Personalised care that is safe

Personalised

Tailoring care and support to each person's needs has been a longstanding objective for our organisation. We know that everyone is different and that working closely with people, to make even the smallest changes to their care and support, can have a hugely positive impact upon their experience and recovery.

As part of this work we are currently working  to extend the Personalised Care Framework (PCF) approach across all of our services. The PCF outlines a more flexible, responsive and personalised approach to supporting people with mental health needs across community and inpatient services. It requires a shift towards even greater collaboration with each person, and the wider system, in order to deliver tailored care for people, to meet their treatment goals and to agree a personalised care plan that is reviewed regularly. This new approach requires teams to work together across traditional service and organisational boundaries with each person.

An important part of this sharpened focus on personalised care is the development of Patient Reported Outcome Measures (PROMs) and Patient Reported Experience Measures (PREMs).

These will deliver measurable feedback, direct from the person using the service, about the impact that the care and treatment has had on their health and wellbeing and their overall experience of the care and support being provided. These will sit alongside feedback from the professional(s) supporting each person, who will record their Clinician Reported Outcome Measures (CROMs).

Safe

As well as delivering care tailored to people's individual needs, we have to do everything possible to ensure that care is safe and based on the best available evidence. This includes reducing or stopping those clinical interventions where there is limited evidence to support their value or impact for individuals and in considering the longer-term harms that may occur when we focus on trying to control and individual's behaviour to reduce short-term risk.

We will continue to focus on seven key safety areas as a touchstone for the care and support that we provide. These are now embedded within our organisation and have delivered important improvements and developments in recent years.

Our seven key areas of safety focus are:

• Safe, high quality information
• Safe, just and learning culture
• Safe from suicide
• Safe from unnecessary restriction
• Safe and effective use of medication
• Sexual safety
• Safe and effective physical healthcare

We believe that continuing to develop a culture of continuous improvement across everything we do will be pivotal in underpinning the delivery of this strategy.

This requires a Board-to-ward commitment to a quality improvement approach that is advanced enough, through our systems and processes, to highlight areas requiring improvement and that equips all levels of staff with the skills, resources and support they need to undertake quality improvement initiatives as a core component of our clinical services. We must also ensure we have policies and processes that ensure safety and good governance, but also support local clinical innovation, and that we have clinical and professional networks in place to support implementation and the sharing of developments in clinical practice.

We will set clear quality parameters around how we interpret, define and manage the delivery of high quality care - across both frontline and back-office teams. We recognise that making this transition will take time and requires the continuous feedback and involvement of people using our services, carers, staff and partners.

We have made good progress with the implementation of our new Patient Safety Incident Response Framework (PSIRF), which we launched at the end of 2023. PSIRF sets out a fresh approach in the way that the NHS responds to patient safety incidents, aiming to increase the effectiveness of the learning we gather and to improve patient safety in all of our services. It is a key part of the NHS Patient Safety Strategy, which was published in 2019, and aims to help the NHS improve  its understanding of safety by drawing insight
from incidents, outlining how providers should respond and when a patient safety investigation should be conducted. The framework promotes systematic, compassionate and proportionate responses to patient safety incidents, anchored in the principles of openness, fair accountability, learning and continuous improvement - and with the aim of learning how to reduce risk and associated harm.

The evidence on which we develop and improve our services and systems can come from many places. As well as population-based data, research findings, learning from incidents and best practice guidance from sources such as NICE, local evidence of what works  well is also incredibly important, alongside input and feedback from individuals, through channels such as Patient Recorded Outcome Measures (PROMS). All of these sources of evidence together help us to make good clinical decisions.