Throughout England, GP practices and Primary Care Trusts are encouraging people to take more control in their consultations with healthcare professionals and demand more of a say when it comes to decisions.
The Year of Care is one of the projects at the forefront of this wave of change. But what is it and what does it mean for you?
What is the Year of Care?
It is a pilot project that aims to give people with diabetes more control over their care and support people to manage their diabetes effectively with the help of their healthcare teams. It does this by making annual review consultations between healthcare teams and people with diabetes truly collaborative, through care planning.
It then uses this information regarding individual choices and needs, to directly develop the services available, through commissioning. Commissioning is when an organisation is funded to deliver a service, eg to run a weight-loss programme.
Who is involved?
Diabetes UK is a key partner in the Year of Care, along with the Department of Health, The Health Foundation and NHS Diabetes (formerly the National Diabetes Support Team).
Where is it being piloted?
There are three areas in England currently testing this approach: NHS North of Tyne; Tower Hamlets PCT; Calderdale PCT, Kirklees PCT and Calderdale & Huddersfield NHS Foundation Trust.
Why is it being piloted?
In 2007, the Healthcare Commission published its Managing Diabetes: Improving services for people with diabetes survey, which highlighted the need for something to be done about the way in which people with diabetes were involved in their care.
It revealed that although 95 per cent of people had diabetes checks at least once a year, less than half discussed ideas about the best way to manage their condition, and fewer still discussed their goals or agreed a plan for the next 12 months. The Year of Care aims to address this, through care planning.
What is ‘care planning’?
It is a process that allows people with diabetes to have active involvement in deciding, agreeing and owning how their diabetes is managed, and has been described by a healthcare professional as ‘looking with rather than at people with diabetes’.
Care planning recognises that although healthcare professionals might have knowledge and expertise about diabetes in general, it’s really only the person with the condition who knows how it impacts on their life. So it is about making sure that every aspect of the person’s life is taken into consideration, not just their clinical issues.
This might include how they manage their diabetes, how diabetes has an impact on the way they live their life – and vice versa – and any other health and social needs they may have as a result.
The idea is to transform the annual review, which currently often just ticks boxes to show that tests have been taken, into a genuinely collaborative consultation by providing a real opportunity for people to share information with their healthcare team about issues and concerns, their experience of living with diabetes, and help with accessing services and support that is needed.
Both the person with diabetes and the healthcare team will then jointly agree the priorities or goals and the actions to take in response to this.
In practical terms, what will care planning include?
It may include sending results of tests out ahead of an annual review with supporting information to help interpret them (eg the person’s blood pressure will be given as well as guidance on what it means).
This allows people to sit down and think about their condition, talk it through with their family and carers and decide what their specific goals are for the coming months.
It will also involve agreeing shared goals for care during the annual review, finding common ground between everbody’s aims and then working out actions to help meet them.
The goals are specific to each person, so might include things like “I want to lose weight before my cousin’s wedding” or “I want to stop smoking before my flight to Australia”.
Similarly, the actions to help meet these goals could be for the service or the individual to carry out, eg either to see a dietitian or stop eating biscuits on a Friday!