Year of Care has worked on large multisite implementation projects using our tried and tested systematic approach to introducing and embedding personalised care and support planning (PCSP) as ‘normal care’.

We have identified that there are consistently a number of critical success factors at whole system, steering group and practice level that need to be in place to ensure maximum impact from the introduction of PCSP. These include:

Whole system level (strategic)

  • Coherence about the purpose of PCSP and how it differs from existing ways of working  

  • PCSP clearly articulated and embedded into local strategy 

  • PCSP envisaged as the new normal way of doing things and not just another pilot

  • A vision of the approach ‘across a lifetime’

  • Forward looking around workforce planning and ongoing plans for training and support

Steering group level (local organisational support)

  • Coherence about the purpose of PCSP and how it differs from existing ways of working  

  • In-depth understanding of the setting in which PCSP is to be delivered

  • GP Champions and exemplars identified and used as expert resource

  • Operational management understands what needs to be done and is able to challenge issues of fidelity associated with adopting the approach

  • Practical support with real issues such as IT and training 

  • Direct working of team members into practices to support a facilitation approach

  • Plans and support on a long-term basis and appreciation that PCSP requires ongoing maintenance and support

Practice level (delivery)

  • Coherence about the purpose of PCSP and how it differs from existing ways of working  

  • Committed to the ethos and not just a change in the process

  • Seen as the 'new normal' way to do things

  • Everyone in the team understands their role and contribution

  • A mini steering group in practice – problem solve and support each other

  • Staff are trained and supported to take on new roles and new ways of working

  • Reflection and review of how it’s going built into day to day practice

The Year of Care comprehensive support and training programme enables systems to get up and running more efficiently and to ensure the above critical success factors are in place.

The Year of Care final report has further details of the key learning including some of the discoveries, dilemmas, debates and key challenges, and how these were overcome. 

This learning, together with our experience from 15 years of practical support and delivery in primary care have informed the above critical success factors.