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An Introduction to Personalised Care for Primary Care Network Leaders (2022)

Updated: Dec 20, 2022

For those of you wanting a greater understanding of the personalised care agenda within the Primary Care Network landscape, in this blog, we break down:

  1. What is personalised care/person-centred care?

  2. The benefits of personalised care

  3. Personalised care and what Primary Care Networks need to deliver

We also provide new PCN Managers and Clinical Leads with an action plan to help them progress the personalised care workstream.

To support this blog, you will need to access the following resources:

Let’s get started!

What is Personalised and Person-Centred Care?

Personalised Care represents a major shift in how our NHS will approach our health and care. As patients, we have more access to information and knowledge about our health than ever before. Many of us walk into our appointments having carried out internet research (which can be a good or bad thing! ), and we will have spoken to friends, family and colleagues and feel informed.

Towards the other end of the spectrum, more economically disadvantaged people will face a myriad of factors influencing their health that widen the gap of health inequalities.

Personalised Care simply means empowering patients to have more control and choice regarding how their care is planned and delivered, taking into account individual needs, preferences and circumstances.

Through our podcast, The Business of Healthcare, I have had the opportunity to speak with Dr Mohan Sekeram who is;

  • The South West London clinical lead Personalised care

  • The Clinical Lead for Social Prescribing in Merton and Wandsworth Borough

  • The locality lead East Merton Borough

  • A GP Partner at Wide Way Medical Centre

  • A London Deanery GP Trainer and Mohan also sits on Merton LMC

Mohan is a tremendous advocate for Personalised Care and Social Prescribing and has amassed over 35,000 followers across Tik Tok, Twitter, Instagram and LinkedIn, where he shares fun and accessible information on Social Prescribing, Health and Wellbeing and Personalised Care.

In this clip, Mohan provides his view of person-centred care.

When so much of our health is by the wider determinants of health. Health is determined by a complex interaction between individual characteristics, lifestyle and the physical, social and economic environment, it’s about understanding what matters to you? Rather than what’s a matter with you?
Dr Mohan Sekeram

The full interview can be found here:

For further information, visit, Broader determinants of health: Future trends published by the Kings Fund.

Aimee Robson, the Deputy Director of Personalised Care has also been a guest on our podcast and provides her definition of Personalised Care.

The full interview can be found here:

What is the vision?

This is not just about general practice, the goal is for 2.5 million people to have benefitted from Personalised Care by 2023/24.

It is a whole system approach that enables a variety of services across the health, social care, public health, and community spectrum to be integrated around the individual in order to deliver better outcomes and experiences.

Personalised Care and what Primary Care Networks need to deliver

Whilst personalised care is everyone’s business across the Primary Care Network; there are some roles and workstreams which have more of an emphasis on helping drive the personalised care agenda forward.

Below, I highlight the Social Prescribing workstreams.

  • A PCN must provide patient access to a social prescribing service either by directly employing a social prescriber or by sub-contracting the provision of the service to another provider. This is funded by the Additional Role Reimbursement Scheme in accordance with the Network Contract DES Specification. (See page 92)

  • Through the Impact and Investment Fund (IIF), PCNs can work towards increasing the number of Social Prescribing referrals.

As highlighted in our blog titled, Primary Care Networks | What to focus on Q3

  • By the 30th of September 2022, as part of a broader Social Prescribing service, a PCN and commissioner must jointly work with stakeholders, including the local authority, VCSE partners and local clinical leaders, to design, agree and put in place a targeted programme to proactively offer and improve access to social prescribing to an identified cohort with unmet needs.

  • From 1st October, a PCN must commence delivery of this programme

  • By March 2023, a PCN must review the cohort and extend the offer to more patients.

If you are looking for some ideas to inform your plan, The report published by the Institute of Health Equity recently published Fuel Poverty, Cold Homes, and Health Inequalities in the UK. Perhaps your PCN could consider an initiative to support your community covering this topic.

4. By 30 September 2022, a PCN must ensure all clinical staff (see page 63 of the DES) must complete the Personalised Care Institute’s 30-min eLearning refresher training for Shared Decision Making (SDM) conversations

Hot off the press! In the letter dated 26th September titled, Supporting general practice, primary care networks and their teams through winter and beyond, this requirement has now been removed.

🎯Action Plan

If you haven’t done this already:

1. Familiarise yourself with the PCN Personalised Care: Social prescribing; shared decision making; digitising personalised care and support planning guidance document found here.

2. Set up a dedicated meeting with your social prescribing / personalised care team to review progress against the Impact and Investment Fund and to review what is working well and areas for improvement.

3. Inform your PCN team of the personalised care training to be undertaken and share why it’s important. The training can be found here.

4. Work with your Clinical Director or Clinical Lead for Personalised Care and your social prescribing team to agree and put in place a targeted programme to proactively offer and improve access to social prescribing to an identified cohort with unmet needs.

( If you are unsure of how a Clinical Lead who is not the PCN Clinical Director could support your PCN, please read our blog, Why does my Primary Care Network need Clinical Leads when we have a Clinical Director?)

5. Share good news stories from your social prescribing / personalised care team to help them understand the positive difference the team is making

We hope this helps.


Work with Us

Going live on 31st October, we have our 3rd cohort of training to support those of you who are involved in PCN Management. You may be a Manager, Administrator or Coordinator.

Whilst we share a lot of information in our blogs, there is so much more, and for those of you who are looking to invest in your professional development and the performance of your network, our programme is full of tools and templates and master classes for you to have access to for 12 months, and we ADD exclusive resources to this each month.

On top of this, you will receive a core strengths assessment to improve your communication and leadership skills.

We have drop-in sessions and a WhatsApp group too.

In this programme, we focus on the skills to lead and manage a network so regardless of changes in the DES and last-minute contractual obligations, you will have learnt the skills to keep a cool head and lead and manage with confidence.

Lastly, we lead and manage PCNs too. We are in the thick of it and experience the good and those days when you think 😫!

About the Author

Tara and Team THC provide project and network management and training to Primary Care Networks. Between our training programmes, facilitation and interim network programmes, we have now supported over 50 PCNs!

Tara has an MBA in Healthcare Leadership and Management, is published in the London Journal of Primary Care, is the author of over 200 blogs also hosts The Business of Healthcare Podcast.

Find out more about THC Primary Care at

Follow Tara on Twitter



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