Population Health Management
People’s health is changing, and care needs are evolving. Our lifestyles are crucial to our long-term health and the health inequality gap is getting bigger. We all need to be more proactive in responding to that change. Population health management (PHM) is key to making it happen sooner. It actively helps to reduce health inequalities and offers proactive, personalised, and preventative healthcare for every community.
PHM techniques will transform the way we work and the way we care for people. It’s for everyone working in integrated care, striving to improve health outcomes for all. A way of working built around three key pillars: Know, Connect, Prevent.
Know
Evidence and knowledge are fundamental to how we make the best decisions for individuals and communities. PHM takes this to the next level by bringing together a much broader range of data. Gathering insight from health and the wider aspects that impact a person’s health, including housing, finances, employment and education, will help us to build a holistic view of people’s needs and identify risk factors that are driving poor health outcomes in different population groups. This will help us to recognise where best to focus collective resources to accelerate prevention programmes and tackle health inequalities and deliver personalised care.
Connect
Working in partnership is key to all of us working in integrated care. By connecting across health, social care, public services and the voluntary sector we can ensure people receive the right service at the right time, from the right people. PHM allows us to connect more effectively to create a more personalised offering that responds to people’s wants and needs.
Prevent
PHM changes the focus from reactive care to proactive, personalised and preventative care – an approach that allows long-term health solutions to be developed. By understanding who is at risk today we can predict who might be affected in the future. Effective prevention models in hospitals and at home can help to improve the lives of people with complex social needs, who feel lonely or isolated living with conditions such as obesity, diabetes, heart disease and cancer.
By supporting people to live their healthiest lives, based on what matters to them, we ensure that every contact and every tailored intervention is effective. This leads to greater job satisfaction for us all and better health outcomes for everyone.
PHM is a critical component in our integrated care system and the foundation to building a healthier future together.
To find out more, take the Introduction to population health management module on e-learning for healthcare and watch the videos below (one of which features Dr Priya Kumar, Slough GP) by clicking on the image.
Population health management: proactive, targeted healthcare for your community.
Population health management – a Slough GPs view.
Population health management – a public health specialist’s view.
Population health management – a voluntary sector view.
On 7 July 2022 Frimley Health and Care ICS held a one-day conference to explore the advances being made across our population health insight tools and to raise their profile. You can learn more about this day and the outcomes by expanding the box below.
On 7 July 2022 Frimley Health and Care ICS held a one-day conference to explore the advances being made across our population health insight tools and to raise their profile across the system, highlighting the key learnings and where these tools have really made a difference.
The conference brought together a wide range of people working in all parts of the ICS who are working to improve the health of our population - including primary care, all our NHS Trusts, the ICS, Local Authorities, and the voluntary sector.
Designed to help colleagues understand what population health insight can offer and how to engage with and use it, the conference aimed to:
- Give colleagues the chance to see tools and ways of working which underpin improvement and transformation initiatives
- Explore ways of supporting integrated, proactive care for our population
- Understand the evidence around what makes residents and patients most likely to feel motivated to be part of managing their own health
Agenda
The day consisted of:
- A welcome and end of the day round up by Priya Singh, Chair, NHS Frimley Integrated Care Board
- Two Keynote Speakers; Gavin Jones, CEO, Slough Borough Council and Essex County Council and Nigel Foster, Executive Director of Finance and Estates, Frimley Health NHS Foundation Trust
- Two panel sessions; Inequalities hosted by Lalitha Iyer, Chief Medical Officer, NHS Frimley Integrated Care Board and Ageing Well hosted by Adrian Hayter, GP Partner Runnymede Practice and National Clinical director for Older People and Integrated Person-Centred Care
- Plus, six additional breakout workshops; Urgent Care, Cardiovascular Disease, Integration, Mental Health, Cancer, and Primary Care
"What a phenomenal day the conference was. Well done to the team for putting together something that was truly special. There was such a lot of positivity in the room and it was great to network with like minded colleagues."
You can access video highlights of the day via the Connect Care You tube channel
And Click here to find out more about Connected Care.
NHS Frimley has also created a Multigenerational Household Outreach Programme using population health management to help tackle health inequalities in Slough. You can find out more about the programme here.