UK: people not given adequate control of own healthcare

New research concludes that despite two decades of policy promises, NHS services still do not give people adequate control of their own health and care, and there is no reporting of whether people’s care is coordinated across health and social care.

The study, conducted by National Voices, a coalition of over 160 health and care charities, looked at key dimensions of person-centred care as reported by patients and service users.

It found that only 3 per cent of people with one or more long term conditions reported having a written plan for their care and support.

Although information and communication with patients has improved over time, large numbers of people are still not as involved in their healthcare decisions as they want to be.

Only 56 per cent of hospital inpatients said they were as involved as they wanted to be in decisions, while 39 per cent of general practice patients said their GP was very good at involving them in decisions.

The report collates patient and service user reported data from 19 England-wide surveys, and focuses on information, communication, involvement in decisions, care planning and care coordination.

Although integrated care has been a key goal since 2013, there is no measurement of people’s experiences of whether their care is coordinated. The limited data available shows mainly the failings in transitions out of hospital, with 46 per cent of inpatients saying they did not get enough further support to recover or manage their condition after leaving hospital.

There is emerging data on inequalities in the choice and control patients have over their care. In hospitals, inpatients who had a mental health condition were less likely to report a positive experience than those with only physical conditions.

In primary care, 41 per of white British patients reported that their GP was very good at involving them, compared to 34 per cent of people of Caribbean origin, and 32 per cent of people of Indian origin.

Some positives

The report authors did find positive results in the quality of information given to patients and service users, and of communication with patients and service users.

In the NHS, 87 per cent of general practice patients said their GP was good at listening to them, 76 per cent of hospital inpatients who had an operation or procedure said that what would happen was completely explained, and 78 per cent of children and young people felt that staff in hospital listened to them.

However, the most recent surveys showed a dip in listening and communication, possibly implying that pressure on services is beginning to affect the quality of people’s experience.