In June 2014 the Royal College of General Practitioners commissioned an independent panel to lead an inquiry into patient centred care in the 21st century – with the aim of identifying cost effective solutions to the medical, social and financial challenges posed by rising levels of multimorbidity.
The report sets out to define what a ‘patient centred’ approach to care means and identify why it is important. It concludes that clinicians must work with patients in a very different way, providing personalised care and empowering patients to play an active role in managing their health. The report also calls for a seismic shift in the way that general practice is delivered, so that practices come together as federations or networks and work with a range of other services to deliver coordinated and proactive care in the community.
The report identifies three core, interrelated elements of patient centred care:
- A holistic–or ‘whole person’– approach to patient care, that considers an individual’s needs as a whole rather than treating medical problems in isolation.
- Flexible care that tailors support according to an individual’s personal priorities, needs and individually defined outcomes.
- The need for a collaborative relationship between patients and the professionals involved in caring for them, through which patients are empowered to be equal partners in their own care.
It sets out a number of changes to support the development of patient-centred services in the community based around general practice:
- Empowering patients, carers and communities through approaches such as supporting self-management and personalised care planning
- Supporting patient-centred professional practice, through approaches such as training and multi-disciplinary working
- Enabling service providers to change, through approaches such as encouraging collaboration between practices and improving out of hours care
- Improving commissioning through approaches such as co-commissioning and patient held budgets
- Creating the right policy and operational infrastucture through approaches such as developing clinical guidelines that reinforce patientcentred care and enable professionals to deliver personalised care
The report sets out a series of recommendations for action at different levels within the health system to enable these changes to be implemented.