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As the NHS Commissioning Assembly annual event gets underway in London, Dr Katie Coleman, a GP and Vice-Chair of Islington CCG, explains how person centred care can become a reality:
Sir William Osler, the renowned Canadian physician, led nineteenth century thinking on what became known as the ‘patient as a person’ movement. This was a reaction against the scientific reductionism of medical advances and a focus on patients as a collection of separate diseases and body parts.
“The good physician treats the disease,” he said, “but the great physician treats the patient”.
In 2014 this holistic method chimes with a family of approaches under the banner of person centred care. A growing body of evidence shows that treating people and their carers’ as equal partners in the care process, and creating access to the right information, can make a big difference.
Taking account of individual skills, knowledge, confidence, hopes and preferences in a genuinely collaborative care planning process can ultimately lead to better outcomes for the person. Health and care professionals report greater job satisfaction with this type of care and it has been shown to be more cost effective.
Simon Stevens, Chief Executive of NHS England, has talked of a coming revolution in the role people will play in their own healthcare and is backing a new programme to this end. NHS England’s ‘Five Year Forward View’ to be published in October will hopefully continue this theme.
In Islington person centred care has been a priority for almost ten years. Today, as a GP and commissioner, I can see how successful this approach can be in supporting people to improve their health and well-being.
As part of our endeavour to build Islington’s ‘house of care’, care and support planning is offered routinely in general practice to patients with COPD and diabetes. Individual’s identify personal goals and, if required, can be referred to health navigators, commissioned from Age UK Islington.
Health navigators then support people to achieve a positive outcome through accessing community and voluntary services such as peer to peer support and onward referral to expert patient programmes. Across the country colleagues are embarking on similar projects based on the evidence that shows what a difference person centred care makes to people’s lives.
Healthcare has changed spectacularly since Sir William Osler’s time. As a result people are now living much longer and long-term conditions have replaced infectious diseases as the main healthcare challenge in our time.
The challenge for commissioners is to respond to this and work with colleagues inside and outside of NHS structures to move person centred care in to the mainstream of healthcare provision.
Though progress is being made, moving to a person centred system will not be an easy task. Implementation requires the unlocking of levers and barriers nationally and locally, commitment and culture change and the spreading of innovation at pace and scale.
To help with this challenge I will be chairing a sub-group of the NHS Commissioning Assembly Partnerships and Participation Working Group which will explore how together we can make this happen.
The new group will learn about, share and test new ideas for bringing person centred care into the mainstream of commissioning practice. The group will also have the opportunity to shape NHS England’s national programmes on Patient Participation to ensure they are focused on supporting best commissioning practice in this area.
By insisting that doctors learned by the bedside and treated the whole person, Sir William Osler brought about a cultural change that still has an impact today. Person centred care, where the person’s needs are heard and acted on in participation with their health or care professional, has the potential to have a similar impact today.
* If you would like to join the group and help us bring about this change please get in touch and email firstname.lastname@example.org.