From standards to better lives

August 6, 2020

Using POET to bring the NICE personal budgets quality standards to life

The National Institute for Health and Social Care Excellence (NICE) has this month published new guidance for adult social care in the form of 'People's experience in adult social care services'. It provides quality standards and recommended data sources for these, including the The Personal Outcomes Evaluation Tool (POET)

John Waters co-creator of the POET sets out here why it is particularly helpful that NICE have chosen to focus on how systems are felt and experienced by people and endorsed the POET tool as the mechanism to understand this. For more information about POET and a forthcoming programme for councils see here  - A Practical Development Programme

trust people

In 2014 the Care Act made personal budgets law for the first time and around the same time the special educational needs and disability (SEND) reforms and the Five Year Forward View placed personalisation firmly within both health and education policy. These policy and statutory instruments represent great progress, and are to be celebrated. However, reshaping systems is not enough - the goal is better lives for those of us who need support. And of course systems don't make great support; people do. The challenge therefore is not just to change how the system looks but more importantly how it is experienced and how this impacts on lives

To help with this In Control have worked with Lancaster University and with people who need support for over 10 years to develop and use our Personal Outcomes Evaluation Tool, POET for short. A simple set of questions that can be used to measure peoples experience of social care and the impact of support on their life. To ensure that it was relevant to local authority systems, POET looks at all the essential aspects of the care and support process described in the 2014 Care Act statutory guidance and includes outcomes aligned with the domains of wellbeing.

poet table 1

Embedding POET

Over the past few years we have worked with a small group of willing councils to embed POET into their review tools and information systems so that it is now used to routinely collect peoples' experiences and outcomes. Using the data we have collected it is now possible to determine both individual and system level experiences and outcomes.

The POET and the data we have gathered using it have given us much more than a new way to measure performance, we have built an understanding of what systems need to 'feel like' for their users if they are to enable better lives - the connection between process, experience and outcomes. Importantly we know that some particular aspects of the care and support process are more regularly and most robustly associated with good outcomes and that we need to improve these areas.

With embedded POET we have a way of routinely understanding whether our system is likely to help people in the way it needs to, if it is to lead to great support.


poet table 2

Using the NICE quality standard

Now NICE have supported the need to assess how care and support systems are experienced by people, not just measure what they do, and have included the POET in their  guidance on how to do this. It is relatively straight forward to use POET to gather data to test local systems and practice against key elements of the standards - see the table below for examples;

poet table 3