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

Former Westminster council pensions boss found guilty of £1m fraud

16/10/2018Former Westminster council pensions boss found guilty of £1m fraud

A former employee of Westminster City Council has been found guilty of stealing nearly £1m from the council pension fund. Ian Woodall,... more >
Protesters gather as councillors meet to discuss mass children’s centre closures

15/10/2018Protesters gather as councillors meet to discuss mass children’s centre closures

Demonstrators and parents have gathered outside County Hall in Norwich to protest against planned mass children’s centre closures as Norfol... more >
'Pioneer' Wigan Council CEO announces retirement

15/10/2018'Pioneer' Wigan Council CEO announces retirement

The chief executive of Wigan Council Donna Hall CBE has announced her retirement, after winning national acclaim for forging a new model of local... more >
149x260 PSE Subscribe button

the raven's daily blog

What cities should become

15/10/2018What cities should become

Tom Leaver, project manager at Future Cities Catapult, examines the rationale behind the creation of the City Data Sharing Toolkit, and explores how this is driving a seismic shift in how cities evolve into our data-rich future. We’re used to big-screen sci-fi future cities being dystopian monoliths to everything wrong with the worl... more >
read more blog posts from 'the raven' >

interviews

Keeping the momentum of the Northern Powerhouse

15/10/2018Keeping the momentum of the Northern Powerhouse

On 6 September, the biggest decision-makers of the north joined forces to celebrate and debate how to drive innovation and improvement through th... more >
Michael King: Time for Ombudsman reform

06/08/2018Michael King: Time for Ombudsman reform

Michael King first joined the Local Government Ombudsman service back in 2004 as deputy ombudsman. At the start of 2017, he was appointed as the ... more >
Helping a city understand itself

06/08/2018Helping a city understand itself

SPONSORED INTERVIEW The urban landscape is changing. How can local authorities keep up with citizen behaviour? Stephen Leece, managing directo... more >
Modern policing: the future is bright

06/08/2018Modern policing: the future is bright

SPONSORED INTERVIEW The public sector, and policing in particular, has often been criticised as being slow to adapt to change. But now, says L... 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