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Treated as a person, rather than a diagnosis: the importance of personalised care and strategic co-production.

Richard Falvey

To mark World Bipolar Day, I reflect on how my lived experience of a bipolar diagnosis has shaped my work as an NHS Peer Leader, a National Voices Lived Experience Partner, and a My Life Choices member, and I emphasise the importance of personalised care and strategic co-production.

  • Lived experience
  • Person-centred care

The importance of a personalised care approach

Some time ago I was able to access a psychotherapist. Being treated as a person, rather than a diagnosis, marked the starting point for the reversal of a downward spiral. Instead of trying to fix my ‘internal error’ with a cocktail of drugs, she listened and most importantly, empathised. She fully explored my circumstances, picking up on relevant events from the past and present while also looking into the future. She acknowledged there were difficult changes in my life and validated my assessment of them.

Moving from being a problem to be fixed to a problem solver…

Then she asked me ‘What have you done before that helped? What approaches and assets can you deploy?’ She encouraged my return to Mindfulness (which is now NICE recommended), encouraged me to focus on what was in my control, and develop supportive relationships – setting boundaries where necessary. She spent time finding out about me, acted like a critical friend, reminding me of how I’d got out of holes like these before, and gave me a helping hand.

Now I’m the expert in the management of my care; medical professionals support me

This upward journey continued when I moved back to Nottingham where I was lucky enough to have supportive GP’s and a recently created Health & Wellbeing team. Recognising me as an expert by experience (almost 40 years in the job!), I was put in the driving seat of my personalised care plan and the Health and Wellbeing team provided a range of support and services, including resilience and sleep workshops, relaxation and Chi Gong groups, mindful nature walks and doing a WRAP. It’s also worth noting that seeing a psychiatrist was always an option available on demand.  

Recently, I worked with My Life Choices, to produce a video on the benefits of personalised care. My Life Choices is a group of people with long-term conditions and unpaid carers who access Health and Care Services in Nottingham City and Nottinghamshire. Supported by Keymn Whervin, who provides a working link to the NHS and care system, we work in equal partnership with senior leaders to help shape and design what services should look like for the local community.

Listening to and involving people with lived experience around decision making, and the value of their experience

I’ve been lucky enough to regain control of my care. I believe it’s important that everyone’s care is driven and shaped by what’s important to them. It is important that people with lived experience are given the platform and seat at the table to be able to step up, participate and make their voices heard. Health and care professionals must then really listen and allow themselves to be lead in order to make meaningful change.

This is a massive culture change for everyone, and one that has been ‘the coming thing’ for a long time – but never quite arrives. In co-production, change usually starts from the bottom up, and I’ve been supporting such a project in Broxtowe, redesigning Dementia services.

I’m also proud to be part of a novel, top-down co-production approach. The Voices for Improvement programme puts Lived Experience partners together with System Leaders. Lived Experience partners coach and mentor system leaders while embodying personalised care and co-production mindsets and approaches. Piloted with leaders involved in the Core20PLUS5 programme, it feels somehow more than reverse mentoring and it has got off to a great start. You can hear from another of National Voices’ Lived Experience Partners below. This gives us hope that, together, system leaders and Lived Experience Partners can accelerate acceptance of co-production, complementing bottom-up approaches.

I’m astounded by the respect, the commitment, and the honesty that the people I coached came with. I went away learning so much more than what I think they did. As leaders I didn’t realise how much you’re up against and how that weighs on you as a person. You just humanised this process for me, this programme is humanising leaders.

Helen Hassell, Lived Experience Partner

Biography

Richard Falvey is a community representative with lived experience as a carer and mental health service user. He is a member of My Life Choices and a National Voices Lived Experience Partner.