Introducing The Lancet Global Health Commission on financing primary health care: putting people at the centre

Impact of ‘Enhanced’ Intermediate Care Integrating Acute, Primary and Community Care and the Voluntary Sector in Torbay and South Devon, UK

Intermediate care (IC) was redesigned to manage more complex, older patients in the community, avoid admissions and facilitate earlier hospital discharge. The service was ‘enhanced’ by employing GPs, pharmacists and the voluntary sector to be part of a daily interdisciplinary team meeting, working alongside social workers and community staff (the traditional model). Enhancing IC through greater acute, primary care and voluntary sector integration can lead to more complex, older patients being managed in the community, with modest impacts on service efficiency, system activity, and notional costs off-set by perceived benefits.

White paper. Health and social care integration: joining up care for people, places and populations.

This white paper is part of the government’s commitment to transform the delivery of care in England following the Prime Minister’s announcement on reforms for health and social care through the Build Back Better: Our Plan for Health and Social Care.

This white paper is part of a wider set of mutually reinforcing reforms:

• the adult social care reform white paper
• the Health and Care Bill, and reforms to the health and care system

It sets out measures needed to make integrated health and social care a universal reality for everyone across England regardless of their condition and ...

The Peterborough Exemplar: a protocol to evaluate the impact and implementation of a new patient-centred, system-wide community mental healthcare model in England

Community mental healthcare has significantly grown since de-institutionalization. Despite progress, service fragmentation and gaps in service provision remain key barriers to effective community care in England. Recent mental healthcare policies highlighted the need to transform service provision by developing patient-centred, joined-up community mental healthcare. In response to policy guidance, a system-wide community mental healthcare model was developed in Peterborough (England). The "Peterborough Exemplar" is based on two main pillars: (1) the creation of knowledge exchange pathways to strengthen interorganizational relationships, and (2) the development of new, accessible community services addressing existing service gaps. 

Integrated Care - Defining for the Future through the Eye of the Beholder

The central defining features of integrated care which cuts across all stakeholders (people and communities, individual providers, a system of organisations, and policymakers) are continuity and coordination. Continuity occurs temporally and coordination occurs spatially. For the person at the centre of care, their experience is seamless across formal/informal care, professional, organisational and sectoral boundaries and continuous over time. For providers, they design care to effectively manage transitions from one profession, organisation or sector to another over multiple episodes of care. For policymakers, integrated care requires them to ensure that the wider context supports continuity and coordination and does not ...

Integrated care: putting principles into practice and becoming the paediatrician of the future

Acute hospital paediatric services and separate primary care paediatricians, with links often fragmented, there is evidence that this delivers neither seamless nor equitable care. Integrating care around population needs is the direction of travel. The recent UK restructure into integrated care systems intends to facilitate improved collaboration and equity of health and care across geographies. Within child health, the Royal College of Paediatrics and Child Health’s (RCPCH) 2040 project describing future models of care has the ‘development of integrated care for children and young people at scale across the UK’ as a key goal.

Terms of engagement for working with patients in a person-centred partnership: A secondary analysis of qualitative data

Evidence is emerging of the potential of person-centred approaches to create partnerships between professionals and patients while also containing healthcare costs. This is important for enhancing outcomes in individuals with complex needs, who consistently report poor experiences with care. The shift towards person-centred care (PCC) is, however, a radical departure from the norm, with increased expectations of both professional and patient. 

Patients’ perspective on supposedly patient-relevant process and outcome parameters: a cross-sectional survey within the ‘PRO patients study’

Patient-centered care implies that patients, their values, preferences, and individual life and health goals are at the heart of care processes and that patients are involved in care decisions. To be able to make informed choices based on their individual preferences, patients need to be adequately informed about treatment options and their potential outcomes. This implies that studies measure the effects of care based on parameters that are relevant to patients. In a previous scoping review, we found a wide variety of supposedly patient-relevant parameters that equally addressed processes and outcomes of care.

The PanCareFollowUp Care Intervention : A European harmonised approach to person-centred guideline-based survivorship care after childhood, adolescent and young adult cancer

Long-term follow-up (LTFU) care, although endorsed, is not available for the majority of adult survivors of childhood, adolescence and young adult (CAYA) cancer. Barriers to implementation include lack of time, knowledge, personnel and funding. Sustainable solutions are urgently needed to address the needs of CAYA cancer survivors to improve the quality of life and reduce the burden of late effects on survivors, health care systems and society. The European Union–funded PanCareFollowUp project, initiated by the Pan-European Network for Care of Survivors after Childhood and Adolescent Cancer, was established to facilitate the implementation of person-centred survivorship care across Europe.

Effects of a person-centred and health-promoting intervention in home care services- a non-randomized controlled trial

Home care recipients have reported little self-determination and opportunity to influence their own care. Person-centred care focusing on involvement has improved the quality of life of older adults in health care and nursing homes; however, knowledge about the effects of person-centred interventions in aged care at home is sparse. The aim of this study was to study the effects of a person-centred and health-promoting intervention, compared with usual care, on health-related quality of life, thriving and self-determination among older adults, and on job satisfaction, stress of conscience and level of person-centred care among care staff.