Personal outcomes, person-centred working and personalisation – are you confused?
Person-centred working, personalisation and personal outcomes approaches have developed alongside thinking about the involvement of individuals in their own care and support.
Many practitioners and managers in health, social care and wider public services in Scotland say they feel overwhelmed by the range of initiatives being implemented. This prompted us to explore similarities and differences between approaches and policies in this area.
Our review
The aim of this review was to reduce confusion and progress person-centred ways of working to improve outcomes for people, tackle inequalities and support the sustainability of services. To make it manageable we had to be selective, so we included the following approaches.
- Shared decision making (in clinical situations).
- Support for self-management.
- Anticipatory care planning.
- Personal outcomes approaches.
- Personalisation through self-directed support.
- Person-centred care for older people with dementia.
- Person-centred planning with people with learning disabilities.
- Facilitating recovery by people living with mental illness.
What we found
A key finding is that apparent differences between sectors and approaches are less common than divergences within approaches. Two main ideological forces influence approaches to implementation – ‘managerialist’ and ‘relationship’ based - both of which are explored in more detail in the review.
- Key similarities between approaches recognise the need to:
- engage with the person/family in the context of their whole life
- engage in knowledge exchange, rather than professionals imparting knowledge
- acknowledge and build on people’s strengths and capacities
- build connections to community and not just services.
Key differences between approaches centre on:
- ideas about what constitutes effective engagement
- ideas about the extent to which and how personally valued outcomes or goals should influence decision making
- the extent to which agreed outcomes are recorded in plans which are then stuck to
- whether families and other carers are included in planning and decision making.
The future
We need to measure, monitor and track outputs and outcomes in order to plan and manage services effectively. However, there are limitations to what is currently measured, and as a result what is considered to count. All of the approaches we reviewed advocate the essential relational and holistic practices needed to maximise outcomes for people and address persistent and increasing inequalities at some level. Enabling such practices to flourish requires a re-orientation of performance management frameworks to include relational and holistic factors.
Further information
You can read the full report - Personal outcomes, person-centred working and personalisation – Thinking about different approaches in health and social care in Scotland here.
You can also find more free resources to support personal outcome approaches on our Learning Zone and at https://personaloutcomescollaboration.org/
The Personal Outcomes Network meeting in September 2018 focused on ways of using personal outcomes data and information for evaluation and performance. Films of the presentations given by practitioners can be viewed here.
If you would like to know more details about the review or the Personal Outcomes Network please email sdsandintegration@sssc.uk