How is patient-centred care understood by the clinical, managerial and lay stakeholders responsible for promoting this agenda?

Abstract

This study explores how the term patient-centred care is understood, particularly by those who are involved in translating the concept from a theoretical idea into a practical application. It examines the ways in which intermediate level stakeholders such as health service managers, educationalists, professional leaders and officers of patient bodies understand and promote patient-centred care among health professionals actually delivering patient care. Qualitative interview study. Interviewees were drawn from groups and organizations from four categories: health agencies and regulatory bodies, Royal Colleges and other professional bodies, educational institutions, patient and user groups and consumer organizations. The meanings and understandings of patient-centred care, commitment to implementing patient-centred care and barriers and opportunities to implementation. Patient-centred care covers a range of activities from patient involvement in individual care to public involvement in health policy decisions. Current Department of Health policy has made patient-centred care a priority, but has not clarified exactly what it means. Thus, health professionals, educationalists, managers and patient representatives have all developed different meanings of patient-centred care to reflect their own particular backgrounds and roles. The individual aspects of patient-centred care have been neglected in policy terms and important research findings have not been incorporated into policies to change the attitudes and behaviours of health professionals. Developing a shared understanding of patient-centred care which encompasses all its components is an important role for the new Commission for Patient and Public Involvement.