Designing services to support holistic healthcare

Neighbourhood working follows a biopsychosocial model. Biopsychosocial refers to a holistic model in healthcare that recognises health and illness as products of the interaction between biological, psychological, and social factors. It contrasts with the traditional biomedical model by encouraging healthcare professionals to treat patients as whole people, considering their life experiences, social context, and mental wellbeing alongside physical symptoms when treating health conditions. This holistic approach has proven valuable in improving healthcare outcomes, patient satisfaction, and quality of life.

The role of design

This has profound implications for how services are designed. The partnerships that come together for neighbourhood working will need to use co-design and research techniques to design digital experiences which take account of the biopsychosocial model. User experience design of patient facing digital services can be the best way to accommodate users’ emotional and practical needs alongside their clinical needs.

Read more about user centred design:
(Whilst NHS Digital now merged into NHS England, these two resources provide useful guidance on using user centred design)

• NHS Digital Service Manual
• How NHS Digital is developing user centred design maturity 
• Understanding user needs, NHS Providers 

Better decisions through shared data at the point of care

The biopsychosocial model of care requires Integrated Neighbourhood Teams (INTs) to work together from diverse organisations. These teams can be made up of team members from GP practices, community services, mental health, acute care, social care, third-sector, housing providers, employment support and faith groups. This requires excellent care co-ordination where everyone in the team can see what others have done with a patient, planned care and their care plans. It also allows care gaps to be identified for instance:

 

• If a patient has an appointment, they can see the appointment and work together to support the patient to get to the appointment.  

• If a patient has a care plan, everyone in the team can see it, so they can all work with the patient to help them achieve their goals

• If a patient has an unplanned admission into hospital then the care team is automatically notified.

 

Effective neighbourhood care will be reliant on timely and consistent data that can be used to make informed decisions and enable real-time collaboration.

 

In order to support this, boards:

 

• Should ensure data sharing is treated as a strategic enabler to the delivery of care through the use of data sharing agreements.

• Build trust and shared accountability with system partners recognising that there will be varying risk appetites.

• Ensure data governance promotes data sharing safely in order to break down silos

 

Interoperability and the ability to share information across systems will be fundamental to neighbourhood working. Shared care records (SCRs) are a vital part of the digital infrastructure, enabling a consistent patient record accessible across all organisations. They can also provide real-time care coordination to help manage unplanned admissions. In order for SCRs and other data sharing systems to be successful, the design of new workflows must be led by clinicians and care professionals to ensure they capture all the data required.

Core infrastructure like devices and connectivity need to be in place. Boards need to ensure frontline staff have the right resources, including mobile devices that work offline and across organisational boundaries.