Voices & Choices: Personalised Care in Nursing

This project discusses the concept of personalised care in nursing and its importance in providing voices and choices to patients. It includes Katy's story, a 24-year-old girl with learning disabilities and complex health needs. The project describes the components of the personalised care operating model as per the NHS long term plan (2019) and the importance of effective partnership between nurses and patients. It also analyses the role of effective communication and interpersonal skills in providing care and explores social prescribing.

Voices & Choices

Table of Content
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
Summary of a person’s episode of care.......................................................................................1
Components of ‘The Personalised care operating model’ as per the NHS long term plan (2019)
and the importance of partnership working between the nurse and person in achieving a
joined-up approach to meeting their needs..................................................................................2
Role of effective communication and the interpersonal skills while providing the unit of care
to the patients while subjacently understanding the katty demands and needs. .........................4
Analyse the obstruction and the asset related to the interpersonal skills while providing the
episode of care to the patient. .....................................................................................................5
How social prescribing could support the persons health and well-being as well as the health
and well being of their family and carers.....................................................................................6
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................9

INTRODUCTION
Voices and choices within the health and social care are related to identification, self-
expression, self determination and rights of human. The patients seeking care, require voice and
control for the the decisions that are relevant to them. Their views and feelings are required to be
respected and taken considerations. The lack of voices and choices within the health and social
care are responsible for low confidence, decrease self-esteem and also a diminished well-being.
Personalised care in nursing provides voices, choices and control to patients in regards to their
care plan. The personalised care is based on involvement of patients in their treatment and care
plan by establishing a healthy relation between patients (people), professionals and the health
care system (England, N.H.S., 2019). The project describes the concept of personalised care in
terms of voices and choices in regards to story of Katy, who is a 24 year girl, living in
Dorchester with her parents. Katy has learning disability and complex health needs, including
vulnerability to infections, psychological well-being and weight issues. The project describes
that how Katy's overall well-being improved with personalised care provided by her parents
along with the importance of personal health budgets for care providers and care seekers for
adhering with the care plan. In addition to this, the project describes six components of
personalised care operating model according to NHS long term plan (2019) along with
importance of effective partnership in between nurses and patients in achieving needs. Further,
the project include skills of nurses in identification of person's need with inter professional
teamwork. Here is also a discussion over social prescribing that can support health and well-
being of patient an their families and carers.
MAIN BODY
Summary of a person’s episode of care
The episode of care of the case chosen for this file is the story of a girl named Katy Tyler
who is 24 years old and her mother Jackie who takes care of her. Katy suffers from many issue
including learning disabilities due to which she had intense care needs for every hour of a day
and every day of the week. She requires 24X7 assistance for her psychological well being,
weight issues and vulnerability to chest infections. As she was wheel chair ridden she also
required assistance for her daily activities like bathing. Earlier her mother and father used take
care of her but after a while her mother has to quit from her job due to her profound care needs.
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Her intense care needs have become a reason for her mother to take anti depressants. Earlier she
used to receive care at a day centre where she received care for five days a week. But Katy did
not like the staff at the day centre and felt that they did not had enough knowledge and resources
for taking care of individuals like Katy. As Katy had issues verbalising her feelings, she was not
able to tell the her care taker about her wash room need. Is she tried to tell them about her needs,
it was interpreted as seizures by them which made her even more frustrated. Then when she was
provided with an option of personal health budget, her and her mother's life became a lot more
easier. The budget allowed them to choose a care provider for her by themselves. This proved to
be very beneficial in case of Katy as she required a care taker who can understand her body
language to understand her needs. At the end this budget resulted in the betterment of her weight
and infection related issues and she got back her social life (Katy and Jackie's story NHS
England, 2021).
Components of ‘The Personalised care operating model’ as per the NHS long term plan (2019)
and the importance of partnership working between the nurse and person in achieving a
joined-up approach to meeting their needs.
Personalised care is defined by NHS as a process that allows the patients and his or her
guardians to have control on the care process that is being provided to them for their health and
care needs. The concept of personalised care makes the delivery of care more apt for the patient
resulting in the patient remaining healthy for an extended period of time. The NHS long term
care plan of 2019 aims at utilising every penny of the tax paid by the tax payers to provide them
with the most valuable care services (Alderwick and Dixon,2019). Through this plan NHS aims
at providing the people with the best health care support for every every phase of their life that is
from best care services at the start of their life to supporting them to age well. This long term
health plan provided the local health care systems with the framework to design an apt plan for
providing the most valuable care services to the people for their entire life span while keeping in
mind the principles of collaboration and co-design (Sanderson and Hawdon, 2018). The plan is
bifurcated into seven chapters which outlines the aims of plan stating that NHS will introduce a
new service model in 21st century and will take more actions for promoting health equalities and
focus more on prevention of diseases. The NHS also aims at digitalising the care provision
process and further increasing the quality of health car services.
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NHS in the past few years have collaborated with the various local government,
voluntary sector and community sector for building a robust model for providing personalised
care to the patients. This model consist of six major evidence based components which include
 Shared decision making
 Planning of personalised care and support practices
 Enabling patients with choices and legal rights regarding their treatment regime.
 Community based support and Social prescribing
 Support for Self management
 Provision of Personal and integrated health budgets
Shared decision is that component that allows the patient to be able to receive advice and
support from the specialists of that field which helps in taking the most apt decision for the care
regime (England, N. H. S. 2018). The shared decision making process involves the inclusion of
both patients ad clinicians who work in collaboration with each other to make decisions on the
best treatment option which will provide the patient with maximum benefit. The Self
management support uses Patient activation measure as a tool to allow the patient to gain enough
confidence and expertise which will allow the patient to become independent. This component
helps in increasing the skills and knowledge of the patients so that they can manage their health
and care needs by themselves. This component is most beneficial for the patients who happen to
have long term health conditions whose management require care services for an extended
period of time.
Personalised care and support planning being another component of the personalised
care model allows the patient to gain maximum benefit from the care services. The support and
care planning process initiates with an integrated assessment of the health priorities of an
individual followed by a conversation to decide a suitable care regime. The component social
welfare connects the patients with non- clinical community services to help them maintain their
mental well-being. Component related to patient choice ensure the patient's awareness about the
set of health care service options from which he can choose from. Personal health budget allows
the patients to take care of the issues that are bothering them the most amongst their helath and
care needs.
The concept of personalised care is majorly governed by the relation between the care
provider or nursing staff and the patient. Provision of personalised care services can be ensured
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by ensuring proper understanding of the health and care needs of the patient by the care provider.
The nursing staff can gain complete knowledge about the health issues faced by the patient only
when the two have good relations with each other and good communication skills are practised
by both (Glasper, 2020). Thus the nursing staff is required to build good relations with the
patient and practice good communication skills with the patient.
Role of effective communication and the interpersonal skills while providing the unit of care to
the patients while subjacently understanding the katty demands and needs.
Effective communication is the action taken by the nurses to communicate with the
patient while building effectual reliance, regard and understanding between each other. It is
primarily the exchange of thought process or the opinions without having the doubt of being
judged and making sure that listener is interested to listen the point of view. Interpersonal skills
is the ability of the health care provider to raise and interpret the patients needs and concerns.
These ability acts as a aid for the health care provider to translate the patients issues into
effective determination approach to provide them the accurate care (Grajo and et. al., 2022).
To fulfil the patient accurate concern and opinions, nurse should have the effective
communication which will support to provide patient-centric care to the patient. It includes the
communicative and non-verbal interaction between the nurse and patient which also includes
active listening, building personal connection through trust and also provide them with the
efficient medical education for the treatment. Since the Katy has learning disability, it is very
essential for the nurse to built the connection with the patient while actively listening to the
patient concern. To accomplished it, nurse should maintain the proper eye contact when the
Katy was trying to explain out and nod their head as a symbol that one is interested to know their
concern. This will boost their self-esteem and bring down the level of irritation or frustration due
to the health condition. Non-verbal communication like using sign language or the expression or
the use of hand motions to make them solve the issue they are facing or making the patient feel
that one is engaged in providing proper care to them. These sign language will work as
assistance in Katy case as they are unable to speak in proper manner. To built the connection
with the patient, nurse should take time and sit with the patient to interest with them. This can
either be done by sharing their own stories or asking the patient to share their story or the issues
which they feel need to be solved. Nurse can incorporate the drawing or the presentation session
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to make patient familiar with their health condition and ways to procreate the intervention
(Waight and Oldreive, 2022).
These skills when integrated in effective manner can work as a aid to improve the patient
health condition. These skills provide high patient satisfaction. These skills improve the quality
of life as through it Katy can acquire back their learning skills as task provided to the Katy in
small parts and proper quality feedbacks nurses provided to analyse the progress report of the
patient. However, to develop the reading skills font in which sentence are written should be in
the bigger size so that patient don't feel stress while reading it out. Nurse should verbalise
distinctly and the in low pitch. Additionally, they should built good connection so that they
would understand patten concern from their body language and the expression straight away
(Pound and et. al., 2018).
Analyse the obstruction and the asset related to the interpersonal skills while providing the
episode of care to the patient.
Advantage of the effective interpersonal skills while providing the episode of care to the
patient is the improvement in quality care services. However, it will work as the aid in improving
the satisfaction of the Katy. This only depends on the attitude of the health care provider. This is
fulfilled when the alteration in the treatment is provided according to the patient wants and
demands. Through it patient can effectively convey the problems they are facing in the treatment
to the health care provider. When nurse will provide proper time to the patients it will built the
good relationship which is flooded of trust and the value that patients can convey whatever they
are feeling without having any second thought on it. This human relationship between the nurse
and the patient will ensure the patient that their though process or the feeling are kept
confidential (Zarkowska and Clements,2018).
Quality of care is improved when patient is in more surrounded with their family
member as long days of hospitals lead to lot of fear, irritation and boredom state. This can be
provided by altered plan of action in solving the issues faces by the Katy which includes three
days in a week the care is provided to the patient in home and in remaining days Katy visit to day
centre. Alteration in plans are made so that Katy been in contact with others patients which will
help them to refresh their mood and make friends to contact. These patient-centric approach
helps the disable patient to brought up their social skills with others. These approaches will
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reduce the Katy forthcoming sign of depression or the anxiety due to the health disability (Klein
and et. al.,2020).
Barrier associated while providing the episode of care to the patient is the communication
barrier. These barriers are very common with the patients when there is lack of understanding
and the misconception for the patient by the nurse and for the nurse by the patient. This might
includes making the patient feel inferior and when nurse don't vale the patient point of view. This
is seen when there is discrimination patient experience or the mistreatment faced by the hospital
staff. Additionally, communication barrier is seen when the nurse utilizes the technical language
to explain the situation to the patient and even in the harsh voice. It work as a barrier for the
learning impairment patient to understand the message they want to convey. This is seen when
nurse don't try to interpret the information that patient want to convey and disruption is occur in
between the conversation due to other patient which can increase the feeling of hindrance in
patient. This can vary the patient the mental health condition and decrement the care they should
be provided with (Bernal and et. al., 2019).
How social prescribing could support the persons health and well-being as well as the health and
well being of their family and carers
Social prescribing refers to the community referral, which is enabling the nurses, general
practitioners and other health care professionals for referring the people to various local and non-
clinical service providers. Social prescribing address the needs of patient in a holistic approach
which aim for supporting individuals who are requiring care, in order to give them control of
their own health (Drinkwater, Wildman and Moffatt, S., 2019).
social prescribing could support the persons health and well-being
as well as the health and well being of their family and carers by application of different
methods of social prescribing, that are:
Community- centred working way: This way of working is considered to improve health
and well being in marginalised groups and in the vulnerable group. They are essential for
reducing the health inequalities in a local community area. Vulnerable people and who find
themselves as an excluded element of society are provided accessibility and benefits from the
services. As in the scenario of Katy, social prescribing methods used by Jacky was the
involvement of local carers and right cares for Katy's care plan. Social prescribing and
community centred approach is a part of NHS long Term plan for making personalised care a
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commitment across the health and care system. This approach socialise the patients with other
people and provide an emotional support to them. The approach is realistic in reducing the
efforts and time of carers and families of patient along with it is effective from psychological
aspect.
Active signposting: It is a light touch approach for connecting patients to an appropriate
help source or advice. In this approach, existing staff of local agencies engage with individuals to
know about their preferences regarding services.
Health literacy: Health literacy referred to the extent by which an individual is able to
find, understand and acknowledge the information and services in regards to health related
decisions and actions for themselves and for others. As Katy's parents acknowledge the health
literacy and planned medical treatment that was suitable to her. They included all medical
treatment, specialist drugs for epilepsy and i.v. Antibiotics with the help of health literacy. This
helps patient as their own family members are taking care of them so their will be an additional
emotional support for patient (Husk and et. al., 2019).
Social prescribing enables the local working agencies to refer people to link workers,
who provide time to people and focus on their role in shared decision making process and
support planning. Social prescribing benefits the health and well-being of patients by connecting
them with the community groups and agency which provide them a practical and emotional
support. This benefits the health and well-being of carers and families of patients by reducing
their efforts in regards to patient's care along with being an emotional support for patients. This
provide them time to manage their daily work and health status too. It reduces the health
inequalities and a dresses the barrier of person's engagement. It utilises assets of local
community in delivering the services.
CONCLUSION
The overall project concludes with the case scenario of Katy, that personalised care is
essential for both, the care seeker and care providers along with the family members of carer as it
provide an emotional support to patient especially if the patient is dealing with multiple diseases
like in case of Katy. As in the scenario, lack of personalised care raised the feeling of exclusion
in Katy and also diminished the quality care. Along with that, the project also concludes the
communication skills and inter personal skills enables the efficient care of person. Effective
partnership between nurses and person are essential in meeting the needs of patient which is
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described using personalised care operating model. Effective communication and interpersonal
skills in episode of care give knowledge about patient's requirement and inner feeling in regards
to treatment provided to them. The project further concludes inter professional teamwork in
person episode of care provide quality of care to the individual and also its influence by variation
in communication. As different health professionals have different communication approaches.
In addition, Social prescribing also take accounts for health and well being of patients, their
family members and carers. These care aspects are referred in regards to the scenario of Katy and
her treatment plan.
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REFERENCES
Books and Journals:
Alderwick, H., and Dixon, J. 2019. The NHS long term plan. Bmj, 364.
Bernal, O.A., McClintock, H.F., Kurichi, J.E., Kwong, P.L., Xie, D., Streim, J.E., Pezzin, L.E.
and Bogner, H.R., 2019. Patient satisfaction and perceived quality of care among
younger Medicare beneficiaries according to activity limitation stages. Archives of
physical medicine and rehabilitation, 100(2), pp.289-299.
Drinkwater, C., Wildman, J. and Moffatt, S., 2019. Social prescribing. Bmj, 364.
England, N. H. S. 2018. Comprehensive model of personalised care.
England, N.H.S., 2019. Universal personalised care: implementing the comprehensive
model. London: NHS England.
Glasper, A., 2020. Strategies to ensure that all patients have a personalised nursing care
plan. British Journal of Nursing, 29(1), pp.62-63.
Grainger, L., Amin, K. and Watkins, D., 2022. Simulation-based training to teach nurses skills in
falls assessment and prevention. Nursing older people, 34(3).
Grajo, L.C., Guzman, J., Szklut, S.E. and Philibert, D.B., 2019. Learning disabilities and
developmental coordination disorder. Umphred's Neurological Rehabilitation-E-Book,
p.321.
Husk, K. and et. al., 2019. Social prescribing: where is the evidence?. British Journal of General
Practice, 69(678), pp.6-7.
Klein, J.P., Stahl, J., Hüppe, M., McCullough, J.P., Schramm, E., Ortel, D., Sondermann, S.,
Schröder, J., Moritz, S. and Schweiger, U., 2020. Do interpersonal fears mediate the
association between childhood maltreatment and interpersonal skills deficits? A
matched cross-sectional analysis. Psychotherapy research, 30(2), pp.267-278.
Pound, C., Parr, S., Lindsay, J. and Woolf, C., 2018. Beyond aphasia: Therapies for living with
communication disability. Routledge.
Sanderson, J., and Hawdon, N. 2018. Ensuring a personalised approach. Advances in Mental
Health and Intellectual Disabilities, 13(1), 15-24.
Waight, M. and Oldreive, W., 2022. Investigating accessible information formats with people
who have learning disabilities. Learning Disability Practice, 25(3).
Zarkowska, E. and Clements, J., 2018. Problem behaviour and people with severe learning
disabilities: The STAR approach. Routledge.
Online:
Katy and Jackie's story NHS England, 2021 [Online] Available through
<https://www.england.nhs.uk/personal-health-budgets/phbs-in-action/patient-stories/
katy-and-jackies-story/>
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