The report explores what is meant by patient centred care, the case for change, some of the current barriers and opportunities and what needs to happen to implement patient centred care.
The inquiry, which was chaired by former NHS Confederation Chief Executive Mike Farrar, 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. It describes the core elements of patient centred care as:
- A ‘whole person’ rather than disease-specific approach
- Flexible care tailored to an individual’s personal priorities, needs and individually defined outcomes
- A collaborative relationship between patient and professionals involved int heir care, through which patients are empowered to be equal partners in their own care.
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. It proposes a series of approaches to making five key changes:
- Empowering patients, carers and communities
- Supporting patient centred professional practice
- Enabling service providers to change
- Improving commissioning
- Creating the right operational and policy infrastructure
To support these changes, the inquiry calls on the Government, NHS England and other stakeholders to work with patients and clinicians to:
- Move away from tick box clinical guidelines and performance indicators to an approach that recognises the need for care to be tailored to patients with multiple conditions and rewards professionals for respecting patients’ preferences.
- Increase resources for primary and community based care and create a primary care ‘transformation fund’ to enable changes in the way care is delivered to happen at pace and scale.
- Introduce flexible commissioning and funding arrangements that help to break down barriers between providers (in particular GPs and hospital-based physicians) and promote collaborative working.
- Implement NHS England’s ‘new deal for general practice’, building on its key strengths including an easily accessible, local point of access; comprehensive services from a generalist clinician; continuity of care; and the registered patient list.