What is patient-centred care
Patient-centred care is a move towards a type of healthcare in which the patients’ needs and desires are the focus of every conversation and decision. The Institute of Medicine describe this as ‘providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions.’ [1]
The active patient is taking a greater involvement in their treatment and the conversations surrounding it, and healthcare professionals need to walk side-by-side their patient on their healthcare journey. This video by the World Health Organisation highlights the importance of this shift towards people-centred care.
The importance of the doctor-patient relationship
The General Medical Council, a highly prominent medical regulatory body in the UK, had this to say about the importance of the principles of informed consent:
‘Successful relationships between doctors and patients depend on trust. To establish that trust you must respect patients’ autonomy—their right to decide whether or not to undergo any medical intervention . . .’ (They) . . . must be given sufficient information, in a way that they can understand, in order to enable them to make informed decisions about their care.’ [2]
General Medical Council, ‘Seeking patients’ consent: the ethical considerations.’
Developing a relationship of trust with a patient is a crucial part of establishing a form of healthcare which is personalised, proactive and patient-driven.
Why is it so vital
Ensuring the patient understands the information they’re given and feels that their concerns regarding their treatment are being heard is a vital part of the doctor/patient relationship. Len Doyal, Professor of Medical Ethics at Queen Mary University of London, assesses the dangers when patients don’t understand what their doctor is saying:
‘The most potentially damaging research suggests that patients are unable to understand or remember the details of the information required for educated choice.’ [3]
Len Doyal, ‘Informed Consent: Moral necessity or illusion?’
It is for this reason that healthcare professionals should adhere to this important standard. If what matters most to the patient is truly at the forefront of every conversation, then a situation should never arise in which a patient leaves the conversation feeling unsure of their treatment or unable to ask questions.
How do we implement it
A study undertaken by BMC Public Health found that in order for patient-centred care to be properly implemented, it had to be integrated into every level of healthcare organisation. [4]
There are numerous ways this model of patient-centred care can be implemented in hospitals and become common-practice:
- Information and education – Adhering to the ruling laid out by the Supreme Court in the 2015 Montgomery v Lanarkshire Health Board court case, clinicians must now assess what the reasonable patient would wish to know, not what they as a healthcare professional think is best. Keeping a patient involved and informed in their care is the best way to ensure that when consent is taken it is completely informed and valid.
- Emotional support – The mental and emotional wellbeing of a patient is paramount to ensuring the best possible care. Helping manage patients’ fear and anxiety about their current condition is critical to this.
- Continued care – The healthcare journey doesn’t end after discharge. Ensure patients are well equipped with clear and detailed information about life after their procedure, to which they can refer back whenever they wish.
These are just some of many steps which can be taken in order to implement the patient-centred approach. In putting the patient’s needs at the forefront of every conversation and ensuring patient values guide every clinical decision, the entire process is a harmonious one for doctors and patients.
Our Annual Consent Review helps clinicians keep up to date with the latest legal cases related to medical consent in the wake of Montgomery, offering advice and learnings from the judgements. Links to previous editions can be found here, and the latest edition can be emailed directly to you using the form on the EIDO Healthcare Homepage.
[1] Institute of Medicine, ‘Crossing the Quality Chasm: A New Health System for the 21st Century’ (2001) p. 3.
[2] General Medical Council, ‘Seeking patients’ consent: the ethical considerations’, London: General Medical Council (1999).
[3] Len Doyal, ‘Informed Consent: Moral necessity or illusion?’, BMJ Journals (2001).
[4] BMC Health Services Research, ‘How can healthcare organizations implement patient-centered care? Examining a large-scale cultural transformation’ (2018).
