Appendix 1 - Personalised care in service specifications

Summary

The following wording has been adapted from the Finance, Commissioning and Contracting Handbook for Personalised Care (NHS England, 2019b), which I authored on behalf of NHS England in 2019.

Personalised care service requirements often need to sit within service specifications for a care pathway or service. They are a single part of a wider whole. It is important to ensure that the requirements for personalised care are captured effectively. Commissioners may find the example wording in the boxes helpful when considering shared decision making, personalised care and support planning, and social prescribing.

This example wording will require modifying to meet local requirements, but offer a useful start as specifications are developed or revised.

Example service specification wording for shared decision making

Shared decision making is a process in which individuals and clinicians work together to understand and decide what tests, treatments, or support packages are most suitable bearing in mind a person's own circumstances. It brings together the individual's expertise about themselves and what is important to them together with the clinician's knowledge about the benefits and risks of the options. This means that lay expertise is given the same value as clinical expertise.

To be successful, it relies on two sources of expertise:

• • the [INSERT health professional] as an expert on the effectiveness, probable benefits, and potential harms of treatment options for [INSERT pathway]; and

• • the individual as an expert on themselves, their social circumstances, attitudes to illness and risk, values and preferences, and the supplied knowledge of the latest evidence.

Shared decision making enables individuals to align their preferences to treatment options that are clinically valid. It does not mean that people can choose clinical treatments that have no evidence base. For this service, the key options are as follows:

• • [INSERT option];

• • [INSERT option];

• • [INSERT option].

The Provider must:

• • implement shared decision making for [INSERT eligible patients];

• • have a clear written protocol in place for shared decision making and its use in the [INSERT care pathway];

• • ensure applicable staff are trained in the skills of shared decision making, and this entails [INSERT requirements, such as type of training and frequency].

The Provider will ensure that the patients are prepared by [INSERT how people are prepared and supported].

The Provider will identify a named clinical champion, and they will be given appropriate time to support the implementation of the new approach for i nteracting with service users.