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Using data to understand and engage your populations

Using data effectively is key to making proactive and personalised care work for your community.

Data helps us understand exactly where the problems are, who needs support, and how well we’re doing to improve things. However, data itself isn’t enough – we need to connect the numbers to real people and real lives.

Initially, data helps us find the right group of people to focus on. By considering factors such as age, ethnicity, or local circumstances, we can identify who might benefit most from our efforts. This means our care and attention is directed exactly where needed.

Data also helps us spot important differences. Often these differences are expected – such as older people having more health issues – but sometimes, they can surprise us.

For example, if data shows fewer health issues in poorer areas than we’d expect, it tells us we need to look deeper. Differences in how healthcare is delivered should always concern us, because they can indicate unfairness and inequality.

Engaging your community is where data truly becomes powerful. When people see that their unique circumstances are understood, they feel respected and involved.

Proactive and personalised care is about continuously checking what’s working, what’s not, and adjusting your actions accordingly.

Clear data can open up meaningful conversations, build trust and lead to care that’s genuinely helpful and relevant.

Regularly reviewing the data with your community ensures the care provided stays effective, fair, and truly meets people’s needs.

Each locality will have access to data via its intelligence health hub. In Greater Manchester the platform is called Curator, which is part of Tableau.

Dr Aseem Mishra, GM’s CVD prevention lead, led the programme’s sessions on data. In this eight-minute video, he explains how data can help you understand and identify different groups.

Workforce matters

Having the correct workforce in place is vital to delivering the best service to patients, and workforce planning and redesign are key elements to achieving this.

Proactive and personalised care projects can benefit from thinking creatively about the workforce you have in your practice.

The Additional Roles Reimbursement Scheme (ARRS), in particular, provides an opportunity for general practice to think differently about how it can support patients.

Lynn Marsland, Greater Manchester Primary Care Provider Board’s strategic lead for HR, Workforce and Organisational Development, explains how to approach creating the best team to deliver services.

Video 1, which is seven minutes, describes the first five Rs: right size; right shape; right skills; right site; right spend.

Video 2, which is 13 minutes, describes the second five Rs: refresh; recruit; re-train; re-focus; release.

How to develop a proactive and personalised care model