Enacting person-centredness in integrated care: A qualitative study of practice and perspectives within Multidisciplinary Groups in the care of older people

Lisa Riste, Peter A Coventry, Siobhan Reilly, Peter Bower, Caroline Sanders

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Person-centredness is important in delivering care for long term conditions. New models of care aim to co-ordinate care through integration of health and social care which require new ways of working, often remotely from the patient.
Objective: To describe how person-centred care is enacted within multidisciplinary groups (MDGs) created as part of a new service, integrating health and social care for older people.
Methods: We followed the implementation of eight neighbourhood MDGs, observing and interviewing staff from three MDGs at different phases of programme implementation using semi-structured topic guides.
Results: Thirty four MDG meetings were observed and thirty two staff interviewed. Three core themes were identified which impacted on enactment of person-centred care: the structural context of MDGs enabling person-centred care; interaction of staff and knowledge- sharing during the MDG meetings; and direct staff involvement of the person outside the MDG discussion.
Conclusions: This study provides new insights into attempts to enact person-centred care within a new model of service delivery. Teams did what they could to enact person-centred care in the absence of the 'real' patient within MDG meetings. They were successful in delivering and co-ordinating some aspects of care (e.g. prompting medication reviews, referring to social worker, health improvement and arranging further multi-disciplinary team meetings for complex cases). This ‘absence of patients’ and time pressures within the MDGs led to reliance on the ‘virtual’ record, enhanced by additional ‘soft’ knowledge provided by staff, rather than ensuring the patient’s voice was included.
Original languageEnglish
Pages (from-to)1066-1074
Number of pages8
JournalHealth Expectations
Volume21
Issue number6
Early online date13 Jul 2018
DOIs
Publication statusPublished - Dec 2018

Research Beacons, Institutes and Platforms

  • Manchester Institute for Collaborative Research on Ageing

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