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Personal Outcomes in Health and Social Care
The new Scottish Health and Social Care standards have been finalised and agreed this year. From next year, after further advice and information giving, they will be rolled out and taken into account in the registration and inspection of all regulated care services in the country. They will also be applicable in nonregulated services, so that any service which provides some element of care will be able to see what public expectations they need to meet.
What the standards are
They are a set of specifications as to what a person receiving health or social care can expect of the service, and are based on the person's human rights, their desired outcomes of the care, and their experiences of how the care is provided.
The standards comprise five headline outcomes, each with descriptive statements of what each person can expect. The headline outcomes are as follows:
- I experience high-quality care and support that is right for me.
- I am fully involved in all decisions about my care and support.
- I have confidence in the people who support and care for me.
- I have confidence in the organisation providing my care and support.
- I experience a high-quality environment if the organisation provides the premises.
The descriptive statements are laid out under five principles, of Dignity and respect; Compassion; Being included; Responsive care and support; and Wellbeing. For example, the headline outcome 2, on Involvement, has these among its descriptive statements:
Dignity and respect
2.1 I can control my own care and support if this is what I want.
2.2 I am empowered and enabled to be as independent and as in control of my life as I want and can be...'
(...etc., with five other descriptive statements.)
Also on Involvement, the principle of Wellbeing includes the following descriptive statements:
2.21 I take part in daily routines, such as setting up activities and mealtimes, if this is what I want.
2.22 I can maintain and develop my interests, activities and what matters to me in the way that I like...’
(...etc., with five other statements.)
Outcomes in personal care
To summarise, the new standards are structured by people's expected personal outcomes and experiences of care based on rights-based principles. The full standards can be seen here https://beta.gov.scot/publications/health-social-care-standards-support-life/pages/1/
I think it makes sense in the run up to the implementation of the standards that services look closely at how they monitor and ensure the achievement of personal outcomes and experiences. Also important is ensuring that all relevant rights are respected in their work. Fundamental to this are I think personal outcomes.
Health Improvement Scotland has an overall monitoring and improvement role in health and care services, and carried out consultation and an awareness-raising program of work with agencies across Scotland on the topic of personal outcomes. It is called 'Meaningful and Measurable', and is worth revisiting, available here http://ihub.scot/media/1138/20160908-po-learning-summary-1-0.pdf
Significant results from the project which stood out for me were:
- The importance of direct communication with people to ensure accuracy of information about desired outcomes and experiences;
- The importance of outcomes in the recording of work done to achieve these;
- Potential tensions between organisational performance targets v personal, qualitative outcomes.
- Complementing professional assessment roles with personal enabling as the service is provided.
The new standards provide an exciting opportunity for health and social care to move to higher degrees of personalisation and effectiveness. The minister, introducing the new standards, pointed out that we will all need personal care at some point in our lives.
We hope these standards can achieve the goal of enabling quality improvement in times of ever higher demand on services, while promoting increasing satisfaction and appropriate outcomes for all of us.
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