It might seem strange to some people that we have to remind people working in health and social care to focus on what really matters to the people they are supporting or caring for. If they aren’t focused on the things that really matter to the person they are speaking to, you might ask, what are they focused on? That’s a good question.
Health and social care services have developed in the modern era from a time, less than a hundred years ago, when there was little or no state support for anyone. In those times the only support, care or treatment that was provided was based either on your ability to pay or the good-hearted generosity of charitable organisations and individuals. Over the last 100 years or so, state-funded health and social care services have gradually developed into what we see around us in Scotland today.
These services have their origins in a time when “doctor knew best” and things were done “to you” without too much recourse to your personal preferences or inherent strengths or capabilities. This paternalistic “we know best” culture has survived down to the present day and means that often decisions are still made on the basis of what someone else thinks is best for you, without very much knowledge about you as a person and what makes you tick. Of course the health and social care system today is focused on people, but is it truly focused on what matters to those people? I would argue that the perspective is still predominantly one which is all about doing things “to” people or “for” people. This way of thinking can only get us so far. The signs around us indicate that we need to do something different for the 21st century.
So, when we talk about “what matters to you?” or person-centred care, we aren’t just talking about being nice to people, important though that is. Neither are we are implying that the current activity of the health and social care system isn’t focused on people; it very much is. But the current perspective is still too much in the “we know what’s best for you” mode of thinking. Not enough attention is paid to the personal preferences and values of the people we serve, the inherent strengths and capabilities that every person has, and the relationships (or lack of) that surround them in their life. This is what we mean when we talk about “what matters to you?” and person-centred care.
The impact of this shift in perspective has the potential to be very significant in helping us to develop health and social care (and other areas of public service) in new and creative directions, but the scale of the task should not be underestimated. This different way of interacting with people and understanding what truly matters to them in the context of their life, requires new skills, new and creative ways to measure, a much stronger focus on people and relationships and new ways of working. This is a generational shift and it will perhaps feel challenging and uncomfortable at times, but these feelings of difficulty and discomfort are a good sign and indicate that we are moving out of our comfort zone into new ways of doing things. We need to lean in to the discomfort!
The Scottish Government has a dedicated Person-centred and Quality team. This team supports “What matters to you?” day along with a range of other work that is underway with health and social care services, the charitable sector and other partners across Scotland. Our aim is to support and develop new ways of thinking about and delivering truly person-centred care and support for those who need it.
We hope that you will be excited by the opportunity to think and work in a way which feels much more meaningful and is strongly focused on people and relationships and the things that really matter. “What matters to you?” day 2017 will be a wonderful opportunity to join in with thousands of people around the world who, together, are working and learning how to create a health and system that starts with a “what matters to you? conversation for every person, every time.
~ Shaun Maher, Strategic Advisor for Person Centred Care and Improvement