The NHS is creaking, under pressure to provide more with less. Morale among staff is generally low and this cannot be conducive for building collaborative partnerships with patients.
Time - there just isn't enough, and yet time spent now will save time later. The same goes for money, spend today, save tomorrow.
Those two things are required - time and money - if collaborative care and support plans are going to be available to the people with long-term conditions who want one. People like me.
We were promised care plans in 2010, we keep being promised personalised care. There's even a model for it. There are probably some lucky people out there who have had collaborative conversations with health professionals committed to partnership working. I'm a patient (sometimes – mostly I'm a person) committed to partnership working and yet, even though I've asked, I've still not got a care plan.
A plan that I've made with a healthcare professional. That is recorded somewhere so it can be reviewed. One that is centred on my preferences and takes into account my social and emotional needs as well as what I need medically. One that goes across secondary and primary care. And one that is dynamic, that changes as I change and adapts as I adapt.
If we look at the House of Care model we can see that personalised care and support planning conversations happen when engaged patients meet with clinicians committed to partnership working in a system that is supportive. All the elements are required. The reason it's not happening with me at the moment I think is because the system isn't supporting it. The system treats me as a passive recipient; I see the doctor to receive results rather than seeing the doctor to discuss results I've received in advance.
I am not a passive patient, I'm one of the ‘activated’ ones; making a collaborative care and support plan with me should be fairly straightforward. What about the people who are less engaged with their health, who perhaps are less health literate than me? Who probably need a care and support plan more than I do?
Surely it's time to start doing, we've talked for long enough. It is happening in pockets, there are tools to help from charities and national bodies. There is evidence that it uses resources better in the long run. We just need to get on with it… Please while I'm still healthy enough!