The main purpose of this assignment is to describe the six components of the personalised

care operating model which are shared decision-making, personalised care and support
planning, enabled choice, including the legal right to choose, personal health budget,
supported self-management and social prescribing. For this assignment, it considers a part
of an episode of care involving a patient with dementia. According to the information
provided by NHS long-term plan is to improve the care and well-being of the person. In
addition, it is important to work together between the nurse and the patient to be able to
evaluate the patient’s needs and plan effective care. This assignment, however, explains
how nurses can use communication and interpersonal skills with the patient to achieve
effective care and support. In addition, it examines the definition of interprofessional
teamwork and the importance of effective teamwork using their knowledge to deliver
appropriate care to patients. Finally, it considers the advantages and barriers to
interprofessional teamwork related to health care.

The episode of care occurred at Manchester Royal Infirmary, in my first placement where I
was assigned to the Manchester Cardiovascular Centre unit. This ward works with people
who have aneurysms, artery disease, severe limb ischemia, carotid arteries and diabetic foot
ulcers. Mary is an elderly person who has been diagnosed with dementia and diabetes. Mary
was waiting for her operation because she had necrosis in her finger. Mary was admitted to
the hospital for the four weeks that I was doing my placement. In the first few weeks, Mary
developed a good relationship with the nurse and me. The nurse gave her medications and
Mary took them without any problem. The only problem was that Mary had dementia and
she wanted to get out of bed, which was a risk of falling. Therefore, the health care assistant
had to constantly monitor her. The last week after completing my placement, Mary's
dementia worsened and she began to engage in aggressive behaviour with the nurse and
me. Mary has fluid retention in her legs and she refused to let the health care assistant
change her dressings. Mary said she was fine and didn't want it to be changed. The nurse
and the student nurse explained to Mary why it was important to treat her legs but the patient
became more agitated and aggressive. In this case, I believe that communication plays a big
role in people with dementia. The nurse and I as student nurses say to stay calm, and
address Mary respectfully and in a friendly tone. The solution is not to yell at Mary because,
at the end of the day, she is a person with dementia. We gave Mary some time to calm
down. When we returned, Mary was calmer and let us change her dressings. The nurse
informed the doctor of the changes Mary was having and changed her medications.
The NHS Long Term Plan (2019) was undertaken by the National Health Service with the
collaboration of healthcare professionals, patients and their families. This plan was designed
for different ages until the end of life, to improve the patient's daily life who suffers from
physical and mental health conditions. Furthermore, this plan is based on improving
hospitals, medical centres and community care, such as ensuring that all medical centres
have the necessary equipment and ensuring that the life of a newborn and its mother receive
all the care before and after childbirth.

To implement this plan, it is essential to apply the success of the six components of
personalised care together so that personalised care can be achieved. Concisely, patients
can understand that everyone has a voice, a vote and, above all, control over how their
treatment is designed and delivered. The purpose of introducing personal care is for people
to have choices and control over their care so that it is planned and delivered effectively,
aiming for patients to live longer and have well-being. National Health Service has worked
with various health fields, such as clinics, professionals and people with lived experience
(Universal Personalised Care, 2019). Once personalised care is in place, people will have a
better experience of health and care. For instance, patients can have access to their
information and can meet their needs. Patients can be valued and involved in decisions
about their health and well-being (Universal Personalised Care, 2019).

However, the descriptions of the following six comprehensive models for personalised care,
the first being shared decision making (SDM) consists of communication between a patient
and their health care professionals to work together on the patient's decisions related to their
health and treatments (Shared Decision Making,2013). Communication is the way of
interacting between two or more people through verbal or non-verbal means, whether
through gestures, writing or behaviours (ThoughtCo, 2019). The patients must give the
health professional information about their experience of illnesses. Once the information has
been collected, the professional can make treatment options that are appropriate to the
patients. To increase patient choice, so that the patient can function alone in the needs of
daily life, without depending on others. Adding, not to make decisions without the patient
being present and in agreement. (Shared Decision Making, 2013). In this episode of care,
Mary necesitaba ayuda para tomar decisions, entre la enfermera y mary trabajaron en
equipo para buscar una solucion. La enfermera invite Mary in makind decision relating to
appropriate treatment.

Shared decision-making is vital so that the patient and the professional can distinguish their
different types of views or that the two people on both sides agree with the chosen treatment
(Shared Decision Making, 2013).
According to Tigger Connect (2023), interprofessional collaboration in health care can be
composed of several health professionals. Different health professionals, such as doctors,
nurses, pharmacists, therapists and many more professionals can develop specific
knowledge, and collaborate with their skills to agree on the type of care that the patient must
receive. Therefore, an effective interprofessional team can guarantee more integrated and
coordinated care for the patient (Tigger Connect, 2023). According to Clinic Clonex (2022),
collaborative health is more than data communication. Health professionals may have to
work highly and together to improve patient care. Collaborative teams, such as from
preventive and primary care to rehabilitative and palliative care. Improving care and
providing for the needs of patients must be a goal for health professionals, at the same time
respecting the functions and experiences of each health collaborator (Clinic Clonex, 2022).
This can be achieved when different health professionals collaborate to share different
treatment options and evaluate the care plan process. A collaborative approach can improve
the treatment journey, such as medical errors can be avoided (Henson, 2022). One of the
most important benefits that the interprofessional team has developed is to improve
relationships with other disciplines. However, these team members with an effective
relationship can improve patient outcomes by preventing hospital visits and reducing
morbidity and mortality rates (Marion Leary, 2023). Evidence suggests that barriers to
interprofessional working partnerships still exist. The communication barrier can occur in
several ways but one of the most common ones found in the health field is each professional
group has been developed independently from each other and therefore will have its sense
of identity, purpose and priorities. Among health professionals, there may be professional
hierarchies related to patient care treatments. Some health professionals may feel with more
authority, power and experience causing confrontations in the team. Including unfair
treatment can make collaboration between team members difficult. Although there may be
times when health professionals do not agree on the course of action related to the patient.
However, to avoid disagreements, it is important that team members have clear
communication and always keep the patient's well-being in the first place (Audrey, 2023).
Interprofessional teams develop different experiences, however, barriers to successful
interprofessional teams can include a lack of role clarity and trust (Experience Care, 2022).

"I was struck again by how intimate the work of nursing really is."
"Nurses have a really unique relationship with us because of the time spent at bedside.
During that time, a kind of emotional intimacy develops."

Communication between the nurse and the patient is vital to improve the patient's health. To
demonstrate, the nurse must ensure that the message that is being transmitted is clear so
that the patient can understand it (IntechOpen, 2018). Therefore, nurses can use verbal
communication to speak with clarity, accuracy and honesty. To achieve effective
communication, nurses must speak appropriately, avoid using jargon techniques and always
encourage patients to feel free to express themselves. To create a good understanding or
have friendly harmonious relationships in non-verbal communication, health professionals
can use various techniques. For instance, facial expression, eye contact, body language,
gestures, posture and tone of voice. Although, active listening is a very important skill for
building trust and commitment with patients. One of the important elements to form effective
listening is attention and engagement. In the field of health written communication, such as
medical records are, vital information so that patients can receive effective care by protecting
patients confidently (Nursing MSN & DNP,2020).

Nurses must consider the environment and give space when communicating with the
patient. Nurses must consider the necessary time to be patient and consider that some
patients have learning disabilities. Therefore, for the patient can feel comfortable and valued,
it is considered to inform them about the procedure before the nurse does anything (High
Speed Training, 2021).

Working in partnership between the nurse and the patient is vital to create an emotional
bond and create a good relationship between them. The interaction between the nurse and
the patient is important to satisfy the patient's desires, such as, nurses must use
professional values to provide good care and achieve successful medical treatment results,
with the purpose that the patient can have good self-esteem, a rapid health improvement
and reduce the number of visits to the hospital. Additionally, nurses can have high job
satisfaction (National Library of Medicine, 2016).

The Kings Fund (2020) mentions the benefits of improving quality of life and well-being and
using social prescribing, this is a method that allows health professionals to give patients a
type of non-clinical activities, such as community groups, to meet practical, social and
emotional needs and help people take control of their lives. Social prescribing includes a
person with long-term conditions, people who need support for mental health, those
individuals with social issues that may affect their health such as being lonely or isolated. In
England, people use different models of social prescribing such as a union work that offers
help, so that people can access sources of information or places of support (The Kings
Fund,2020). Social prescribing is based on activities collaborated by various community-
based- organisations and voluntary groups to help patients with practical, physical or social
needs. Some social activities are gardening, cooking, group learning, art activities and sports
or leisure clubs that promote physical activities and social interaction with more people. The
King's Fund (2020) shows evidence that improves stress and anxiety levels, with a range of
positive impacts and well-being outcomes when implementing social activities.

According to The Grange Practice (no date) The health of patients may not only be treated
by medications or doctors. People’s health can be impacted by some structural issues, such
as stress, loneliness, money problems or poor housing, which means that people need other
types of help. According to the Grange practice shown that people can be helped by
connecting them to a community that may have a range of benefits, for instance, help as
employment opportunities or money management which can improve their living conditions,
economic opportunities and confidence. Therefore, social prescribing has a great impact on
people's lives, these services can help patients overcome it and prevent further medical
problems. However, it also offers emotional and practical support to family members (The
Grange Practice, no date). Social prescribing can help people's health and well-being to feel
more positive, sleep better, improve physical health and make the patient feel more
confident in their daily life (Royal College of Psychiatry, 2021). The review describes the
benefits of social prescribing to the patients. The outcomes were, the benefits include an
increase in self-esteem, confidence, sense of control and empowerment. Although also an
enhancement of mental well-being and improvements in psychological. Additionally, 66% of
patients who participate in social prescribing reduce the number of visits to the GP. Social
prescribing can help less lonely and increase belonging (Tilly CTEL, 2016).

The role of voluntary, community and social enterprise is to support people in different ways
through care and supporting planning. Voluntary, community and social enterprise
organisations formally compose a plan with the information and condition of the patient.
Additionally, organisations can contact clinics to gather more information from the patient.
The patient needs to recognise someone within the community to help them in their support
planning (National Voices, 2016). Voluntary, community and social enterprise ensures that
people are involved in discussions and are aware of their rights. This is a way for patients to
participate in their social, emotional and well-being interests. The role of Voluntary,
community and social enterprise organisations is to help people keep their plan process in
place. However, the techniques that have been used by other patients are communication
tools, apps or paper-based records. Another role in Voluntary, community and social
enterprise organisations is to ensure the person's wishes and points of view (National
Voices, 2016).

The main purpose of personalised care and support planning is part of the role of the
programme in which health care professionals, families, carers and the patient are involved,
such as disabled people or people who suffer from chronic illnesses. In such a way, patients
have knowledge and skills about their illness so that this does not impact their daily lives and
patients can establish their needs (NHS, 2016,11). According to the British Geriatrics Society
(BGS) (2019), Personalised care and support planning are defined for people who no longer
need only medicines. However, support planning must be considered, such as clinical
treatments, to help people meet their physical, emotional, and psychological needs. To
achieve personal care and support planning, the health professional and the patient must
have a conversation to discuss the treatment and support options for the patient. Including
the points of view of both and both can work together for the well-being of the patient
(BGS,2019).

Health and Social Care Rights (2023) informs that patients have the legal right to receive all
information about their medical history and to be fully informed about their illnesses.
Evidence from the Department of Health and Social Care (2024) stated that the Government
of England is committed to giving patients the rights they have under the law to have their
own choices and control over how they can receive their healthcare. However, in other
circumstances, some people do not have the right to choose but are offered options about
their care. Therefore, patients must be able to obtain their medical information so that they
feel valued and can participate in decisions regarding their health care. People who are in
the process of choosing which GP practice want to register and make appointments for the
doctor, nurse or health professional practices as many times as necessary. Additionally,
patients have the right to ask for a change of doctor when patients do not feel comfortable
with the doctor assigned to them (Department of Health and Social Care, 2024). In this
episode of care, Mary had the right to refuse to change their dressings and the decision
must be respected. Mary had to give us consent before receiving any type of medical
intervention.
Supported self-management is a set of tasks that helps patients develop knowledge of their
conditions and treatments. This self-management is based on reducing health risks with the
collaboration of medical professionals, families and the patient and support groups. The
patient must be able to administer their medications themselves and recognize the effects of
their medical condition, whether physical, emotional or social. In Scotland, there is a method
called “Gaun Yourself” which is a motivational phrase for people with long-term conditions
(Supporting people to self-manage, 2020,5). The purpose of supported self-management is
to support and establish that people with long-term conditions have knowledge, skills and
know how to manage their physical, emotional and social needs. Some modifications to the
system are important, such as planning a plan to fit the needs of patients. However, it is also
important that health professionals and people with long-term conditions work together as a
team. To have effective self-management support (The Health Foundation, 2015).

The latest model called Personal Health Budget and Integrated Personal Budget is based on
contributing by giving an economic budget to people identified with long-term health
conditions and disabled people. This NHS funding can be used for medical equipment,
therapy classes or personal care. Integrated Personal Budget is a way for people to benefit
from funds from local authorities and the NHS for health and social care needs (NHS,
2021,8). Personal Health Budget is the patient's care plan, which involves the NHS team
helping them decide on the money the patient can spend specifically for their essential
health needs, such as therapies, personal care and equipment. However, patients with long-
term conditions are not allowed to use the money for personal expenses. There are three
ways of personal health budget can work, such as A notional budget refers to the fact that it
is not acceptable to hand cash. A real budget held by a third party is a different way in which
the organisation maintains the money and helps to decide what the person needs. The last
option is direct payment for healthcare, which is the people receiving the money to buy the
required related to their health and support. However, the person receiving the personal
health budget, family members or whoever obtained the money must show evidence that the
items have been spent (Department of Health, 2012).
CONCLUSIÓN:

The six comprehensive models of personalised care are designed for all ages to support
people to have the right to decide in their care, for people to learn to live with their health
conditions and to have a better quality of life. On the other hand, communication between
the nurse and the patient is very important for greater patient satisfaction and good health.

Social prescribing is one of the most important supports by the collaboration of organizations
and communities. To help patients to provide better health outcomes, effective experiences
and good satisfaction. Interprofessional collaborations are vital for delivering thorough
patient care. When collaboration between health professionals is successful, patients have
better outcomes and a better guarantee of receiving the best care.

Feedback

1. Knowledge & understanding (K&U):

It is clear that you have read the assignment brief and understood what was required. It is a very
strong start.
2. Writing:
You have an adequate writing style. Some of the paragraphs were quite lengthy and difficult to
follow, please consider breaking up the paragraphs and keep your writing concise and academic.

You may find this useful to further develop your academic writing
https://www.salford.ac.uk/library/skills-for-learning/academic-skills/academic-writing

3. Structure:
The structure was good and each section was easy to identify.

4. Use of evidence:
There was a very limited use of evidence within this section of work and some of the statements
were vague and unsupported by evidence.

You may find this link useful to develop information searching skills and your ability to provide
evidence to inform and support what you write https://www.salford.ac.uk/library/skills-for-
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5. Referencing in text & on end list:

Please refer to the UOS referencing guidelines to use the correct in text citation format..
Please access this link to ensure that you meet the UoS guidelines
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6. Areas for development for your summative assignment:

- What you did well?
Your work was informative and it was clear you understood the assignment brief
- Areas for improvement?
Please be careful not to use conversational text and keep your work academic. Also be aware
that spellcheck will use American spellings, so please proof read
- What needs to be changed or considered for final assessment?
More evidence is needed to support your statements and to ensure the work flows.