Comment

22.12.17

Person-centred care: is it really happening?

Source: PSE Dec/Jan 2018

Laura Bell of National Voices, the coalition of health and care charities, analyses the state of person-centred care and whether government rhetoric has matched reality.

For the last 20 years, policymakers have been talking about delivering ‘person-centred’ care – care that focuses on what’s important to the individual, is co-ordinated around their needs and involves them in decisions. Yet how much of a difference has this actually made for the people using adult health and social care services? We wanted to find out.

Using service user reported data from 19 national surveys, National Voices’ report, ‘Person-centred care in 2017,’ attempts to discover whether aspects of person-centred care are happening across health and care services in England.

What did we find?

Person-centred care means something different to everyone, because we are all individuals with our own different priorities and needs. However, we looked at the five key indicators of person-centred care: good information, good communication, involvement in decisions, care co-ordination and care planning.

We found that personalisation of care is more advanced in adult social care than in the NHS, with 89% of adult social care users reporting that the care and support they received helped them to have control over their daily life.

Similarly, 63% of people using a social care personal budget said that this had improved their ability to make everyday decisions. It is important to note, however, that in 2017 27% of personal budget-holders said they could not fully decide how their personal budget was spent, and anecdotally we are hearing of personal budgets being taken back or being restricted. These restrictions do not allow people control over their own healthcare.

Participation and control of decisions is well-established in adult social care, with just over 90% of those using community adult social care saying they were involved in decisions about their care and support needs.

It is a less positive picture in the NHS: in primary care, only 39% of patients said their GP was ‘very good’ at involving them in decisions. What’s more, personalised care planning doesn’t really happen. Only 3% of GP patients with one or more long-term conditions reported having a written care plan, suggesting that opportunities to deliver personalised care in the NHS are being missed. Similarly, although the Care Act 2014 embeds personalised care and support planning in adult social care, there is no national data collected on this, so it’s impossible to see if it is really happening.

What about the co-ordination of care?

With an ageing population where people increasingly have multiple needs or conditions, they are likely to need a range of health and social care support from different services.

To be person-centred, that care needs to work together to wrap around all the needs of the individual in a holistic way. Sadly, our report found that neither the NHS nor adult social care can demonstrate co-ordination of care, despite ‘integrated care’ being a key goal of all national and local leaders over the past five to 10 years.

The way health and care services work must change to reflect the needs of the population. It would be a start to recognise that co-ordination of care is an important factor, and that we need to be measuring whether it is happening.

It is clear from our report that a strategic overhaul of how care is measured is needed. Rather than single-service, single-setting, activity measures, more credence needs to be given to the experiences of the people who rely on services. Only then can we help local systems succeed in offering personalised, integrated and holistic care.

Whilst there have been some advances in the delivery of person-centred care, there is still a long way to go before the policy rhetoric matches the reality experienced by people.

Top Image: Ipopba

FOR MORE INFORMATION

Tw: @NVTweeting

W: nationalvoices.org.uk/publications

Comments

Peter Jones   13/01/2018 at 21:58

Hello A fascinating report which I would say under estimates the efforts on person centred care when tied to integrated care. Once upon a time the Dept of Health was the DHSS. Now of course the Sec of Health has taken on Social Care... PCC is a legacy problem. I have posted points from the report on my blog on a generic conceptual framework Hodges' model for health and social care: https://hodges-model.blogspot.co.uk/2018/01/national-voices-report.html Will tweet to NV also. Regards Peter Jones Lancashire @h2cm

Add your comment

 

related

public sector executive tv

more videos >

latest public sector news

Bill for cash-strapped council’s usage of ring-fenced money could be up to £16m

21/05/2018Bill for cash-strapped council’s usage of ring-fenced money could be up to £16m

 A new investigation into the usage of public funds by Northamptonshire County Council could levy the authority with a £16m grant bill... more >
Local authority’s enhanced powers ‘ripe for misuse’ for convicting hundreds of homeless, new figures show

21/05/2018Local authority’s enhanced powers ‘ripe for misuse’ for convicting hundreds of homeless, new figures show

People sleeping rough on Britain’s streets have been fined, given criminal records, or even imprisoned due to enhanced council powers to re... more >
Council calls on Whitehall to fix ‘broken’ funding system, rejects claims of bankruptcy

21/05/2018Council calls on Whitehall to fix ‘broken’ funding system, rejects claims of bankruptcy

A Conservative-controlled council has called on the government to sort out its “broken” funding system, and claimed it was not going ... more >
149x260 PSE Subscribe button

the raven's daily blog

The complexities of Brexit and the hunt for exceptional data scientists

16/04/2018The complexities of Brexit and the hunt for exceptional data scientists

Christopher Gallagher, public sector – SAS, says it’s imperative that organisations have the most experienced data scientists at hand. The Civil Service is feeling immense Brexit stress. Making the right decisions, analysing the ‘best interests’ of the nation as a whole, as well as discrete segments of the populati... more >
read more blog posts from 'the raven' >

interviews

GDPR: The public sector scarecrow

03/04/2018GDPR: The public sector scarecrow

SPONSORED INTERVIEW PSE’s Josh Mines chats to Martin de Martini, CIO of Y Soft, about what the General Data Protection Regulation (GDPR)... more >
Data at the heart of digital transformation

03/04/2018Data at the heart of digital transformation

SPONSORED INTERVIEW Grant Caley, UK & Ireland chief technologist at NetApp, speaks to PSE’s Luana Salles about the benefits of movin... more >
Keeping London safe

05/03/2018Keeping London safe

Theo Blackwell, London’s first-ever chief digital officer (CDO), speaks to PSE’s Luana Salles about the role he plays in ensuring the... more >
BIM: Digitising the public sector

19/02/2018BIM: Digitising the public sector

PSE’s Josh Mines talks to Stephen Crompton, CTO at GroupBC, and Stuart Bell, the company’s sales and marketing director, about how Bu... more >

last word

The importance of openness after Grenfell

The importance of openness after Grenfell

Following the recent Grenfell Tower tragedy, Lord Porter, chairman of the LGA, argues that if the public are going to have faith in the safety testing process then everything must be out in the o... more > more last word articles >

editor's comment

25/10/2017Take a moment to celebrate

Devolution, restructuring and widespread service reform: from a journalist’s perspective, it’s never been a more exciting time to report on the public sector. That’s why I could not be more thrilled to be taking over the reins at PSE at this key juncture. There could not be a feature that more perfectly encapsulates this... read more >

public sector focus

The legacy of Grenfell

30/04/2018The legacy of Grenfell

PSE’s Seamus McDonnell looks at the rea... more >
Inquiry warns of ‘lack of transparency’ around child sexual abuse failures

27/04/2018Inquiry warns of ‘lack of transparency’ around child sexual abuse failures

There has been a “lack of transparency&rd... more >