Wednesday, January 24, 2018

Blog - The Importance of Person Centred Care

Person Centred Care is about ensuring patients are at the centre of all aspects of their health and care, and that their individual needs, wishes and circumstances are listened to, considered and respected.

In the first of our new series of blogs exploring this approach, our Programme Manager Brook Howells looks at the case of why it's important for the NHS to achieve genuine Person Centred Care.

Over the next instalments, both AQuA staff and our members will be sharing their own thoughts and experiences of different aspects of Person Centred Care, so stay tuned to our News Page for more updates!
Brook Howells, AQuA Programme Manager

NHS policy has been driving the person-centred care (PCC) agenda for over 20 years, but the system has been slow to respond. With current austerity, there is an increased imperative to achieve the paradigm shift, away from traditional paternalistic models of care towards a more enabling, facilitative culture of healthcare delivery that supports PCC. This has been described as clinicians shifting from “parent to coach”.

Supporting self-management was the number one priority identified for commissioners of NHS healthcare services (The King’s Fund, 2015). Coulter et al (2008) state that: “too often, the way in which clinicians and patients interact tends to promote passivity and dependence, instead of self-reliance, thus sapping patients’ self-confidence and undermining their ability to cope” (p.5).

Despite these policy drivers, the system has been slow to respond at scale. Whilst evidence of improvements can be seen in pockets, for example in chronic kidney disease, the whole-scale change is difficult to evidence, and it appears that the shift is dependent on groups of individuals having sufficient motivation to drive the change within their locus of control.

The Advancing Quality Alliance (AQuA) has been working with clinicians and healthcare organisations since 2011, supporting a change in culture through quality improvement methodology and coaching techniques. The transformation is relatively easy for individuals and small teams or services to complete successfully, but achieving systemic change remains a major challenge, despite the obvious benefits.

We know that there are a lot of competing priorities vying for attention across healthcare right now and often PCC is, erroneously, seen as a “nice to have”; the cherry that will top the cake once the rest is successfully baked, rather than as a fundamental and necessary part of the solution.

There are clear indicators that many see the opportunities though since influential documents and policies like the Five Year Forward View point towards PCC as an essential element of modern healthcare. So why are we still so far away from achieving the goal of truly person-centred care embedded across all we do?

Trying to answer this question, a small group of people passionate about person-centred care has formed a community of interest, to share ideas, challenge each other and provide mutual support.

In recognition that a lot of this thinking would be of interest to a much wider audience, AQuA is launching a series of blogs by the group members about some of the key successes and challenges noted to date.

We hope this will inspire others, whether they be clinicians, patients or system leaders, to consider what more they can do to support PCC, and we welcome comments, queries and requests to join the party!

Next time...Brook takes a look at why the NHS has historically struggled with Person Centred Care, and how this is changing.

In the meantime, feel free to share your thoughts with Brook on Twitter via @BrookH_AQuA or @AQuA_NHS, or leave a comment below.

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