A year in the life of AQuA: Rachel Bryers

As we near the end of the year, we start to think back on the months gone by, and having time to reflect on the year offers us the opportunity to celebrate achievements, learn some lessons and reassess for the New Year.

Over the next couple of weeks, some of our programme leads will be sharing their reflections on 2019, covering the expert work that AQuA have done to support our members and customers on their improvement journeys and what they’re looking forward to in 2020.

First up is Rachel Bryers. Rachel is the programme manager for Person Centred Care and works across a wide range of programmes and bespoke work to support the development of Person Centred Care practices to achieve benefits for service users, careers, local communities and the whole health and care system.

It’s been another busy year for Person Centred Care programmes since the launch of NHS England’s Universal Personalised Care (UPC) plan back in January. We’ve worked with teams across the North West to embed some of the key aspects of the UPC plan, namely shared decision making, self -management support personalised care planning and patient activation. We worked with two teams from North West Boroughs NHS Foundation Trust in partnership with the collaboration for Leadership in Applied Health Research North West Coast (CLAHRC NWC). This project focused on providing clinicians with the knowledge and skills required in delivering a patient centred approach to healthcare interventions and related conversations using the Patient Activation Measure- PAM® -as a tool to support behaviour change conversations. One of the main objectives was to achieve a culture shift around the delivery of whole person care based on ‘What matters to you’.

We’ve also worked with North West Ambulance Service supporting the request caller’s team to use quality improvement methodology to embed personalised care. Another are of work we have been proud of this year is working in partnership with St.Helens Healthy living team and the school nursing team at North West Boroughs NHS Foundation trust to review their approach to completing the National Child Measurement Screening Programme .We’re testing new ideas for this to be more person centred and engaging and we are aiming to increase the uptake of families engaging with services that promote and support healthy lifestyles.

We’ve worked closely with NHS England’s personalised care group to deliver 5 cohorts of shared decision making train the trainer and offered mentorship/coaching support for demonstrator sites. Emma Walker and I have become members of the international network of shared decision making practitioners (SHARP) and from next year we will be offering support to 20 clinicians to join the network.

Reflecting on our challenges highlights the common problems in embedding personalised care: time constraints, competing priorities and pressure to meet targets and KPI’s. I often talk about how when we don’t focus on what matters to people and care is not personalised, these are silent harms. When we refer to patient harms we focus on safety: serious falls, MRSA, never events, all of which are vitally important to patient’s health and wellbeing, but equally important is the need to actively involve people in shaping their own care and support. The growing body of evidence shows us that this leads to better outcomes and experiences, as well as reduced health inequalities. We cannot under estimate the challenges of delivering personalised care but we if we see the patient as a whole person within the context of their whole life, value their skills, strengths and experience, we can deliver care that focuses on what matters most to them. Next year we will continue to build on the programmes we have delivered, striving to improve our offer to support frontline staff to achieve personalised care.

You can keep up with Rachel and her work over on Twitter, @rachelbryers.