15 Person Centred Care
15.1 Taken as a group, the survey results relating to person-centred care provided a mixed picture. Some characteristics reflective of person-centred care, such as staff listening to patients/service users and explaining things appropriately received amongst the most positive results in the survey.
15.2 However, questions relating to tailoring or involvement in services were less positively answered. Over a third of GP patients were not involved in decisions about their care and treatment as much as they would like, and users of care services scored 'I had a say in how my help, care or support was provided' as their lowest ranked statement.
15.3 An important element of the NHSScotland Quality Strategy4 is to support person-centred care. Similarly, delivering person or patient centred care is one of the six core competencies required to be a trained general practitioner. It is based on the concepts of autonomy, human rights and choice.
15.4 The Person-centred Health and Care Portfolio has been established to support ways to enhance person centred care and support. This involves putting people at the centre of care, ensuring that care that is responsive to individual personal preferences, needs and values and assuring that individual values guide all care decisions.
Consultation with GP medical staff
15.5 A key area where person-centred would manifest itself is in consultations between patients and GP health professionals. In this regard, there were some very positive findings. There was high agreement that Doctors or Nurses listened to patients (95% and 96% respectively) and that the Doctor or Nurse talked to patients a way that helped them understand their condition and treatment (90% and 91% respectively).
15.6 Additionally, that staff had treated patients with respect was one of the few findings where responses had grown more positive since the last survey, albeit slightly (91% vs 90%).
15.7 However, a negative finding related to the involvement of patients in decisions about their care and treatment. Over a third of patients were not involved as much as they would like. The bulk of these were involved 'to some extent' however.
15.8 Additionally, 'the doctor or nurse took account of the things that matter to me', a key aspect of person centred care, was the lowest scored statement in the set of questions for both doctors and nurses.
Out of Hours care
15.9 Findings were very similar for out of hours care as for consultations with nurses and doctors. 'I felt I was listened to' and 'things were explained to me in a way I could understand' were the highest rated of the Out of Hours statements and 'taking account of the things that matter to me' was the least positively answered.
15.10 A high number of social care users agreed that they were treated with respect and were treated with compassion and understanding (923% and 89% respectively). However, their lowest scored statement again related to involvement in care: 'I had a say in how my help, care or support was provided' (843%).
15.11 Taken together these findings suggest that health and care providers are generally good at listening to patients/service users, providing appropriate explanations and treating individuals well. All of which are foundations for person-centred care.
15.12 The findings relating to the involvement of patients and service users in their care and taking account of what matters to them suggest that these are being achieved to a lesser degree.
15.13 The question of what 'matters' is open to interpretation by the survey respondent. Further investigation would be required to establish the aspects of their situation that some respondents felt were not being taken account of. The free text comments left by respondents as part of the survey may offer some insight into this and these have been provided to GP practices, CHPs and Boards, and will be the subject of a separate Scottish Government report.
Email: Andrew Paterson
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