System Transformation Through Co-Design: Beyond Person-Centred Planning

Person-centred planning, practices and terminology are well recognized across disability and community services. Most service providers have some reference to a person-centred approach on their website, so it would be assumed that they practice this client-led framework.  

An article by Hazel Chapman in Nursing Times notes that, according to Rollin (2011), person-centred care is gathering knowledge about the individual as a whole person and involving them, and their circle of support as required, to assess their needs and preferred supports. Contrary and adversely, an outdated alternative is remaining task-focused (input focused), where physical tasks and staff management are prioritised above person-centred care. 

Further, Chapman writes that Rogers (1951) believed without growing within trusting, genuine and open relationships, insecurity blossoms, we become unhappy, which often leads to illness; physical, mental, emotional. With an ideal person-centred framework, understanding the person’s world from their perspective through empathy and inclusion, allows them to gain confidence and self-esteem which adds value to their lives. 

As we have exercised this approach for a few decades, we have become familiar with person-centred practices. For many years through government block funding, service providers have done their best to incorporate a person-centred approach which has not always been easy. Although allowing provision of much needed services, these were very generalised and universal, lacking the values-driven, tailored and more personalised approach. To reach new levels of person-centred services, it took Australia’s launch of individualised funding for people with disability, followed by the inception of the National Disability Insurance Scheme (NDIS). 

Likewise, in New Zealand, we are currently seeing a new model for supporting people in the roll out of ‘Enhanced Individualised Funding’ (EIF). Previously, ‘Individualised Funding’ (IF) enabled people with disability to directly manage their disability supports. Like the NDIS, IF gives people with disability more choice in how they are supported. 

EIF allows further and greater choice, control and flexibility to people supported when using their disability supports budget. Expanding on traditional supports (Personal Care, Household Management or Respite Services currently available under IF), EIF enables a broader range of disability supports options.  

Coming from a block funded “person-centred approach” to an individualised funding module has allowed people supported and service providers to design true person-centred services. This service model approach and the outcomes experienced are genuinely life-changing for people supported. 

The Honourable Bill Shorten MP recently addressed the DSC “Where to from here” conference on the future of the National Disability Insurance Scheme (NDIS). In his speech, Mr Shorten stated that they ‘will put participants at the centre by co-designing improvements to the NDIS’. This allows people supported to be part of the future design of the Scheme, to improve transparency and further inclusion and potential-centred planning. 

As people supported now have more choice and control over their services, it is encouraged that services providers embed co-design practices to maintain and enhance inclusion. This forms the framework of Potential-Centred planning. 

We are approaching a new world through Potential-Centred Planning where we focus on quality of life, well-being and achieving life’s potential. We are moving from personalised, person-centred services to a complementary, self-directed approach. To do this, we need to have the right framework and tools available to capture and encourage these potentials. 

In the support sector we have seen organisations move away from traditional time-and-task based planning to person-centred services. We encourage true person-centred providers to take the lead and consider what potential-centred planning may mean to them and the people they support. 

What do we mean by Potential-Centred Planning? 

• We have practiced independence orientated services models and we now suggest providers move towards relationship orientated services, where circles of support, families and the community work cohesively to achieving life’s potential.
• In the past, the sector has taken a risk averse approach, though now it is evident we can move to a Personalised Risk Management philosophy where the person can decide to reach for goals that have risks identified through being risk aware. Read more here.
• Remember the period when service providers only captured input data? With the new individualised funding methods, we are now more goal and outcome-focused, moving towards capturing real quality of life events which enhances personal wellbeing.
• Person-centred support helps us focus on a person’s strengths and skills which may be seen as a limitation as it does not allow for blue sky thinking. Shifting our approach to being potential based, the opportunities for the person supported are now far more expansive.
• A natural progression towards a more sustainable self-directed approach in decision making and service design by the person. 

In order to be progressive, as we look beyond a person-centred approach leading organisations must be provided with tools to move beyond the transactional (input focused) approach to focusing on the achievement of potential in their interaction with people supported .  

Co-design for Potential-Centred Planning, how you can shift your approach 

• Keep practicing inclusion and the involvement of people supported and their ‘circle of support’. 
• Discuss their wishes and aspirations, and ensure this is an ongoing, flexible approach to care/support to allow change of mind.   
• Identify meaningful outcomes and life aspirations that lead to further enhancements of quality of life.  
• Move on from “follow the plan” to a more creative and fluid approach. 
• Discuss the meaning of wellbeing to deliver a holistic approach. 
• Never underestimate connections between people and encourage the value of relationships. 

We know that software developed from a staff-point-of-view for staff/workforce management is often ‘task and transactional’ driven, therefore limits the ability to deliver person-centredness. 

Embedding the right Client Management System (CMS) can support further inclusion of people supported, driving greater transparency, service quality and real personal achievements. There will be an increased focus on digitising client-centred processes in a “relationship centric” way that optimises client inclusion, personalisation, and co-production of service delivery. This is achieved when the software coding is developed so that the person supported is positioned at the centre of the product. 

As an international CRM software provider focusing on relationship centred planning, co-production and person-centred inclusion, Aspirico has been recognised with multiple international awards for innovative software development for more than a decade. 

Upcoming Tour

Aspirico are planning a roadshow and are looking forward to finally being able to hold some internal strategic discussions with leadership teams of forward-thinking care and support providers in New Zealand and Australia this August. 

Facilitated by Aspirico Senior Executives from Customer Engagement and Product Development teams, the Aspirico roadshow will tour New Zealand in early August and Australia mid-late August to discuss best practices for system transformation towards co-design of disability service provisions. 

If these topics are of interest, we would welcome the opportunity to meet as part of our schedule. Please get in touch to discuss availability, as the itinerary is filling fast.