6 March 2024

Creating long term health: Four key ingredients for a different approach


Jamie Tulley

Medical approaches to health commonly diverge around acute and chronic presentations. What I need after an unexpected accident, a short illness or a new concern is very different from when I am living with a condition long term.

In an acute illness, rapid, transactional models of care are effective – even welcome – lives are at stake, care is short term, and expertise largely sits with the trained professional.  

Translating this mode into chronic care is filled with risk. A chronic condition affects our whole lives, from morning to night, throughout the seasons. Any treatment approach cannot be simply prescribed from professional to patient, and compliance monitored. We need to flip the lens – any treatment regime needs to ‘comply’ with our lives – what is important to us and what can be sustainably incorporated into our unique set of circumstances.

The perfect treatment approach for one, can be radically flawed for another. Humans do not come in neatly packed boxes.

Photograph: Jenny Handy

This challenge of what makes the right health collaboration is what makes us tick at Here. We are inspired and driven by the right combination of skills that builds health – the collaboration between expertsbyexperience and health professionals, that has peak potential in working with long term conditions.  

Now more than ever before, this is where we focus our time.  So what sits at the heart of this approach?  

It breaks into 4 key pillars:

1: What Matters To You

This is at the heart. Conversations, not consultations. We start every contact with every patient focused on knowing what matters most – an honest and safe space to match their personal experience, hopes, aspirations and obstacles, with the knowledge and skills a professional might provide. It sounds simple, and it many ways it is. It takes a commitment to putting your needs as a clinician, an administrator, a busy health professional second place, making sure value to the patient is the offer on the table.

2: True collaboration

Every individual conversation is a collaboration. Shared decisions with people seeking care are made and ways forward devised. Then we learn, we change, the service and our partnerships evolve. The people who use our services become part of our infrastructure – with paid roles bringing deep expertise. 

This isn’t ‘representation’, we invest time and resource in people who have the skills we need – we co-design, improving the services we provide because we have access to a secret weapon – the inside track of what it is like to receive them. We do this, not just because it is the right thing to do, but because it is the smart thing – our services are better – for the people who use them, the people working in them, and the communities they serve. 

Photograph: Jenny Handy

3: Our data

We believed our approach would be better. Now, we know that it is with real time data, available to all, that tracks outcomes. It tells us what works, and what our populations need. It lets us manage our resources well, particularly in services under pressure. Our data enable us to create equity by design. All our services generate and report data on who uses them, and who doesn’t, driving us to take action to reach the people who may need us most, and who are least often served well. Smart data system drives real change in the world.

4: Our approach is sustainable

A temporary pilot, that leaves no lasting legacy of change waste opportunity, effort and resource. We know our world is changing, and that’s why we have a continuous approach to innovation and improvement. We have to take the best of the innovations and bake them in to our service design. Complex repetitive tasks are prone to human error, we use the best technology to free precious time for clinicians and care staff to invest in human and unhurried connections.

We are committed to connecting to people all over the world who are innovators in health. We learn wherever we can, and where evidence is not available, we set out to experiment and find solutions ourselves.

We share what we find, taking pride when others adopt approaches we have road–tested. Working with partners, we can step in, and out of delivery. We work alongside anchor institutions and community groups who may be taking this work forward long after our role is complete.

If it sounds right, intuitive, that might be because it speaks to what you would want to build a healthy life. Driving these principles through what we do every day, is what keeps us here, working in health, every day.

It inspires us to better things, and it’s the beating heart of exceptional care, for everyone.

Also of interest

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