Is the NHS delivering patient-centred care?

Clearly, there is work to be done to deliver the goal of ‘person-centred’ health and care. As the NHS comes under financial pressure amid reports of shortages in staff, Louise Frampton believes the lessons learned from Mid Staffordshire provide a reminder that dignity, compassion and respect, which underpin the principles of ‘patient-centred care’, can be eroded if we are not vigilant.

The NHS Constitution, first published as part of the NHS Next Stage Review led by Lord Darzi, stated that: “NHS services must respect the needs and preferences of patients, their families and their carers. Patients, with their families and carers where appropriate, will be involved in and consulted on all decisions about their care and treatment.”1 This principle of ‘person-centred’ care was further strengthened in later versions of the Constitution and brought to the fore during the Mid Staffordshire inquiry. In the wake of the Francis report2 there was a renewed focus on providing care with ‘dignity, compassion and respect’, and Robert Francis QC set out 290 recommendations with the aim of fostering a ‘common culture’ shared by all of ‘putting the patient first’. This paved the way for the declaration of a commitment by the Department of Health, and all the system leading bodies across health and social care, to make ‘person-centred coordinated care’ the norm.3

In recent years, the NHS Five Year Forward View set out the vision for the future NHS including a new relationship with patients and communities to supports people to gain greater control of their own care. Personalised care and support planning was to be a key part of this shift.4 While there has been an increasing focus on this objective, how well has the NHS continued to perform in delivering person-centred care – has it become ‘the norm’? Furthermore, what exactly do we mean by ‘patient-centred care’ in actual practice, and can it be delivered at a time when staff and finances are under extreme pressure?