The House of Care model represents a tangible and proven approach that allows healthcare to embrace Care and Support Planning and fulfil its responsibilities to support the self management of people living with multiple long term conditions.
This approach supports and enables people to articulate their own needs and to decide on their own priorities, through a process of joint decision making, goal setting and action planning.
This model is an important tool in thinking about healthcare systems and ensuring that these systems are responsive to the needs of people with long term conditions. It consists of
- The right hand wall: Health and care professional team committed to shared decision making, partnership working and a ‘what matters to you?’ conversation
- The left hand wall: Engaged, informed, empowered individuals and carers ready to engage in a ‘what matters to you?’ conversation
- The foundation: ‘More than Medicine’ Informal and formal sources of support and care sustained by the responsive allocation of resources
- The roof: Organisational processes, policies, systems and arrangements
All these are built around Care and Support Planning conversation, which is at the heart of the house. This conversation enables a person with long term conditions to engage with their healthcare professional in a person centred manner, and to make use of resources in the community – ‘more than medicine’. All this supported by a policy landscape and organisational systems that enable Care and Support Planning conversations to take place – the house needs all the components to stand strong.
The model has a strong evidence base developed by Year of Care Partnership behind it and is an adaptation of Ed Wagner’s model of Chronic Care. For more information, please see the King’s Fund report on the House of Care and a video of Ed Wagner explaining the Chronic care model.
Local evaluation and experience suggests it improves public and practitioner satisfaction, develops meaningful person-centred quality improvements, and
enhances system transformation. It also seeks to address health care inequities and support public health aims.
It does this by preparing people through information gathering and sharing prior to a collaborative conversation involving goal setting and action planning. This promotes empathy, enablement and an active role for people and their carers.
Important information is gathered about individual support needs. This information can be aggregated at regional, locality and GP Cluster level to inform the provision of self management support (‘More than Medicine’) in local communities and help realise enhanced public health.
The final Evaluation Report of the three year BHF House of Care Programme will be published autumn 2018.