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What's in a name? All patients want is care

Integrated care, personalised care, seamless care. As Professor Chris Ham told me this month, what patients are concerned about is just the 'care' bit.

Integrated care, personalised care, seamless care. As Professor Chris Ham told me this month, what patients are concerned about is just the 'care' bit.

What label it arrives in - primary, secondary - is irrelevant to them.

They simply want someone to take responsibility for making sure what needs to be done is done and that they can phone that single person responsible for putting together the jigsaw of all the different NHS pieces, rather than having to call numerous secretaries, booking lines or charities (see his article on integrated care in this month's edition).

Personalised care through personal healthcare budgets has caught my attention this month.

At the NAPC's spring conference I learned how an MS sufferer whose carer needed respite managed to use his direct social care budget to pay for a couple of football season tickets for him and a ‘respite companion' to attend a match.

A big financial saving for social care and a much more pleasant experience for him I am sure than a stint in the local respite home or day centre.

Should NHS money be used in the same way? Independent health expert Roy Lilley, who chaired the conference summed up the decision-making this kind of commissioning requires as being about the ‘dignity of risk'.

My friend has cancer and has children the same age as mine. She still wants to be mum to them but gets very tired. At the moment she sends them to a local nursery there days a week so she can get the rest she needs.

She doesn't want counselling, a home help, reflexology or other services. She wants to get on with her life and to be as normal as she can, for as long as she can.

With a personalised healthcare budget she could pay for a nanny to come in and look after her children so she can still spend precious time with her children without getting too worn out.

Would that really require much risk assessment to ensure resources weren't abused?

Of course it is much harder to set a personal healthcare budget than a social care one, but that shouldn't put you off.

One GP made a start looking at how much his patients individually cost the NHS and found one heartsink cost the NHS £20,000 in one year – and she wasn't even admitted to hospital.

Instead she went to the different nurses and GPs at the practice – at different times they noted, which they suspect she did to avoid team members who had already seen her – used the walk in centre, requested out of hours visits and repeatedly visited A&E.

When he relayed his ‘finding' on to his practice nurses they commented she could have had her own nurse dedicated to her for the year and they wouldn't have had to see her anymore.

Are you inspired now?

Susan McNulty

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