This article aims to explore the meaning of person-centred care and why it is important when implementing care. It considers where this model is used and why, as well as how patients and professionals can benefit from this approach.
Person centred care is a practice in which patients actively participate in their own medical treatment in close cooperation with their health professionals. Sometimes, relatives may be involved in the creation of the patient’s health plan. The person-centred model of health care is used both in outpatients, emergency care, palliative care as well as rehabilitation.
en.m.Wikipedia. org. 2022.
Principles of person-centred care
Many patients are unaware of this model and appreciate professional’s opinions when providing care and treatment. However, according to the The Health Foundation, there are four principles of person-centred care everyone should know about:
- Dignity, compassion and respect.
- Offer co-ordinated care, support or treatment.
- Offer personalised care, support or treatment.
- Support people to recognise their own strengths, abilities and enable to an independent, fulfilling life.
Carl Rogers (1960) a psychologist, was the first to use person-centred care. He believed this model to be both beneficial to the professional as well as the patient:
- Reduce complaints and improve treatment and care.
- Help to negotiate a treatment plan.
- Support with structured education
- Help decision-making – whether to take medication, surgery or lifestyle/dietary changes.
Choices to consider
So what choices are there to consider when treatment is suggested by professionals? We all have different needs – cultural, religious, social, economic and levels of understanding. When vulnerable it can seem easier to accept what treatment is suggested but are there reasons why the person-centred approach can assist in compliance to the treatment? Many feel that taking drugs for a condition is the last resort: side effects or allergies will prolong the condition and maybe lifestyle/ dietary changes are worth considering first. Informed choice of alternatives to invasive procedures are worth considering. Not only can this save money but less likely to use emergency services and more likely to stick to their plan of care.
Main areas for person-centred care also includes Mental Health, Learning Disabilities and End of Life. It is important to get the balance right ensuring safety, comfort, and well-being. Values, food choices, individual needs can be discussed with family members and aim to plan care taking these issues into account.
New Models of Vanguard sites highlights the following:
- Care and support, personalised, coordinated, empowering.
- Services created in partnership with citizens and communities.
- Focus on equalities and inequalities.
- Carer identified, supported and involved in plan of care.
- Voluntary, community and social enterprise and housing sectors are involved as key partners and enablers.
- Volunteering and social activities recognised as key enablers.
Community focused health and social care
It is not only important to provide person-centred medical treatment but community focused health and social care. If an elderly patient is treated in hospital and can leave to a safe environment for rehabilitation, a valuable hospital bed becomes available for someone in need. Are there suitable places to discharge patients from hospital? Many patients would prefer to leave hospital and have rehabilitation at home. Are there carers available to provide appropriate rehabilitation and care? Care planning and risk assessments need to address individual needs and values such as dietary choices, hobbies, religious, cultural and personal likes and dislikes. Family input can also be important to enhance the plan of care.
Recruitment and training
Recruitment is an important factor to consider. Promoting health care with the relevant training and support can lead to a valuable career. Knowledge of current social, political, environmental, economic and cultural values will enable the professional to take individual needs into consideration when implementing a plan of care or treatment. This can lead to person-centred care and compliance to treatment. Management must take into consideration time to spend with patients to achieve good care planning and documentation. Keeping patient and family contented can reduce the number of complaints and possible compensation claims if anything of importance has not been considered. It is also worth considering the professional and making sure that appropriate support is available when dealing with sensitive or distressing issues. Staff are human too and may have a family with similar problems. To reduce stress in the workplace requires good management skills and organisation to avoid work overload. It is more likely to retain staff when support is available and management work with the team and understand some of the problems faced when they aim to provide person centred care. Community visits, for example requires time for the carer to get to the patient, provide a care plan and risk assessment and provide care. Time allowed for each patient must allow for this – it can be stressful if a carer is late for the next patient.
Technology
Technology can improve certain aspects of care provision. However, it cannot replace the need for human contact. Sometimes there can be too much information and cause conflicting views and treatment. Systems being set up must be accessible to everyone – General Practitioners have set up their systems for patients online – however, many do not have access to the internet. Elderly patients still need to see the receptionist or wait in the queue on the telephone. Artificial Intelligence (AI) is now being used in some areas such as diagnostic tests and some operation procedures. This can reduce waiting times for these appointments and assist the medical teams on their diagnosis. Ethical issues need to be considered when providing care: confidentiality is important when discussing patients’ needs face to face – storage of information must be safe and secure.
Conclusion
To improve quality of health and care for patients and communities it is important to give information that is clear, accurate, evidence based, up to date to allow patients to become better informed and more involved in their health care. (NHS England 2008)
Developing a workforce
By developing a workforce with appropriate skills and competencies will improve sense of wellbeing and feeling of involvement in their plan of care. Dignity, compassion, and respect when offering personalised care, support or treatment enables people to develop their own strengths and abilities to live an independent and fulfilling life. CQC (2008). Person centred care is both beneficial to patients and to staff. Allowing time to spend with the patient and the family is important to understand what their values, needs and fears are and making sure they have an informed choice.
Support and knowledge
Person centred care is implemented in many areas such as Mental Health, Learning Disabilities and End of Life Care. These areas deal with sensitive issues and requirements and family input is important. Professional knowledge will require an understanding what the patient’s values and fears are. If a parent, who is going to look after the children when they have treatment? If I must have time off work, who is going to pay the bills? I live alone, how can I afford to heat my home or meet dietary needs? Sometimes it may be necessary to contact support in other areas to reduce the stress such as Citizen’s advice, Macmillan Team or Local Support Teams.
Education
School education can be a valuable source of knowledge and children can be aware of any risks or dangers to their health. Good diet, exercise and well-being will be a good start to ensure a healthy life. Technology can be an advantage to learning but it is important to get the balance right and avoid addiction to phones or computers and not be overwhelmed by excessive information. Access to services and activities must be improved for all to ensure fulfilling lives and reduce isolation and depression.
Person centred care can benefit the patient, family and the multidisciplinary team members. Considering individual values and needs will enhance communication and compliance to treatment. This can save money in the long term and provide quality of care for all.
References
Care Quality Commission (2008)
Health & Social Care Act 2008 (Regulation 9)
NHS England ( 2008)
Person-centred care. En.m.wikipedia.org
New models of Care Vanguard sites. Hee.nhs.uk
