A Framework for Personalised Care and Population Health for Nurses, Midwives, Health Visitors and Allied Health Professionals

Dawne Garrett is Professional Lead for the Care of Older People at the Royal College of Nursing, and a BGS member.

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The Department of Health recently released the Framework for Personalised Care and Population Health for Nurses, Midwives, Health Visitors and Allied Health Professionals. This web based framework has been developed to support nurses, health visitors and allied health professionals to operationalise current policy on improving health outcomes and reducing inequalities for all ages including older people.

The six areas of health activity covered include:

  • Improving the Wider Determinants of Health
  • Health Improvement
  • Health Protection
  • Health Care Public Health
  • Health Wellbeing and Independence
  • Life course

In each population health activity area there are one or more worked examples on national health priority areas that illustrate how the framework should be used. Two older people’s examples are in place, falls and dementia. It also provides links to the outcomes frameworks, especially the Public Health Outcomes Framework, to demonstrate and measure impact, and provides links to national guidance and underpinning evidence.

Where is it?

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/326984/PHP_Framework_Version_1.pdf

Who is it for?

It provides practitioners, managers and commissioners with high quality evidence to underpin the delivery of the best health outcomes for the populations they serve and is likely to be well received by nurses and AHP’s in BGS. Whilst this framework isn’t primarily aimed at medical staff it does provide some useful information and could be used to form the basis of education sessions for multidisciplinary teams or even junior medical staff.

How is it relevant to members of BGS?

It can provide key support in commissioning services and for those not involved in commissioning might encourage us to add value to our own service provision. As individual practitioners it can make us consider delivering our consultations with a wider public health focus.

The Framework supports Making Every Contact Count (MECC) which focuses on staff working with the public delivering opportunistic, appropriate and timely advice on health and wellbeing to patients, their carers, staff and communities they come into contact with, visits to care homes would be an obvious opportunity for those of us who work in older peoples care to use the framework. It is recognised that health practitioners can contribute significantly to promoting healthy lifestyles as part of their day-to day role through considering how their interactions with all can be used to promote health and wellbeing. Opportunities may include advice on stopping smoking, reducing excessive alcohol intake, improving diet and also guiding people towards information and services that provide the support they need.

These activities will, in the main, be led locally through health and wellbeing initiatives such as MECC. There are 24 indicators in the Public Health Outcomes Framework that can be used to measure outcomes in this activity area!

What else is planned?

DH suggest that the Framework is dynamic and will evolve over time. Specific examples under development that are related to older people include:

  • Healthy ageing
  • Smoking
  • Obesity
  • Respiratory health
  • Homelessness
  • Liver disease

 The worked example concerning healthy older ageing is being written by the Royal College of Nursing but input would be very welcome.

What are the challenges to implementation?

The framework uses terms that are well understood in public health arenas but are not necessarily intuitive to those of us who work with older people. However it would be useful for BGs members to become more familiar with this terminology as we increasingly address public health issues.

The website can take time to navigate as there is a broad body of evidence and by the very nature of older people they sit towards the end of the life course, thus practitioners may have to wade through  (some very interesting) information before landing on the required pages.

The final challenge is that the format means that for peripatetic practitioners it may be difficult to access on smartphones and other small devices but for staff with easy access to laptops or desktops it is a highly engaging resource.

What are the benefits?

The key facts are pithy and sometimes startling. There is a wide range of evidence and useful links. The framework also lends its self to being an educational tool and could be used to underpin a series of multidisciplinary short sessions or themes which could be taken to stimulate a public health perspective on ward rounds.

In addition to being used with staff, for health and IT savvy patients, patient groups and families we could use it stimulate debate about services and public health priorities.

The Department of Health are happy to receive feedback about the resources and can be contacted at: PHPFramework@dh.gsi.gov.uk.

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