What can we do to promote person-centred primary care? Response to BMJ spotlight

 Patient centred care invites doctors and patients to work collaboratively to improve the way healthcare is designed and delivered so that it better meets the needs and priorities of patients. Charlotte Paddison reflects on the BMJ spotlight on patient centred care, and asks what this might mean for primary care?

How can we get better at providing patient centred care?

According to the BMJ contributors, new electronic decision aids; patient access to clinician notes online; and care plans for all people with long term conditions, are the way forward. Indeed, these seem like useful suggestions. With one possible exception. See what patients had to say about care plans in research by my colleague Jenni Burt (1).

Call me old-fashioned, but I agree with the BMJ roundtable contributors that, ultimately, “healthcare is about relationships.”

If person centred care is about understanding the patient’s needs and priorities, then being able to see the same doctor each time you visit (relational continuity) seems a really important goal. So what is the evidence that patients really want this? Our recent research using the national general practice patient survey shows that, among people who have diabetes, 25% of those who preferred to see a particular doctor were unable to do so.Can we do better? I think we can. And should.

Primary care, in particular, has a crucial role here. GPs are well placed to provide care that gives continuity over time, enabling clinicians to understand the patient’s personal circumstances, social history, and to explore their health needs and priorities in the context of their ‘life world’. Continuity of care is especially necessary to provide quality care for people with multimorbidity, as Martin Roland and I have highlighted(2).

So how can we get better at providing patient centred primary care? Better use of technologies to engage and empower patients feature highly in the BMJ spotlight. Just as important might be promoting better relational continuity – not expensive, doesn’t require new resources, but perhaps not quite as sexy as the latest wearable activity trackers and patient apps on your ipad…


Interested to learn more?

The BMJ spotlight: Patient centred care

BMJ roundtable debate: How can we get better at providing patient centred care? BMJ 2015;350:h412

(1) Care plans and care planning in the management of long-term conditions in the UK: a controlled prospective cohort study  BJGP September 1, 2014: 64(626): e568-e575 doi: 10.3399/bjgp14X681385

(2) Roland, M., Paddison, C.A.M. Better management of patients with multimorbidity. BMJ 2013;346:f2510 doi: http://dx.doi.org/10.1136/bmj.f2510

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