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NHS England’s Deputy Director for Long Term Conditions makes her own declaration:
Person-Centred Care seems to be the latest thing the NHS has suddenly got excited about, but is it real, is it of value, will it last, or is it the latest fad?
A famous quote by the famous physician William Osler (1849 – 1919) reminds us “the good physician treats the disease; the great physician treats the patient who has the disease” – so maybe it’s not so new.
The term itself has different definitions however, the consensus is that person-centred care takes into account service users’ needs, preferences and strengths, and that people who are using services have the opportunity to make informed decisions about their care and treatment, in partnership with their health and social care practitioners. The Health Foundation defines it as personalised, co-ordinated, and enabling, and treating people with dignity, compassion and respect.
For many, person-centred care is seen as ‘nice to do’, with a level of cynicism as to the value of it, the impact it can have, and the ability of both patients and clinicians to “do” person-centred care, despite some pretty compelling evidence that it improves clinical outcomes, quality of life and can reduce cost; but more importantly it can help people living with long term conditions thrive rather than just survive.
Even when the power of person-centred care is recognised, in a system where demand is increasing, time is precious and ways of working seem to be entrenched, it can be incredibly difficult for clinicians and patients to change how they can work together. I heard a phrase recently from a GP in Ealing, that the current form of health care provision is “nowism”, treating what’s in front of you at that point in time or to use another well-known phrase “putting a sticking plaster over the problem”.
But it doesn’t have to be like that. There are some great examples of person-centred care in action: patients using a plan on a page to support consultations; clinicians writing letters with the patient in the room; care and support plans that are owned by the patient and taken with them wherever they hit the system; care co-ordinators helping individuals to navigate around the system – we want to help this way of working together with patients become the norm.
There are certainly system changes that need to be made. However, there are also simple actions that individuals can take that can have a huge impact. As a starting point we have just published “Our declaration: Person-centred care for Long Term Conditions” which sets out to help describe what person-centred care should look like. It was developed with people with lived experience of Long Term Conditions, clinicians and many other stakeholders. We’re asking people who want to see real change towards person-centred care sign up and pledge their own actions; to make their personal declaration.
We want to encourage people to think about what person-centred care means to them, talk to others about it, and practice being person-centred in their interactions as clinicians and patients – perhaps even a simple change for both from asking “what’s the matter with you/me” to “what matters to you/me today” could help a different conversation happen with different results for all concerned.
My own declarations are both personal and work based. On a personal level I have pledged to support my family and friends – who between them have a significant numbers of LTCs under their belt – to understand what person-centred care means to them and how they can work with their local clinicians to co-produce their care.
In my role within NHS England I have pledged to continue to raise awareness of the importance of person-centred care and to progress national actions to facilitate real change on the ground, for instance the results of a recently commissioned ethnographic research.
So what do you believe – fantasy, fad or far-reaching in it’s potential? And if it’s the latter, what will your declaration be? Tell us at www.engage.england.nhs.uk/survey/ltc-declaration