The Aligned Care Programme recognises the need to take an aligned and holistic, whole person approach to patient care, particularly for those patients with multiple long-term conditions.
Rather than treat each long-term condition individually, this programme recognises the cross implications of multiple-morbidities and emphasises the need to align the management and treatment to the person, rather than simply treat the disease.
This aligned, personalised care approach means that people have choice and control over the way their care is planned and delivered. It is based on ‘what matters’ to them and their individual strengths and needs.
The need to take a holistic, proactive, preventative and patient-centred approach to the management of care for people with long-term conditions has been recognised for some time within the NHS. For example, the House of Care Model (Click for further details) uses the metaphor of a house to describe the components that need to be in place to make co-ordinated personalised care planning a reality. The care planning conversation with clinicians and patients working together is at the centre of the House, supported by the right wall of effective teams of healthcare professionals skilled in partnership working with patients, the left wall (engaged, empowered, and well-supported patients), the roof (appropriate and robust organisational systems and processes), and the foundation (responsive commissioning and support from statutory and voluntary organisations, community groups, and peers).
There can be little doubt that adopting such a model to draw together the integrated blocks of integrated care and provide the three types of continuity (see the continuity of care multidisciplinary review published in the BMJ in 2003). (Click here for more details)
Informational continuity—The use of information on past events and personal circumstances to make current care appropriate for each individual
Management continuity—A consistent and coherent approach to the management of a health condition that is responsive to a patient’s changing needs
Relational continuity—An ongoing therapeutic relationship between a patient and one or more providers
In our opinion, the gap is not in the recognition of the need to provide this aligned, holistic and whole person approach, it is in the means to provide health professionals with the skills and knowledge to be able to take this into their consulting practice. This bridging of this gap is the basis behind the development of the Aligned Care Programme.
The Aligned Care Programme gives Health Care Professionals the skills to help improve the clinical outcomes and quality of life for patients with long term conditions by empowering patients and their carers.