Population Health Management (PHM) involves using data we hold about our patients and communities and their health requirements to plan how we deliver the best, tailored care for our local population. As an approach, it uses data to design new ways of proactively offering patients care before they need to go the NHS with a problem – and helping them to improve their health and wellbeing.

PHM is a way of working that enables us to understand health and care needs in a population. The approach requires:

  • quantitative insight about a population acquired from various sources of linked data, and
  • qualitative intelligence gathered from care professionals and local communities.

These insights help us identify opportunities to improve or transform the way care and services are delivered to our population to achieve better and more equitable outcomes.

This also involves making sure that all health and care staff in south east London have access to the information they need to make the best possible decisions for the people they care for and to support people to get more involved in their own care.

Adopting a PHM approach will bring significant benefits to south east London. For the people and families that we serve, there will be increased prevention of ill-health and improved wellbeing. For professionals, a PHM approach will improve pathways, with truly integrated care. There will be more collaboration and shared opportunities across the ICS. For the integrated health and care system there will be a reduction in health inequalities, more joined-up health and care services, and more efficient services which are financially sustainable.

Our vision is one that builds our population health management capacity and capability resulting in improved outcomes and a reduction in health inequalities for our population.

We aim to do this by working in partnership across the system;

  • Raising awareness of population health management as a new way of working across south east London and its successes to date, including lessons learnt from the Wave 2 NHS England and Improvement (NHS E & I) Population Health Management Development Programme
  • Highlighting the benefits of population health management and why population health management should be adopted as a way to work;
  • Producing content that tells the story of establishing population health management as core way of working for the south east London operating model;
  • Promoting services and tools being developed to enable population health management as a way of working.

At our Population Health Conference we showcased some fantastic real-world examples of how a Population Health Management approach with data was used in our local communities. The slides from the day can be found here and include examples such as:

  • Harnessing the power of neighbourhoods, data & collaboration in Orpington & the Crays: A community-first approach to population health management
  • Health Equity Partnership – Lewisham’s model in tackling health inequality
  • Reducing health inequalities in children with asthma

Community of practice

As part of our collective endeavour to embed a population health management approach (PHM) to improving health and care across South East London, we are launching a PHM Community of Practice and welcome you to be part of a PHM virtual community.

Further information

You can find out more about what Population Health Management involves and how it can help in this explainer video, from Dr Jonty Heaversedge, former Clinical Chair and Lead for Population Health at South East London Integrated Care System:

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