Joining the dots on person-centred care

By Mike Smeeton, Director of Health and Social Care at Sue Ryder

In 2010 the pre-election healthcare debate was dominated by the 'C' word. It was almost impossible to tune into a debate or party political broadcast without hearing it.

Choice was the only show in town.

Five years down the line, the debate is much the same but the language is changing. This time round, you're much more likely to hear rhetoric dominated by person-centred care.

There's a subtle, but important, difference between the two.

It's hard to disagree that choice delivered some benefits, and that patients now have many more options open to them than at any time in the NHS' history. But there's still a nagging sense that in a number of areas the system is still trying to do healthcare 'to' people rather than 'with' them

That's because simply having lots of options doesn't encourage people to make the right choice for them. Without confidence, understanding and support, choice can actually be counter productive - it can paralyse decision-making and lead to an increased reliance on others. This is particularly true when people are at their most vulnerable: through illness or distress.

Person-centred care takes a more holistic approach. It places the needs of the individual at the core of their treatment and encourages collaboration with family and friends, as well as different clinical disciplines, to create shared health and care decisions.

This joined-up approach is already being used successfully in parts of the NHS. Maternity care, for example, is being transformed through better continuity of care and co-created birth plans, while mental health teams are adopting, as standard practice, a range of approaches that aim to treat conditions within the wider context of a person's life.

There are pockets of excellence within end of life care too, where co-ordinated and shared palliative care plans are helping patients in the latter stages of their lives to not only make choices, but to ensure those choices can be put into action when the time comes. Our own 24/7 coordinated palliative care support centre, PEPS, at Sue Ryder - St John's Hospice in Bedfordshire is a case in point, with round the clock access to a patient's care records as well as jointly agreed guidance on their end of life choices.

The challenge for whichever party takes home the electoral spoils in May will be to join these person-centred care dots and create consistency.

Because that's the thing about focusing care around the needs of individuals and their families - it has to fit with the way human lives play out. Babies are born at all hours of the day and night. A psychotic episode can be triggered at any time.

Maternity and mental health services recognise this and have round-the-clock support services in place across the board to support patients and their families, to try and help to make their choices real.

Within palliative care, this 24/7 support network does exist in some areas of the UK but many vulnerable people are missing out.

Our recent research revealed a shocking result that only 8% of local health services provide a comprehensive package of dedicated 24/7 advice and support which includes a specialist helpline and coordination service for people dying and their carers.

And that's why, as a first step towards joining the dots, we're calling for a Government commitment to extend access to 24/7 expert coordination, advice and emotional support for dying people, their families and carers across the entire country.

Our Dying doesn't work 9 to 5 campaign has person-centred care at its heart. It recognises the fact that people's greatest fear of death is that their loved ones may have to care for them on their own in their final hours.

It also acknowledges that the 'C' word, however well communicated, is meaningless without the support to be able to execute it at times of need.

Mike Smeeton

Before joining Sue Ryder Mike focused his career in the acute sector of the NHS. In this time he directed a broad portfolio of services including operational clinical services, ICT, Commercial Development, Capital Projects and Strategy Development. He has been a Board Director for over 10 years and also spent time as acting Chief Executive.