Person-centred and co-ordinated care for long-term conditions

Developing models and approaches for people with multiple long-term conditions.

The welcome increase in life expectancy has created new challenges for health care. One of those challenges is that greater numbers of older people are now living with multiple long-term conditions. This has amplified the demand on healthcare services at a time when UK healthcare costs are rising faster than GDP. Traditional, single-disease-focused approaches to clinical care are not necessarily accommodating to the person-centred care that older people with multiple long-term conditions need and benefit from most. Person-centred approaches to care have also been shown to reduce costs, for example through reduced bed days and reduced readmission rates) and improve outcomes for patients (e.g. increasing wellbeing, self-efficacy, and reductions in pain and fatigue). Dr Helen Lloyd’s work has been instrumental in developing models and approaches to integrating person-centred and coordinated care (P3C, from ‘PCCC’) for people with multiple long-term conditions.

Dr Lloyd led a team as principal investigator to develop a model, toolkit, and guidance to implement P3C through a programme of mixed methods research and collaboration within NHS settings. Within this model, patients are viewed as people with capabilities that can be harnessed through personalised goal setting to improve self-management and self-efficacy. Goals are then used to drive a coordinated service response. This is a radical shift from the traditional view of patients as passive recipients of care.

This work has led to improvements in the delivery of health care in the UK and Australia and led to changes in National Health Service for England (NHSE) policy for UK General Practice, and informed policy guidance and strategic recommendations by the Social Care Institute for Excellence (SCIE).