Person centred care

What is Person Centred Coordinated Care (P3C)?

Person-centred care is an approach to healthcare that values people as individuals and as equals, and recognises their strengths. It is a core NHS aim in the improvement of healthcare quality, and a number of policies (both national and international) promote a more person-centred approach in the delivery of healthcare.

Person centred coordinated care (or P3C) emphasises the importance of care coordination. This is particularly important for people with long-term health conditions, as they often receive care and treatment from multiple health and/or social care professionals. We define P3C as ‘Care that is guided by and organised effectively around the needs and preferences of the individual and their support network’.

We work together as part of a team of researchers, healthcare professionals and members of the public to develop a better understanding of what P3C is and how to implement it. We are also interested in establishing how to demonstrate P3C improves the experiences and outcomes of professionals and patients. Our focus on ‘applied’ health and social care research that will directly benefit people.

Why P3C matters

Fragmentation and poor care coordination are enduring problems for health and social care systems. These problems have the greatest impact on those who rely on healthcare services most, such as older people and those with complex health and social needs. P3C has the potential to improve healthcare quality, efficiencies and outcomes by implementing a modern integrative care system around the individual.

P3C is often seen as important because it promotes a philosophy of empowerment, dignity and respect of the person, and emphasises that care needs to be tailored to their needs and preferences if it is to be experienced as appropriate and good quality care.

Trials of Person centred care have shown links to quicker recovery times, less time in hospital, and better symptom relief. These studies focused on people with arthritis, hip-fracture, chronic heart failure, acute coronary syndrome, cancer, palliative care, mental illness, and dementia. These studies of person-centred care in single long term conditions are important, but P3C may be even more vital in improving care processes and outcomes for people with multiple conditions. This is the central focus of our work through a number of interlinked work packages that seek to 1) develop a conceptual framework for P3C, 2) study the implementation of these models of care, 3) advance the measurement of P3C and 4) share this learning with practice organisations to improve care delivery and outcomes. 

Speaker biographies

Inger Ekman, University of Gothenburg Centre for Person-Centred Care (GPCC)

Inger Ekman is Professor in Care Sciences, Sahlgrenska Academy, University of Gothenburg. During the period 2006-10 she was Head of Institute (prefekt) of Health and Care Sciences, and 2010–12 Vice Dean at the medical faculty (Sahlgrenska academy). Inger's research focuses on communication and symptoms in patients with long term illness, and evaluation of person-centred care interventions. She has more than 100 publications in scientific journals and is the founding Director of GPCC. Research on person-centred care is the focus of GPCC which is built on a large governmental grant (15 million Euros) involving about 30 multidisciplinary research groups in for example care sciences, medicine, pedagogics and economics. Since 2016 Inger is also the coordinator and chair of COST 15222, a European initiative (with 27 countries are partners) on testing implementation of person-centred care and health promotion within the frame of cost containment with maintained or improved quality of care in Europe. 

Karl Swedberg, University of Gothenburg Centre for Person-Centred Care (GPCC)

Karl Swedberg is Senior Professor of Medicine, Sahlgrenska Academy, University of Gothenburg, and Professor of Cardiology, National Heart and Lung Institute, Imperial College, London. His research interests include beta-blockers and angiotensin-converting enzyme inhibitors (ACEIs) and their effects on heart failure (HF) and myocardial infarction (MI), neuroendocrine activation in HF and the treatment of chronic HF. Karl was the first to report on the survival benefits of a beta-blocker (1979), ACEI (1987) and angiotensin receptor blocker (2003) in chronic HF. He has published widely, including over 330 original research papers and 25 textbook chapters. He was included in the 2016 listing of Highly Cited Researchers by Thomson-Reuters.

In addition, he has been a steering committee member for numerous outcome trials in HF and MI and is a member of the Executive Committee for the PARADIGM-HF trial. Karl received the 2004 Kaufman Award from Cleveland Clinics (USA) for his HF research, the European Society of Cardiology Gold Medal 2007 for his outstanding contributions to the cardiovascular field and in 2016 the Lifetime Achievement Award from Heart Failure Association (HFA). He has been an Honorary Member of the Thai Heart Association since 2007, the Swedish Society of Cardiology since 2008, and the Japan Circulatory Society since 2009. In addition, he was Editor-in-Chief of the European Journal of Heart Failure from 2005 to 2009. He is associate Editor of the European Heart Journal since 2012.

Dr Helen Lloyd, University of Plymouth

Dr Helen Lloyd is a PenARC Senior Research Fellow (Qualitative) in the Institute of Translational and Stratified Medicine at the University of Plymouth. A central theme of her work with PenARC focuses on complex interventions and experiences of care. She is currently co-leading the Person Centred Coordinated Care (PCCC) collaborative with Professor Richard Byng. The aims of this work involve creating a shared understanding and a taxonomy of components of PCCC to map the different ways in which models deliver this type of care. Helen and Richard are also using practice-based innovation to build robust theory about what forms of PCCC work for whom in what circumstances. Helen is also supporting the activity of several projects across the CLAHRC. The Partners 2 study is a multi-site PGfAR funded study developing and piloting a system of primary care based collaborative care for people with severe mental illness.

Research papers

Sugavanam, T, Fosh B, Close J, Byng R, Horrell J & Lloyd HM 2018 'Codesigning a Measure of Person-Centred Coordinated Care to Capture the Experience of the Patient: The Development of the P3CEQ' Journal of Patient Experience , DOI / PEARL

http://journals.sagepub.com/doi/pdf/10.1177/2374373517748642

Lloyd H, Wheat H, Horrell J, Sugavanam T, Fosh B, Valderas JM & Close J 2018 'Patient-Reported Measures for Person-Centered Coordinated Care: A Comparative Domain Map and Web-Based Compendium for Supporting Policy Development and Implementation' Journal of Medical Internet Research 20, (2) e54-e54 , DOI / PEARL

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5830608/

Close J, Valderas JM, Byng R, Britten N & Lloyd H 2017 'FUTURE OF QUALITY AND OUTCOMES FRAMEWORK Adapting QOF to focus on wellbeing and health' BMJ-BRITISH MEDICAL JOURNAL 359, Author site, DOI / PEARL

https://www.bmj.com/content/359/bmj.j5541

Lloyd H, Pearson M, Sheaff WR, Asthana S, Wheat H, Sugavanam T, Britten N, Valderas J, Bainbridge M & Witts L 2017 'Collaborative action for person-centred coordinated care (P3C): an approach to support the development of a comprehensive system-wide solution to fragmented care' Health Research Policy and Systems, DOI / PEARL

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5700670/

Horrell J, Lloyd H, Sugavanam T, Close J & Byng R 2017 'Creating and facilitating change for Person-Centred Coordinated Care (P3C): The development of the Organisational Change Tool (P3C-OCT)' Health Expectations Author Site , DOI / PEARL

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867330/

Behrman S, Wilkinson P, Lloyd H & Vincent C 2017 'Patient safety in community dementia services: what can we learn from the experiences of caregivers and healthcare professionals?' Age and Ageing 46, (3) 518-521 , DOI / PEARL

https://academic.oup.com/ageing/article/46/3/518/2654235

Lloyd H, Jenkinson C, Hadi M, Gibbons E & Fitzpatrick R 2014 'Patient reports of the outcomes of treatment: a structured review of approaches' Health and Quality of Life Outcomes 12, (1) 5-5 , DOI / PEARL

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899626/pdf/1477-7525-12-5.pdf

Lloyd H, Witts L, Callaghan L, Horrell J, Roberts J, Byng R, Blackwell R & Close J 2015 AN EVALUATION OF THE SOMERSET PRACTICE QUALITY SCHEME (SPQS). Academic Health Science Network Publisher site

https://www.swahsn.com/wp-content/uploads/2016/06/Evaluation-of-the-Somerset-Practice-Quality-Scheme-July-2015.pdf

Person-centred care – ready for prime time, European Journal of Cardiovascular Nursing, Ekman I, Swedberg K, Taft C et al (2011)