areas. Any attempts to tackle these inequalities must therefore be able to target different demographics, by taking into account disparities in access to technology, health and wellbeing, and life expectancy.
The local nature of ICSs will mean that the professionals involved are better placed to understand the needs of different populations and the communities in which they are based. This will then enable better collaborations so that place-based care can be defined, which will in turn support more tailored care that plays a key role in reducing health disparities between communities.
The majority of the population moves between different places, such as the workplace and home, on a daily basis, and this impacts our ability to deliver place-based services across a range of sectors. However, this presents significant challenges when it comes to health and care delivery. Consideration of how to adapt where and when care is provided to each individual that needs it is very important if services are to become proactive and preventative.
A key question is how to ensure that the right objectives, targets and outcomes to manage this are in place. For place-based care to integrate technology and be truly effective, it has to be mobile.
Person-centred and community care
Achieving personalised care will support the transition beyond a holistic approach to one where it is possible to deliver place-based care that targets specific areas, particularly those that require transformation.
Only by making person-centred care a reality can healthcare services be transformed to become flexible and have a place-based approach at their core. To look after a population as a whole in the right places, we need to look after individuals first, particularly through individualised health and care records.
Timings and the evolution of service provision will need to flex for different areas, and the skillset of the workforce will have to change accordingly. By bringing equilibrium to the living standards and available opportunities of our population, we will see an immediate and sustained benefit on health and wellbeing and a reduction in the need for severe elective activities.
Funding streams and ICSs
Changes in funding streams could precipitate a real system change that removes the silos that are currently placing barriers on delivering the most effective services with their own outcomes. However, it is first necessary to take a step back and define these outcomes, to keep the population healthy and deliver real change.
Considering single accountability and each step of an individual’s care journey will empower Tunstall to support ICSs in their role. For example, providing winter funding to social care services first, rather than straight to the acute trust, could have the potential to cut the numerous problems and pressures that the colder weather places on healthcare services and reduce the number of people requiring hospitalisation and other complex care services.
This will be further supported by real collaboration and integration across the system, with a particular focus on enabling data sharing. If issues and demand are addressed earlier, budgets and funding streams can be allocated to the specific areas that need them, and professionals will have peace of mind that there will be fewer significant hospitalisations of vulnerable people.
Falls protection is a particular point that places significant pressures on the health and care spectrum. For example, unaddressed fall hazards in the home are estimated to cost the NHS in England £435 million.1 If the right funding streams, people and technology are put in place, we can build on preventative and proactive approaches to reduce the number of people experiencing falls and the complex and often severe elective activities that can occur. This will in turn lead to a significant pressure being removed from the system.
The impact of technology
Technology’s role as an enabler can move the prevention agenda forward, however it is only valuable if it drives sustainable system change. In order to integrate technology effectively, we must bring the right skill sets into our services to ensure they can deploy digital solutions successfully.
Technology can have a significant impact on the citizen, particularly with the advancement of wearable technology. The ongoing progress that’s been made around data privacy is likely to continue, particularly as the next generation grows up in a digital-first landscape. This will lead to citizens being more comfortable with health and care technology and their data being fed directly into their health and care records.
Technology can provide a longitudinal profile of an individual instantaneously, which is particularly important for personalised care provision, and for making citizens feel more in control and responsible for their own health, wellbeing and care. The more that technology is integrated into care provision, the more empowered the population will become.
However, technology can also initially make people feel less empowered which has contributed to the uptake challenge. Providing education to citizens and care providers can help them to understand how and why they should use technology, which is ultimately to help people live freely and independently in a place of their choice.
Facilitating system change
Tunstall can facilitate system change by integrating technology into our services and considering big data, trends analysis and early indicators. Preventative services will develop effectively when individuals are willing and open to engage with technology and allow the right people to have access to their data. If this engagement is not driven forward, it’ll be more challenging to generate system change and the generational improvement that is needed.
The need to address short term pressures is one of the fundamental challenges within our services. Immediate pressures can become overwhelming and all-=encompassing, which then make it challenging to get to the root causes and tackle them in a systemic way. This is where technology can help, by increasing the bandwidth of the people who can make these changes happen. By giving them access to the right information in the right way they will have the ability to make the right changes at a place based and population level.
As a leading provider of technology, Tunstall is working closely with ICSs to understand the challenges that are faced by our health and care services and how these can be solved collectively. Technology leaders should be focused on breaking down barriers between organisations to help ICSs have the desired impact. Communication through the system, partnerships and problem solving will drive a central vision that ensures shared outcomes.
For more information, please visit www.tunstall.co.uk.
This article was kindly sponsored by Tunstall Healthcare.