12 January 2016

Collaboration, Control and Choice in a Person Centred Scotland


Alex Stobart works for Mydex Community Interest Company, a social enterprise registered in Scotland. Mydex provides citizens with personal data stores and services - essential components of control and choice in a person-centred ecosystem.

2016 offers opportunities for citizens and communities to design system conditions and points of leverage with a person-centred Scotland.

As Scotland considers at the start of 2016 whether to empower citizens, communities and the third sector to work with the public sector, we can pause to consider progress. Collaboration and more person centred, humanised systems and services can help Scotland, and individuals could be supported to act and tackle inequalities. The fulcrum of powers, system conditions and levers still seems out of balance today, and citizens can help to realign it. For example, the hopes for health and care integration will only work if the person is at the centre. Scotland needs powers to transfer from the producers to the citizens, for behaviours to change, and consent, permission and active participation by individuals for the data to flow.

The organisation-centric design that prevails in Scotland today means individuals cannot easily engage with, and fully trust the system; health, care and wellbeing systems and outcomes will deteriorate if citizens, local intermediaries and community anchor organisations are not allowed in to design and then play an active role.

To change a system, individuals and communities need more control and more choice so that they feel empowered to self manage, self direct their support, personalise their services and prevent co-morbidities. Working together with innovation small and medium-sized enterprises (SMEs), patient groups and citizens would speed up the NHS and local authority innovation system.

In many other areas of the economy, citizens and business leaders have recognised that digital is an enabler, and have worked with its potential for economic growth. As the data and Application Programme Interface (API) economy grows, people wish to be equal participants in services that are democratic and engaging and where two-way communication thrives, not to be subjects of the system and feeling dis-empowered.

People in Scotland would rather take part in their care and wellbeing with the NHS and care providers as equals. Human beings prefer two-way, digital, secure, empowering processes, and not to be (b)locked in a one-way culture. Community Health could deliver innovation - it is local and trusted, encourages standards, interoperability and systems thinking.

When the person is at the centre, then the person (and family; carer; support worker) can work with the NHS and other service providers. The person has control and choice - they have the steering wheel for their health, care and wellbeing. They are an equal participant with control and choice, not the passive dependent of the system.

The Christie Commission also recognised that the citizens of Scotland like identity and agency, to use their assets, their democratic participation tools, and have the resources and means to live in a person centred system. We should all work more with people, government, Third Sector, businesses and data to solve these health, care, wellbeing and other challenges together through collaboration. Proofs of concept and test experiment sites are enabling this to happen.

Person-centred responses and behaviours are also vitally important in mental health where many people would choose to have more control, more privacy and more choice in order to manage a condition that often requires multiple, person centric responses including privacy and anonymity while people work through the conditions, the responses and the recovery from illness.

Scotland in 2016 needs local people who make a difference in communities to work together, and with existing community anchor organisations to build a person centred system that uses new levers to empower individuals.

Together we can design and integrate person-centred services that deliver services based on control and choice, and build equalities with citizens in Scotland through the right levers and system design.

Views expressed by guest bloggers may not reflect the views of What Works Scotland

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