Over the last years, we have seen how disruption in routine health care negatively impacts the most vulnerable communities that suffer from the cumulative impact of health inequalities. The risk of patients exacerbating their long-term health conditions (mental health, respiratory and cardiovascular diseases, diabetes, cancer) drives the demand for urgent care and increases premature deaths.
Can proactive preventive care for managing long-term conditions help patients and staff to make a difference?
Benefits of a proactive care approach
We have experienced disruption in routine health care and a drive towards adopting digital technology for proactive preventive care for managing long-term conditions over the last years.
Evidence suggests promising benefits from proactive care related to:
- Patients experiencing more streamlined, and personalised care
- Patient care and work processes are improved
- Motivation to use digital technology
- Prevention of conditions getting worse and related cost efficiencies
Proactive care
Proactive care helps people with health conditions stay well and focuses on preventing health from getting worse rather than curing the conditions. Proactive care activities and interventions contribute to improving health and well-being by increasing self-reliance, capacity and resilience in the people and local communities. Many organisations, from care homes and hospitals to primary care, are already implementing proactive care. For example, in England roll-out is happening across all integrated care systems.
Personalised care
Personalised integrates the person’s agenda into the care plan and the relevant competencies to design the whole-person care plan. Only when the personalised care plan and competencies are in place can proactive and preventative care across health conditions be integrated successfully into the activities.
Digital health
Digital health technology support functions as a change agent and is essential for scalability. Digitally supported, person-centred, integrated and proactive care seeks to reduce the risk of clinical crises which are costly in human and economic terms. However, proactive care will fail if it is not completely embraced by the people who deliver and experience the pathways: the patient, their carers, and the care professionals.
How can organisations deliver proactive preventative care?
Delivering proactive preventative care requires bringing together experts and leaders to focus on translating the ’what’ needs to be done into ‘how’ to do this in practice. With experts, we mean a vast array of individuals who commission, deliver and receive proactive care interventions.
Health equity and empowering the most vulnerable
It also means empowering the most vulnerable communities who experience the cumulative negative impact on health equity by:
- Supporting primary care and the wider health economy to address the social health determinants.
- Addressing the inverse care law to allocate resources equitably.
- Collaborating with Voluntary Community and Social Enterprise sector and extend social prescribing to address the social determinants of health, food and fuel security.
Organisations and senior leadership at the national and local level guide the proactive preventative care planning, communications, and engagement, as well as partnering with staff, patients, and the public. They must adapt their engagement approaches to avoid excluding communities by actively engaging with those seldom heard and who are frequently, the most starkly impacted by an inequitable health and care system.
Practical support to optimise patient care
Optimising patient care on the ground involves a workforce that are fully equipped and supported to implement interventions. This ranges from practical support with identifying patients at risk of deterioration through existing GP system search tools, prioritising health equity and highlighting patients with undiagnosed conditions to optimise their care and assessing outcomes achieved. Evaluating the intervention is built in from the outset, working with academic evaluators to measure a range of outcomes and patient experiences, and looping this learning back, to strive for further improvement.
Flexibility to extend capacity, capabilities and collaborate
And finally, organisations require the flexibility to extend teams capacity and capabilities to meet these demands. It requires collaboration with the experts to deliver solutions tailored to specific challenge areas, identifying opportunities and challenges, and exploring views from system actors and the public as the ultimate beneficiaries.