A quick guide to person-centred care

Person-centred care – it’s simple, right?

Most people working in our health services believe they’re already delivering it. Yet research shows that only half of patients say they are involved as much as they want to be in decisions about their health care. Only 3% of people living with a long-term condition report having a care plan – and only three-quarters of them report having helped put it together.

So despite a growing recognition of the need for more person-centredness in care – in governmental policy, the strategies of NHS organisations, and a growing practical evidence base – there remains a stubborn gap between the commitment to person-centred care and the reality on the ground.

Perhaps we need to go back to basics? Here we summarise some of the key points from our new quick guide, Person-centred care made simple.

What is person-centred care?

Attempting to pin down a simple description of person-centred care is where it gets complicated. This is partly because person-centred care is still an emerging area. It is also because, by its very nature, care will look very different depending on the person and what matters to them.

Instead of offering a concise but inevitably limited definition, we have identified a framework that comprises four principles of person-centred care:

• Affording people compassion, dignity and respect: basic rights set out in the NHS Constitution and patient charters and strategies for all four UK countries.
• Offering coordinated care, support or treatment: especially for people using multiple services, or at transition between parts of the health and social care system.
• Offering personalised care, support or treatment: treating the person as a human being, not simply a set of diagnoses or symptoms. This means taking into account their emotional, social and practical needs, and those of their carers.
• Enabling: supporting people to recognise and develop their own strengths and abilities so that they can live an independent and fulfilling life.

Where does person-centred care come from?

With its roots in early psychotherapy approaches, the ideas behind person-centred care can be seen underlying many developments in care over the last century. Person-centred care reflects a general move from a purely medical model to a bio-social approach to health care.

Notions of person-centredness are now embedded in the health care policies of all four countries of the UK.

Why is it important?

Given the current focus on safety and financial targets, some might ask whether person-centred care is a ‘nice to have’ rather than an essential priority. But there are some very pressing and practical reasons for adopting person-centred care.

Evidence shows that when people are actively involved and supported in their care:

• It improves clinical outcomes. Patients are less likely to use emergency hospital services and are more likely to stick to their treatment plans and take their medicine correctly.
   
• People are more satisfied with their care, more likely to choose treatments based on their values and preferences rather than those of their clinician, and tend to choose less invasive and costly treatments.
   
• People take more responsibility for their own health. Individuals who have more knowledge, skills and confidence to manage their health and health care are more likely to engage in positive health behaviours and to have better health outcomes.
   
• It’s good for health care professionals. As patient engagement increases, staff performance and morale see a corresponding increase.

What do patients say?

We asked three people living with long-term conditions, Anya, Bindie and Trevor, to tell us what person-centred care means to them and why it's important.

Watch their short videos to see what they had to say.

How can we put it into practice?

Our quick guide summarises a wide range of approaches and initiatives currently being developed in order to make health care more person-centred. These include approaches such as self-management support or shared decision making, specific initiatives like the ‘Hello, my name is’ campaign, and quality improvement approaches such as experience based co-design and Schwartz rounds.

Some approaches focus on improving the experience of individual patients, whereas others look at how to increase the person-centredness of services and organisations.

If you’re looking for an inspiring practical example of person-centred care, our case study this month looks at how teams from Salford and Yorkshire and the Humber have transformed the renal care offered to patients. We explore the new model of ‘shared haemodialysis care’, and the impact it’s having on patients and staff.

Also in the newsletter this month we have a blog from Adrian Sieff, Assistant Director at the Health Foundation, about our latest research report (Person-centred care: from ideas to action) and its implications for policy makers and those responsible for providing strategic direction.