Articles / Leadership for Personalised Care: A Strategic Guide to Transforming Healthcare Delivery
Development, Training & CoachingDiscover the essential leadership competencies, frameworks, and strategies required to implement personalised care in healthcare settings. Learn how to drive cultural change and improve patient outcomes through the NHS Comprehensive Model.
Written by Laura Bouttell • Sun 4th January 2026
The National Health Service stands at a pivotal moment. With an ageing population increasingly living with long-term conditions and multimorbidity, the traditional paternalistic model of healthcare delivery—where clinicians decide and patients comply—has reached its limits. Personalised care represents not merely an operational adjustment but a fundamental reimagining of the relationship between healthcare professionals and the people they serve.
Leadership for personalised care demands a distinctive blend of strategic vision, emotional intelligence, and unwavering commitment to co-production. Those who master these competencies will shape the future of healthcare delivery. Those who do not will find themselves managing increasingly unsustainable systems that fail both patients and practitioners.
This guide examines the leadership capabilities required to implement personalised care effectively, drawing upon the NHS Comprehensive Model and established leadership frameworks to provide actionable insights for healthcare leaders at every level.
Personalised care represents a paradigm shift from doing things "to" and "for" patients towards doing things "with" them. It acknowledges a fundamental truth that healthcare systems have historically overlooked: patients possess expertise about their own lives, circumstances, and preferences that no clinician can replicate.
The NHS Long Term Plan positioned personalised care as a core priority, with ambitions to benefit 2.5 million people by March 2024 through expanded access to social prescribing, personalised care and support plans, and personal health budgets. These targets reflect recognition that sustainable healthcare depends upon empowering individuals to manage their own wellbeing rather than creating ever-greater dependence upon clinical services.
The evidence supporting personalised care is compelling. In Cambridgeshire and Peterborough, the implementation of over 6,000 personalised care plans in a single year produced measurable outcomes: reduced trips to Accident and Emergency departments, 20 per cent reductions in non-elective admission costs, and improved patient outcomes across multiple indicators.
Yet implementation remains inconsistent. A patient survey examining personalised care appointments identified ten key elements that define quality interactions, including active listening, shared decision-making, and tailored advice. Nearly one in five patients reported that none of these elements were evident in their healthcare interactions over the preceding two years. Only two per cent experienced all ten elements.
This gap between aspiration and reality underscores why leadership matters so profoundly. Cultural, operational, and system barriers prevent clinical staff from delivering care that is genuinely personalised, even when they strive to do so. Overcoming these barriers requires leaders who understand both the vision and the practical mechanics of transformation.
The Comprehensive Model of Personalised Care establishes a whole-population approach organised across three tiers: whole-population approaches for general wellbeing, a proactive and universal offer for people with long-term conditions, and intensive and integrated approaches for those with complex needs.
Effective personalised care delivery requires all six components to be implemented together and in full. Partial implementation yields partial benefits; comprehensive implementation creates transformational change.
| Component | Description | Leadership Implications |
|---|---|---|
| Shared Decision Making | Collaborative healthcare decisions between patients and providers based upon the best available evidence and individual preferences | Leaders must create environments where clinicians have time and skills for meaningful conversations |
| Personalised Care and Support Planning | Individual care plans developed through facilitated conversations that explore health management within the context of whole-life circumstances | Requires investment in training and protected time for quality conversations |
| Enabling Choice | Legal rights to choice in healthcare options, including provider selection for first outpatient appointments | Systems and processes must be designed to present and facilitate genuine choices |
| Social Prescribing and Community-Based Support | Non-medical interventions connecting people to community resources through link workers | Partnership development with voluntary and community sectors becomes essential |
| Supported Self-Management | Patient education and skill-building for managing conditions independently | Investment in health coaching capability and accessible resources |
| Personal Health Budgets and Integrated Personal Budgets | Individual control over allocated care resources enabling people to determine how money is spent on their care | Financial governance systems must balance autonomy with accountability |
The NHS England framework identifies four essential enablers that leaders must cultivate:
Strong System Leadership remains the primary enabler. Without committed leadership that models personalised approaches and holds organisations accountable for implementation, the six components become aspirational statements rather than operational realities.
Co-production with Stakeholders ensures that services reflect the perspectives and priorities of those who use them. The Universal Personalised Care Model was itself co-produced with people with lived experience, establishing a precedent that implementation should follow.
Workforce Engagement across health and care systems addresses the reality that personalised care requires new skills, different time allocations, and fundamental changes to clinical practice. Staff who feel unsupported in this transition will struggle to deliver transformation.
Partnership with Voluntary and Community Sectors recognises that healthcare systems cannot deliver personalised care in isolation. Social prescribing, community-based support, and non-medical interventions depend upon robust relationships with organisations beyond the NHS.
The NHS Healthcare Leadership Model identifies nine dimensions of leadership behaviour that apply across all healthcare settings. When viewed through the lens of personalised care, each dimension takes on specific significance.
| Dimension | Core Behaviour | Application to Personalised Care |
|---|---|---|
| Leading with Care | Understanding unique qualities and needs, providing caring environments | Modelling person-centred approaches in all interactions, including with staff |
| Sharing the Vision | Communicating a compelling picture of the future | Articulating why personalised care matters and how it transforms outcomes |
| Engaging the Team | Building productive working relationships | Creating psychological safety for staff to experiment with new approaches |
| Inspiring Shared Purpose | Creating common purpose across diverse individuals | Connecting clinical, administrative, and support staff to personalised care goals |
| Connecting Our Service | Understanding how services link together | Building partnerships across organisational boundaries and sectors |
| Developing Capability | Building organisational and individual skills | Investing in training, coaching, and experiential learning opportunities |
| Holding to Account | Setting clear expectations and reviewing outcomes | Establishing meaningful metrics that measure what matters to patients |
| Evaluating Information | Seeking and using evidence for decisions | Using patient experience data and outcome measures to guide improvement |
| Influencing for Results | Gaining support and commitment from others | Advocating for personalised care resources and priorities within systems |
The NHS Leadership Academy, in partnership with NHS England, offers the Introduction to Leadership for Personalised Care programme through FutureLearn. This three-week course equips participants with foundational understanding and practical tools for leading personalised care implementation.
By the end of the programme, participants can:
The programme recognises that personalised care leaders need skill, will, knowledge, and confidence to work together across boundaries and systems. This combination distinguishes personalised care leadership from traditional healthcare management.
The NHS Leadership Competency Framework for Board Members establishes six domains that senior leaders must demonstrate. Each domain connects directly to personalised care priorities:
| Domain | Competency Focus | Personalised Care Connection |
|---|---|---|
| Driving High-Quality Outcomes | Ensuring services deliver excellent results | Patient-reported outcomes become central to quality assessment |
| Setting Strategy | Defining direction and priorities | Personalised care must be embedded in strategic planning |
| Promoting Equality | Addressing health inequalities | Personalised approaches can reduce inequalities when implemented equitably |
| Ensuring Robust Governance | Maintaining accountability and oversight | Governance frameworks must accommodate individual flexibility |
| Creating Positive Culture | Building supportive working environments | Culture change is essential for sustainable personalised care |
| Building Trusted Relationships | Developing partnerships and collaboration | Co-production requires trust between patients, staff, and leaders |
Successful implementation requires leaders to address multiple dimensions simultaneously. Focusing exclusively upon training without addressing culture, or upon culture without addressing systems, produces limited and unsustainable change.
Assess Current State: Before launching transformation initiatives, leaders must understand their starting point. This includes evaluating existing practices against the six components, identifying strengths and gaps, and understanding staff perceptions and capabilities.
Engage Lived Experience: Co-production should begin from the earliest stages. Invite people with lived experience of personalised care—both positive and negative—to contribute to planning. This is not consultation; it is partnership in design.
Secure Executive Commitment: Personalised care implementation requires sustained investment and attention. Board-level sponsorship ensures resources are allocated and competing priorities do not derail progress.
Develop the Business Case: Articulate the financial and clinical case for personalised care using local data and evidence from comparable implementations. Address scepticism with evidence whilst acknowledging uncertainties.
Invest in Training: The Personalised Care Institute offers accredited training that care coordinators should complete before taking referrals. Broader workforce development should include shared decision-making skills, coaching approaches, and understanding of the six components.
Establish New Roles: Three personalised care roles have been introduced within primary care settings: health and wellbeing coaches, care coordinators, and social prescribing link workers. Leaders must ensure these roles are properly supported and integrated.
Create Time for Conversations: Personalised care and support planning requires unhurried, facilitated conversations. Without protected time, clinicians cannot deliver the quality of interaction that personalised care demands.
Build Partnership Infrastructure: Social prescribing depends upon robust relationships with voluntary and community sector organisations. Leaders must invest in partnership development and ensure referral pathways are effective.
Model Personalised Approaches: Leaders demonstrate commitment through their own behaviour. Applying personalised care principles to staff management—listening to what matters, co-producing solutions, enabling choice—reinforces messages about patient care.
Address Resistance Thoughtfully: Some staff will resist change due to genuine concerns about workload, competence, or professional identity. Distinguish between resistance rooted in fear and resistance rooted in legitimate objection. Address both, but differently.
Celebrate Progress: Recognise and publicise successes, however small. Cultural change builds momentum through visible evidence that new approaches work.
Sustain Attention: Transformation is not a project with an end date. Leaders must maintain focus on personalised care over years, not months, resisting the temptation to move on to the next initiative.
Define Meaningful Metrics: Performance measures should capture what matters to patients, not merely what is easy to count. Patient experience surveys, patient-reported outcome measures, and qualitative feedback all contribute to understanding impact.
Embrace Learning from Failure: NHS England explicitly allows metrics and key performance indicators to evolve, creating space for failure and improvement. Leaders should create similar psychological safety within their organisations.
Use Data for Improvement: The purpose of measurement is learning, not judgement. Data should inform conversations about what is working, what is not, and what adjustments might help.
Personalised care and support planning represents the practical expression of personalised care principles. It transforms routine clinical encounters into meaningful conversations that acknowledge patients as experts in their own lives.
Traditional clinical consultations begin with the clinician's agenda: symptoms, diagnoses, treatments. Personalised care and support planning inverts this approach. The conversation starts by discovering what matters to the person in their life before discussing health in detail. This builds a picture of how someone wants to live rather than viewing them solely through the lens of their condition.
The five technical criteria for personalised care and support plans establish quality standards:
Leaders create the conditions for quality conversations by:
Protecting Time: Rushed consultations cannot support meaningful personalised care and support planning. Leaders must challenge productivity metrics that undermine quality.
Developing Skills: The changed conversation requires different skills from traditional clinical communication. Investment in training, coaching, and peer support enables staff to develop competence.
Supporting Emotional Labour: Personalised conversations can be emotionally demanding. Leaders must acknowledge this and provide appropriate support.
Enabling Continuity: Ideally, personalised care and support planning conversations should be carried out by professionals who already have relationships with patients. Leaders should design systems that support continuity rather than fragment relationships.
The NHS England Peer Leadership Development Programme represents a distinctive approach to personalised care leadership. Rather than training clinicians to lead, it develops knowledgeable, skilful, and effective peer leaders from among people who could benefit from personalised care.
Peer leaders use their lived experience to:
This approach recognises that people with long-term conditions and disabilities possess expertise that professional training cannot replicate. By developing leadership capacity among this population, the NHS expands both its leadership capability and its connection to the people it serves.
Supporting peer leadership requires organisational leaders to:
Create Genuine Roles: Peer leadership must involve real influence, not tokenistic involvement. People with lived experience should contribute to meaningful decisions.
Provide Appropriate Support: Peer leaders may require adjustments, flexibility, and support that traditional employment structures do not accommodate. Leaders must ensure organisational systems can adapt.
Value Different Expertise: Professional hierarchies often undervalue experiential knowledge. Leaders must actively counter this tendency and ensure peer perspectives carry appropriate weight.
Enable Development: The Peer Leadership Development Programme provides foundation training, but peer leaders benefit from ongoing development opportunities comparable to those available to professional staff.
Despite compelling evidence and policy support, personalised care implementation has been slower than ambitions suggested. Understanding barriers enables leaders to address them systematically.
Healthcare culture has historically positioned clinicians as experts and patients as recipients. This dynamic, whilst well-intentioned, can infantilise patients and limit their engagement in their own care. Shifting to genuine partnership requires cultural transformation that some staff find challenging.
Leadership Response: Model partnership approaches in all interactions. Challenge paternalistic language and behaviour. Create forums for reflection on professional identity and the transition to collaborative practice.
Rigid structures designed for standardised care delivery accommodate personalised approaches poorly. Appointment slots are too short for meaningful conversations. Information systems do not support individual care planning. Pathways assume linear progression rather than iterative adaptation.
Leadership Response: Redesign systems with personalisation in mind. Pilot flexible approaches and evaluate outcomes. Challenge operational assumptions that prioritise throughput over quality.
Personalised care requires investment in training, new roles, protected time, and partnership development. In resource-constrained environments, these investments compete with immediate pressures.
Leadership Response: Build business cases demonstrating return on investment. Sequence investments to generate early benefits that support continued funding. Seek transformation funding and external support.
Integrated care systems are designed to facilitate personalised care, but integration across organisational boundaries remains challenging. Information does not flow smoothly. Accountability structures create competing incentives. Professional boundaries limit collaboration.
Leadership Response: Invest in relationship-building across organisational boundaries. Champion system-level approaches to personalised care. Advocate for policy and regulatory changes that enable integration.
Traditional healthcare metrics—waiting times, throughput, readmission rates—capture important dimensions of performance but may not reflect personalised care quality. Leaders must develop measurement approaches that assess what matters.
The London personalised cancer care key performance indicators emphasise "measuring what matters to patients." This principle should guide metric development across all personalised care domains.
Meaningful metrics include:
| Metric Category | Examples | Data Sources |
|---|---|---|
| Patient Experience | Quality of conversations, feeling listened to, involvement in decisions | Patient surveys, qualitative feedback |
| Patient-Reported Outcomes | Quality of life, functional status, goal achievement | Validated outcome measures, patient self-report |
| Care Plan Quality | Completeness, individualisation, patient ownership | Documentation audit, patient verification |
| Service Utilisation | Appropriate use of services, reduced crisis presentations | Administrative data |
| Staff Experience | Confidence in personalised approaches, job satisfaction | Staff surveys |
Performance measurement serves two purposes that can conflict: accountability for results and learning for improvement. Over-emphasis upon accountability can drive defensive behaviour and gaming. Over-emphasis upon learning can undermine rigour and comparability.
Effective leaders balance these purposes by:
NHS England acknowledges that metrics and key performance indicators should evolve alongside implementation. Early-stage measurement focuses upon process and capability development. Mature-stage measurement emphasises outcomes and impact. Leaders should plan for this evolution rather than locking in premature metrics.
The NHS Management and Leadership Framework, expected by autumn 2025, will establish consistent professional standards for all NHS managers and leaders. This framework responds to recommendations from the Messenger Review for unified leadership standards and development pathways.
For personalised care, this framework represents both opportunity and risk. The opportunity lies in embedding personalised care competencies within universal leadership expectations. The risk lies in standardisation that insufficiently emphasises the distinctive capabilities personalised care demands.
Several trends will shape leadership for personalised care in coming years:
Digital Enablement: Technology offers opportunities to support personalised care through better information sharing, remote monitoring, and decision support. Leaders must ensure technology serves personalisation rather than standardisation.
Integration at Neighbourhood Level: Integrated Neighbourhood Teams represent the operational expression of personalised care within local communities. Leaders must develop capability for cross-organisational, cross-sector working at neighbourhood scale.
Population Health Management: Data and analytics enable identification of individuals who could benefit from personalised care approaches. Leaders must ensure these tools are used ethically and effectively.
Workforce Sustainability: Healthcare workforce shortages threaten personalised care ambitions. Leaders must find ways to deliver personalised approaches within constrained resources, potentially through greater peer involvement and community capacity.
Patient-centred care and personalised care share philosophical foundations but differ in scope and systematisation. Patient-centred care describes an orientation towards individual needs and preferences within clinical encounters. Personalised care represents a comprehensive model with six defined components, specific implementation requirements, and system-level enablers. The NHS Comprehensive Model of Personalised Care operationalises patient-centred principles into a framework that can be implemented, measured, and improved across entire health systems. Leaders should understand personalised care as the systematic application of patient-centred principles rather than a fundamentally different concept.
Measuring return on investment requires capturing both costs and benefits across multiple dimensions. Costs include training, new roles, protected time, and partnership development. Benefits include reduced emergency department attendances, decreased non-elective admissions, improved medication adherence, enhanced patient satisfaction, and better staff retention. The Cambridgeshire and Peterborough implementation demonstrated 20 per cent reductions in non-elective admission costs alongside improved patient outcomes. Leaders should establish baseline measures before implementation, track changes over time, and account for the fact that benefits may emerge over longer timeframes than costs.
The Introduction to Leadership for Personalised Care programme offered through FutureLearn provides essential foundation training. This three-week course covers the meaning of personalised care, why new leadership approaches are required, and practical application of leadership frameworks. Beyond this foundation, leaders benefit from training in coaching approaches, shared decision-making facilitation, co-production methods, and change management. The Personalised Care Institute offers accredited training for specific roles. Leaders should also seek experiential learning through involvement in personalised care implementation and reflection upon their own practice.
Resistance often reflects legitimate concerns rather than mere obstruction. Leaders should first understand the nature of resistance: Is it rooted in concerns about competence, workload, professional identity, or philosophical disagreement? Each requires different responses. For competence concerns, provide training and support. For workload concerns, address time and resource constraints. For identity concerns, create space for reflection on evolving professional roles. For philosophical disagreement, engage with the evidence base and provide opportunities for dialogue. Forcing compliance without addressing underlying concerns produces superficial change that does not sustain.
Integrated Care Systems provide the structural framework within which personalised care operates at system level. They enable coordination across organisational boundaries, alignment of incentives, and pooling of resources for transformation. For leaders, Integrated Care Systems offer opportunities for learning and collaboration across organisations, access to system-level resources and expertise, and frameworks for partnership with voluntary and community sectors. Leaders should engage actively with Integrated Care System personalised care strategies and contribute to system-level learning whilst maintaining focus upon implementation within their own organisations.
Personalised care holds potential to reduce health inequalities by tailoring approaches to individual circumstances, but this potential is not automatic. Without deliberate attention, personalised care could benefit articulate, confident individuals whilst leaving others behind. Leaders should analyse implementation data by demographic characteristics to identify disparities. They should invest in approaches that reach underserved populations, including community-based delivery and peer support. They should ensure personalised care and support planning conversations are accessible to people with communication needs, learning disabilities, or limited health literacy. Co-production with diverse communities helps identify and address barriers to equitable access.
Personalised care and clinical guidelines are complementary rather than contradictory. Guidelines synthesise evidence about what works for populations; personalised care applies that evidence to individuals within the context of their lives and preferences. Shared decision-making, a core component of personalised care, involves presenting evidence-based options and supporting individuals to make informed choices. Leaders should ensure staff understand this relationship and feel confident adapting standardised approaches to individual circumstances. The goal is not to abandon evidence-based practice but to integrate it with individual expertise about personal circumstances, values, and priorities.
Leadership for personalised care demands more than technical competence in healthcare management. It requires fundamental commitment to partnership, genuine respect for expertise that lies outside professional credentials, and patience for cultural transformation that unfolds over years rather than quarters.
The NHS Comprehensive Model provides the framework. The leadership competencies are established. The evidence base is compelling. What remains is the sustained, determined effort of leaders at every level to translate aspiration into reality—one conversation, one care plan, one transformed relationship at a time.
Those who rise to this challenge will not merely improve healthcare delivery. They will help restore a relationship between the National Health Service and the public it serves that acknowledges the expertise, dignity, and agency of every individual seeking care.