What is patient-centred healthcare?
Patient-centred healthcare, the healthcare of the future
The concept ‘doctor knows best’ has been accepted for centuries1. This is understandable, as doctors spend many years gaining specialist medical skills and experience. However, while doctors are experts in diseases, no-one understands an individual patient’s own experience of a disease and how they get on with treatments better than the patient themselves. Patients live with their conditions every moment of every day, while a doctor or nurse usually only sees a particular patient every so often. This is why there has been a growing trend towards viewing patients as the most important member of their own healthcare team1.
The internet and social media have made it easier than ever for patients to share experiences with each other and gain a deeper understanding of their own condition. In addition, new health technologies such as wearable devices or heart monitors help patients measure their own health scores and learn what works best for them1. Patients have a unique perspective on their own needs, priorities and reactions to treatment, and should therefore contribute to a process of shared decision-making with healthcare professionals.
What does patient-centred healthcare mean?
According to the International Alliance of Patients’ Organisations (IAPO)2, patient-centred healthcare is based on five core principles2: 1) patients have individual needs and preferences; 2) patients have the right and responsibility to be involved in making decisions that affect their lives; 3) governments and healthcare organisations should involve patients when designing new healthcare policies; 4) patients must have access to safe, quality and appropriate health services, treatments, and preventive care (e.g.
vaccinations); 5) patients should be given the information needed to make decisions about healthcare, treatment and living with their condition.
Small changes can help to achieve care that is more patient-centred3. Some hospitals in England have introduced ‘what matters to me’ boards by patients’ beds, where they can write messages to their healthcare team4. Sharing their preferences (e.g. views about pain relief or the types of food and drinks they prefer) helps hospital staff provide care that takes these personal needs into account. Other health systems are trying to be more patient-centred by introducing a personal health budget, where patients (usually with long-term care needs) are allowed to decide how a certain amount of money may be spent to contribute to their care5.
Patient-centred care relies on well-trained healthcare teams who have the time and resources available to understand patients’ personal needs and educate them on how to start playing a greater role in their own care
What are the benefits of patient-centred healthcare?
Health improvements over the last century mean that more people are living longer with conditions like cancer, heart disease, and diabetes6. Many people also live with more than one condition, which means they may take several types of medicine or see different specialists.;Involving, educating and motivating patients about their own care will enable them to ensure each of their specialist healthcare teams knows what the others have recommended. This can help to avoid communication problems, reduce waste from unused medications, and increase the chance of patients getting the intended benefit from their treatment3. It has been found that people who are more involved in their own care are less likely to use emergency hospital services, more likely to stick to the treatment plans agreed with their doctors, and more likely to take their medication correctly7,8. This may lead not only to better health outcomes but also to more efficient use of healthcare resources.
Are there any challenges with achieving successful patient-centred healthcare?
Patient-centred care relies on well-trained healthcare teams who have the time and resources available to understand patients’ personal needs and educate them on how to start playing a greater role in their own care. It may also mean that healthcare providers need to consider investing in new technology (e.g. electronic health records) to help ensure patient preferences and agreed care plans are known by all health professionals treating them.
Once patients start taking greater control of their own care, the internet is often the first place they go for health information9. However, taking decisions based purely on information accessed online carries risks. Almost half of people responding to one survey admitted to using supplies of a painkiller that had been prescribed to someone else after diagnosing themselves online10. This can be dangerous, not only because you should never take medicine intended for another person, but also because a new diagnosis or change to a treatment plan should always be discussed with a healthcare professional. When reading information online, it is important to consider whether it is reliable, up-to-date and represents the viewpoint of experts rather than just one person’s opinion11. Your doctor should be able to recommend good websites and provide guidance on which types of online information to avoid.
New roles for ‘expert’ patients
Advances in modern technology and an increased focus on patient-centred care have meant that some patients are becoming real experts in their own conditions1. People like this can act as partners with their doctors in making healthcare decisions and may even be invited to help design research studies. In other cases, patients may use the knowledge they have gained through personal experience of a condition to help other patients. People who are able to make this sort of contribution to society are still in the minority of course but it’s possible for almost every patient to play a greater role in ensuring their own personal healthcare is as beneficial as it can be.
 deBronkart, D. From patient centred to people powered: autonomy on the rise. BMJ 2015;350:h148
 International Alliance of Patients’ Organisations, June 2007. What is Patient-Centred Healthcare? A review of definitions and principles. 2nd
Edition. Available from: http://iapo.org.uk/sites/default/files/files/IAPO%20Patient-Centred%20Healthcare%20Review%202nd%20edition.pdf [Accessed 20 April 2017]
 The Health Foundation, October 2014. Patient-centred care made simple. Available from: http://www.health.org.uk/publication/person-centred-care-made-simple [Accessed 20 April 2017]
 Guy’s and St Thomas Hospital, April 2014. What matters to me today – patients personalise their care. Available from: http://www.guysandstthomas.nhs.uk/news-and-events/2014-news/Named-nurse-board.aspx [Accessed 20 April 2017]
 NHS England. NHS Personal Budgets Frequently Asked Questions. Available from: https://www.england.nhs.uk/healthbudgets/understanding/faqs/ [Accessed 20 April 2017]
 World Health Organization Western Pacific Region, 2007. People-Centred Health Care: A Policy Framework. ISBN 978 92 9061 317 6 Available from: http://www.wpro.who.int/health_services/people_at_the_centre_of_care/documents/ENG-PCIPolicyFramework.pdf [Accessed 20 April 2017]
 National Institute of Health and Care Excellence (NICE), 2009. Medicines adherence: Involving patients in decisions about prescribed medicines and supporting adherence. Available from: http://www.nice.org.uk/guidance/cg76 [Accessed 20 April 2017]
 De Silva D. Helping people share decision making, The Health Foundation, June 2012. Available from: www.health.org.uk/publications/evidence-helping-people-help-themselves. [Accessed 20 April 2017]
 HealthIT.gov. eHealth: Find quality resources. Available from: https://www.healthit.gov/patients-families/find-quality-resources [Accessed 20 April 2017]
 The Guardian, November 2016. DIY diagnosis of illness is dangerous trend, say pharmacists. Available from: https://www.theguardian.com/society/2016/nov/14/diy-diagnosis-of-illness-is-dangerous-trend-say-pharmacists [Accessed 20 April 2017]
 US National Library of Medicine. Evaluating health information. Available from: https://medlineplus.gov/evaluatinghealthinformation.html [Accessed 20 April 2017]