Abstract
BackgroundPerson Centred Coordinated Care (P3C) is a UK priority for patients, carers, professionals, commissioners and policy makers. Services are developing a range of approaches to deliver this care with a lack of tools to guide implementation.MethodologyA scoping review and critical examination of current policy, key literature and NHS guidelines, together with stakeholder involvement led to the identification of domains, subdomains and component activities (processes and behaviours) required to deliver P3C. These were validated through codesign with stakeholders via a series of workshops and cognitive interviews.ResultsSix core domains of P3C were identified as follows: (i) my goals, (ii) care planning, (iii) transitions, (iv) decision making (v), information and communication and (vi) organizational support activities. These were populated by 29 core subdomains (question items). A number of response codes (components) to each question provide examples of the processes and activities that can be actioned to achieve each core subdomain of P3C.ConclusionThe P3C‐OCT provides a coherent approach to monitoring progress and supporting practice development towards P3C. It can be used to generate a shared understanding of the core domains of P3C at a service delivery level, and support reorganization of care for those with complex needs. The tool can reliably detect change over time, as demonstrated in a sample of 40 UK general practices. It is currently being used in four UK evaluations of new models of care and being further developed as a training tool for the delivery of P3C.
Highlights
The current UK fiscal climate is demanding greater efficiency and cost-saving across public sector organizations
In a European context, Ekman et al have provided a guide on how to approach Person Centred Care (PCC) through the development of three routines based around (i) eliciting the individuals narrative, (ii) the cocreation of a plan of care and (iii) documenting this plan within a care plan.[4]. Lloyd has expanded this into four routines to fully encompass the needs of those with complex needs; (iv) an agreement to act in conjunction with the person and other professionals to coordinate care.[11]
We found evidence of only one co-created quality improvement organizational tool that encompassed an element of PCC.[18]
Summary
The current UK fiscal climate is demanding greater efficiency and cost-saving across public sector organizations. The NHS in particular is facing unrivalled challenges to do more with less and deliver better quality and more efficient care whilst reducing deficits.[1,2] It is in this context that a move away from disease-based models towards a more effective, integrated, and person-c entred approach is perceived as a. Methodology: A scoping review and critical examination of current policy, key literature and NHS guidelines, together with stakeholder involvement led to the identification of domains, subdomains and component activities (processes and behaviours) required to deliver P3C. These were validated through codesign with stakeholders via a series of workshops and cognitive interviews. It is currently being used in four UK evaluations of new models of care and being further developed as a training tool for the delivery of P3C
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