Review: Crafting person-centred intermediate care: one team’s journey towards integration and innovation

Abstract

Development of effective models to support intermediate care is at the forefront of health and social care reform within the United Kingdom, and whilst it could be argued that the key incentive driving this agenda is financial, such models are endorsed as promoting the well-being of older people living in the community. The interesting point, however, made in this paper is the challenges of implementing an agreed policy direction, and I quote ‘‘without a robust supporting evidence base or detailed blueprint’’. This study provides an excellent example of how developments in services can be evaluated using research methodologies that lend themselves to a real-life context, in order to contribute to the evidence base and enhance our understanding of what works in practice. This paper offers insight into the development of an innovative multi-disciplinary, multiagency model for person-centred intermediate care. In my view, the findings present a story of two halves. On the one hand we have patients who were largely satisfied with their care and who felt that they had made an appropriate recovery. On the other hand we have staff who were highly challenged by the change process recounting experiences that were largely negative. Some of the emerging themes identified as problematic for staff included: poor communication; lack of clarity regarding the integrated care model and roles/responsibilities; growth of factions within the team; professional judgments being disregarded; and the perception of leadership that was autocratic. I would concur with the authors’ conclusion that this highlights the complexity of person-centred care, and for me it reinforces the need to understand who we are referring to when we use the term ‘person’. In nursing, our understanding of person-centredness is as applicable to our colleagues as it is to the