The image below is from twitter and the #NHSMillion campaign which I've RT a couple of times on @h2cm. The graphic is repurposed here representing the NHS as an organisation with its Socialist founding. On twitter the arrow would point to the twitter account holder's name. In Hodges' model we can readily travel from the individual to the million and more; from personalised healthcare to population health:
Within Hodges' model the arrow points to the INDIVIDUAL axis. The stress is placed on a person* and their experience of the NHS whether for themselves or a family member. Care should always encompass physical and mental health care, with emergency care prioritised firstly of course.
As an NHS employee I have been cocooned from many of the financial vagaries of the world. This does not mean I work for nothing, don't pay tax, have holes in my pockets ... On the contrary I'm frustrated and increasingly annoyed about austerity and the pay situation over the past 5 years and more. Interest rates, Brexit, the Euro, the $ ... all count here too. Healthcare does need to be paid for - one way or another. The cocoon refers to the effect of the founding core principles of the NHS:
- that it meet the needs of everyone
- that it be free at the point of delivery
- that it be based on clinical need, not ability to pay
A further tweet from @NHSMillion brings home the SOCIO-ECONOMIC and SOCIO-POLITICAL dimension of health and social care. The cocoon is ruptured, the vulnerability of the NHS's core principles and values is laid bare:
We need to assure and ensure that the many can continue to make a difference to the one. Even as that gratitude is increasingly reframed as people learning how to stay well for longer and better look after themselves.
*The arrow is also pointing to the center of the model. Truly person-centered care should be able to demonstrate that full round of the four domains have been factored into any assessment, plan, intervention and evaluation with the spiritual also duly considered.