Person Centred Care

Demonstrating ‘respect for patients’ values, preferences and expressed needs,’ is one of the eight dimensions of person centred care outlined by the Picker Institute (ref). Morgan and Yoder (2012) described ‘respectful care’ as being an attribute of person centred and while the author does not disagree with this idea of ‘respectful care’ being inherent to person centred care, the author believes that Slater (2006) more accurately describes dignity and respect as being antecedents of person centred care. These antecedents drive respect of personal values, individual needs and decisions, a consequence of which is an improved therapeutic relationship and health outcomes. The author considers this view of dignity, compassion and respect as antecedents

‘More care, less pathway: a review of the Liverpool care pathway’ (Neuberger et al, 2013). However the author considers pathways are an important component of person centred care if presented in the form of an a la carte rather than a set menu. Pathways can be used as a resource to talk through choices with patient. Pathways support practitioners and patients to navigate through the range of services that are available to meet individual needs and preferences. Within primary care and community services, this is frequently a challenge due to the sometimes short term nature of pilot projects that commence and do not continue following evaluation or services which close after a short period due to funding changes. Van Herck et al (2004) completed a review of studies relating to patient pathways and found 62.2% of the studies demonstrated higher levels of patient satisfaction where pathways are in

3.3% of patients have a written care plan of whom 71% had helped to put it together. 67% reported they utilise their care plan day to day to manage their own health Unfortunately it is not evident from the findings what percentage of patients who had contributed to their care plan use it day to day compared to those that had not contributed. These findings which have been relatively consistent in recent years suggest the existence of other barriers to person centred care.

One of these barriers may be the challenge of changing existing mindsets of clinicians to move from the biomedical models of care to a biopsychosocial model, from expert to partner. As leaders we need to be able to actively respond to concerns and make the case for change, demonstrating the value (Health Foundation, 2014b). Within the authors organisation patient stories have been a powerful tool in achieving