Reaching the majority - how to make person-centred care everyone’s business

Dr Katie Coleman, a GP and Vice-Chair of Islington CCG and RCGP Clinical Champion for Collaborative Care and Support Planning, explains how we need to capitalise on the enthusiasm of patients, service users and citizens to make person-centred care a reality.

Wouldn’t it be fantastic if every contact with a health care professional resulted in partnership-working, with people feeling able to identify what was important to them and as if they had been heard? We know person-centred care makes sense, so why isn’t it happening?

As a provider of general practice and a clinical commissioner working with professionals across the NHS landscape, I can honestly say I’m not surprised. The health system is creaking and people are working flat out, trying to deliver high-quality care to an ever expanding population, whose conditions become more complex as they live longer. Even if there are pockets where person-centred care is embraced, these are the innovators and early adopters - we have a long way to go before it reaches the majority!

So how can we achieve this vision of person-centred care being the norm?

We know from the pockets of great practice that there needs to be a whole-system approach with senior buy-in, from commissioners and providers. We need champions who are opinion leaders, who are listened to, respected and can promote the cultural shift needed. We need systems that are user-centric, not provider-centric and which reward quality care. But for me, we need to harness our most valuable resource; our citizens, our service users, our patients. We need to capitalise on the enthusiasm of those people in our population who are telling us that person-centred care is what they want.

We need to ensure that these groups are aware of the resources available to them, such as care planning in primary care, diabetes self-management programmes and Patient Online. We need to find out what would enable them to go further faster, engaging with them in co-production, so they feel empowered to ask practitioners for the care they want and deserve. Enabling those within society with the right skills, knowledge and confidence to take an active role in their care, will allow resources to be refocussed to support those who have the greatest need.

We need to develop a greater understanding of our population; to measure and record people’s level of skills, confidence and knowledge so we know how and with whom to work. We need to understand what the different parts of the population need in order to take action to self-manage and work in partnership as equals. This will differ depending on where that individual is on their journey - it may be an online health forum, such as PatientsLikeMe or a self-management support group like helponyourdoorstep in Islington. But whatever form it takes, it must be enabling!

Together, members of the Commissioning for Person-centred Care Working Group have been seeking to understand these issues. Patients, commissioners and providers from across England come together quarterly to share learning, provide challenge to each other and to policy makers in NHS England and disseminate examples of innovation and good practice, so that local populations have the chance to benefit from new ways of working. 

The group’s thinking is also influencing new programmes like Realising the Value, which is exploring a new relationship between patients and communities, to identify a set of evidence-based approaches that will strengthen the case for a person-centred care system across local communities and the NHS. We are linking with the Coalition for Collaborative Care to help get these approaches embedded across the system, and the Royal College of GPs to drive the culture shift towards Collaborative Care and Support Planning in general practice.  

In the meantime, we need to build on the new service offers that have tried to introduce care planning and we need to capitalise on our most valuable assets, our patients and communities, as it is only through enabling them that we will achieve our vison of person-centred care for the majority.

Dr Katie Coleman is the joint Vice Chair (clinical) of Islington CCG. She is a GP in Islington, setting up a new practice in 1999 in collaboration with Dr Josephine Sauvage, her co-Vice Chair. Together they developed the organisation into a thriving inner city training practice. If you would like to join the Commissioning for Person-centred Care Working Group and help bring about this change, please get in touch and email alexandra.gray1@nhs.net.

This blog appeared in its original form on NHS England's website.