Are patients really ‘at the centre’ of integrated care?

Patient centred care

For some time now, the Government has been promoting its policy of ‘person-centred care’. In fact, the term was first introduced in the NHS Plan and other government policy documents in 2000.

What is person-centred care?

According to the Care Quality Commission (CQC), person-centred care is defined as ‘providers making every reasonable effort to provide opportunities to involve people in making decisions about their care and treatment and supporting them to do this’.

Since then, we have seen governments come and go with not much progress being made to ensure patients are at the heart of their own health and social care plans and treatment.

What are the latest developments in person-centred care?

Patient surveys have shown that there are still large gaps between the ambition of a person-centred health service and the reality or patient perception of their experiences.

In December, a report was published by the House of Lords entitled Patients At The Centre: Integrating Primary and Community Care. The purpose of the report was to look at the quality and accessibility of healthcare services and how primary and community care can work in a more integrated way to benefit patients and achieve that elusive ambition of ‘person-centred care’.

The report highlighted a number of major concerns with how the NHS is run, stating that ‘The NHS has failed to improve its organisational structure, funding mechanisms, infrastructure, and workforce to meet this challenge (of an aging population with multiple health conditions). As a result, it is ill-equipped to meet current healthcare demands, and its long-term sustainability is threatened.’

It went on to say that:

‘Patients are constantly being inconvenienced, endangered, or miss improved long-term health because they are not receiving joined-up care, in the right place, at the right time. Integration can help improve patient experience and offers a viable solution to many of the challenges facing the health service.’

The report suggests that the four main obstacles to achieving person-centred care through integration are:

  • Structures and organisations
  • Contracts
  • Data sharing
  • Workforce

Earlier this month, the Government published a response to this report, which has been widely criticised by those working in primary care.

What does all this mean?

Essentially the Government believes that Integrated Care Systems (ICSs) and Integrated Care Partnerships (ICPs) need time to ‘mature’ before their impact can be properly assessed. A study that will explore the impact of these system changes, formalised in the Health and Care Act 2022, has been described as ‘a multi-year project’ that will take ‘approximately three years to complete’.

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