Person-centred approach to health and social care integration NHS Ayrshire and Arran

People with long-term conditions, such as chronic obstructive pulmonary disease (COPD), often experience fragmented and uncoordinated care. This can lead to problems including repetition of assessments, poor transmission of information and delays in care.

This project from NHS Ayrshire and Arran sought to improve the quality of care and patient experience of people with long-term conditions by gaining insights from patients and clinical teams, and subsequently acting on the results to improve care integration.

This innovative approach encompassed three elements: asking patients about their experience of integrated care; engaging teams who deliver that care and measuring how effective communication is; and using quality improvement methods to create seamless pathways delivered to patients by high-performing teams. The intervention was tested in people with COPD from four general practices in Ayrshire, along with health and social care staff involved in their respiratory care.

Two international surveys were adapted and used to measure participants’ views of care and aspects of team coordination. These provided a basis for reflection and discussion from different perspectives. This, in turn, kick-started a drive towards achieving quality improvements in person-centred care and a learning culture.

This innovation successfully increased patient involvement in respiratory services, identified areas for improvement along the COPD patient pathway, and brought patients and staff together in a positive, inspiring and energising way.

The project was more complex and time-consuming than anticipated. A key challenge was adapting and processing the results from surveys. However, priorities were reassessed throughout and the valuable information, intelligence and learning gathered will be used as a basis for ongoing quality improvement initiatives by the health board.

This Innovating for Improvement project ran from the beginning of May 2015 until the end of July 2016.

Contact information

For more information about this project, please contact Hans Hartung or Erica Reid.