Person-Centred Coordinated Care (P3C)

Background

There is now widespread recognition that care provided by the NHS, social services and other associated community services should strive to be more person-centred, i.e. both centred around and responsive to the needs of the individual.

For this to be achieved effectively, services need to be better co-ordinated and, in some circumstances, integrated fully. Person-Centred Coordinated Care (P3C) is perceived as a way of achieving better outcomes for patients and improved efficiency for health and care economies. We have defined person-centred and coordinated care as:

‘Care that is guided by and organised effectively around the needs and preferences of the individual’

Read more about the project on the P3C website.

Project aim

This programme combines the following activities, contributing to both local service improvement and international knowledge:

• Reviews of literature, including evidence synthesis to build practical theory about how to provide and implement P3C
• Support for bottom up service redesign and implementation
• Evaluation of system redesign and new services

Approach

Our ‘consistent evaluation framework’ is designed for challenging healthcare evaluations, where a flexible approach is often demanded by rapidly evolving environments. We build our evaluations from a suite of mixed-methods approaches, where we have expertise in both quantitative (e.g. healthcare records, surveys, psychometrics etc.), and qualitative techniques (e.g. ethnography, in-depth interviews, focus groups etc.). Quantitative results are contextualised with qualitative insights, which are blended to produce nuanced perspectives. These are presented in rapid, actionable and easy-to-comprehend reports, with our outputs often direct towards multiple stakeholders (e.g. staff, managers, researchers and patients).

Measures

Through our work, we have extensive experience of using quantitative survey tools for staff, user and organisational perspectives. We have developed the first free and openly-available comprehensive data resource for international measures relating to patient experience and person centred care. This ‘Measures for Person Centred Coordinated Care’ information gateway tool provides a ‘one-stop’ website for commissioners, health managers, researchers and others:

We have developed psychometrically validated tools for:

Patient Experiences: The P3C Experience Questionnaire (P3CEQ)

This validated measure (see references below) has been translated into five different languages and is being used in major studies in the EU, Australia, Canada and the UK.

Organisational Perspectives: The P3C-OCT

We have designed a validated, comprehensive survey tool (see references below) aimed at organisations named the “Person Centred Coordinated Care Organisational Change Tool” (P3C-OCT). It is designed as both an evaluation tool and an implementation tool, supporting the reorganisation of care for those with complex needs. It can be used for internal or external benchmarking and auditing of service development.

P3C-PREM-CAT

In collaboration with the Gothenburg Centre for Person Centred Care, we are currently developing a state of the art tool. Research Graduate Ben Fosh is developing a computer adaptive (CAT) measure examining patient reported experiences of person centred care, allowing measurement of P3C with an efficient, modern system.

Work so far

Some of the P3C development and evaluation projects we have been involved with:

SPQS: Evaluating the impact of replacing the Quality Outcomes Framework with the Somerset Practice Quality Scheme on Quality of Care in Primary Service Providers

ICE: An evaluation of the Integrated Care Exeter Social Prescribing project to assess the impact of social prescribing on patient reported outcomes

IPC: Evaluation of the Southwest Integrated Personal Commissioning intervention on Quality of Life, Quality of Care and P3C

Test and Learn: An evaluation of the impact of three different care hubs on experiences of person centred care

Newton Abbot: An evaluation of an Older Persons Hub to identify barriers and facilitators to implementation and develop an embedded internal monitoring process

Torbay: A researcher-in-residence programme examining how integrated care increases experiences and outcomes in multimorbid patients

Find out more on the Plymouth University P3C page

Resources

We have developed the first free and openly-available comprehensive data resource for international measures relating to patient experience and person centred care. This Measures for Person Centred Coordinated Care information gateway tool provides a ‘one-stop’ website for commissioners, health managers, researchers and others.

Other resources: If you would like to use any of our other measures please register and complete our user agreement form. We are happy for these to be used for research and service development and would welcome the opportunity to discuss this with you further:

• An evaluation of the Somerset Practice Quality Scheme (SPQS)
• Patient experience measure identification
• Creating and Measuring Organisational Change

News​

• Somerset Practice Quality Scheme (SPQS)
• Improving health care pathways for patients with chronic conditions
• Collaborative Action for the Delivery of Effective Person-Centred Coordinated Care
• New Study Underpins the Future of Person-Centred Care

Related publications

Naldemirci Ö, Britten N, Lloyd H, Wolf A. The potential and pitfalls of narrative elicitation in person-centred care. Health Expect. 2019; DOI: org/10.1111/hex.12998

Lloyd, H., Fosh, B., Byng, R., Whalley, B., and Close, J. (2018). Enhancing Person Centred Coordinated Care for People with Long term Conditions: Development and Validation of the Person Centred Coordinated Care Experience Questionnaire (P3CEQ). International Journal for Quality in Healthcare. [In Press]

Close, J., Byng, R., Valderas, J., Britten, N., and Lloyd, H. (2018). Quality after the Quality Outcomes Framework (QOF) British Journal of General Practice. Invited Editorial.

Lloyd, H., et al (2018). Patient-Reported Measures for Person-Centred Coordinated Care: A Comparative Domain Map and Web-Based Compendium for Supporting Policy Development and Implementation. Journal of Medical Internet Research (JMIR). 14.02.18 in Vol 20, No 2 (2018): February.

Sugavanam, P., Close, J., Fosh, B., Byng, R., and Lloyd, H (2018). Co-designing a Measure of Person Centred and Coordinated Care to Capture the Experience of the Patient: The Development of P3CEQ. Journal of Patient Experience.

Lloyd, H., Britten, N., Sheaff, R., and Byng, R. (2017). Collaborative Action for Person Centred Coordinated Care. Journal of Health Research Policy & Systems: 15.

Close, J., and Lloyd, H., et al. Adapting QOF to Focus on Wellbeing and Health. BMJ Letter. Dec 2017.

Horrell, J., Lloyd, H., Close, J., and Byng, R. (2017). Creating and Measuring Organisational Change for Person Centred Coordinated Care: The Development of the Organisational Change Tool. Health Expectations. First published 15th Nov. 2017.

Bramwell C, Don RM, Porter I, Lloyd H, Kadam U, Rijken M, et al.(2016) Caring for people with multiple chronic conditions in the United Kingdom: policy and practices with a focus on England and Scotland. Factsheet ICARE4EU; 2017.

Britten N, Moore L, Lydahl D, Naldemirci O, Elam M, Wolf A. Elaboration of the Gothenburg Model of Person-Centred Care. Health Expectations 2016.

Sheaff R, Halliday J, Ovretveit J, Byng R, Exworthy M, Peckham S, Asthana S. Integration and continuity of primary care: polyclinics and alternatives – a patient-centred analysis of how organisation constrains care co-ordination. Health Services and Delivery Research 2015; 3(35)

Heaton J, Britten N, Krska J, Reeve J. Person-centred medicines optimisation policy in England: An agenda for research on polypharmacy. Primary Health Care Research and Development 2016; 18(1)

Naldemirci O, Lydahl D, Britten N, Elam M, Moore L, Wolf A. Tenacious assumptions of person-centred care? Exploring tensions and variations in practice. Health 2016

Moore L, Britten N, Lydahl D, Naldemirci O, Elam M, Wolf A. Barriers and facilitators to the implementation of personcentred care in different healthcare contexts. Scandinavian Journal of Caring Science 2016

Sheaff R, Halliday J, Byng R, Ovretveit J, Exworthy M, Peckham S, Asthana S. Bridging the discursive gap between lay and medical discourse in care coordination. Sociology of Health and Illness 2017