Proposed definitions vary and there is no universally accepted definition.¹ For the purpose of this discussion paper, person-centred health care is most simply understood as a system that is designed to respect the patient’s preferences, values and/or needs.¹

This approach involves partnership between health professional and patient, with shared aspirations for treatment and acknowledgement of people’s life goals. For those with long-term conditions, it means giving them the understanding and skills to optimise their investment of time in their condition to keep themselves well. This idea is not new, but is increasingly supported by clinical evidence, particularly in the areas of diabetes, asthma and arthritis. Health professionals working in primary care, particularly GPs, are already recognised for their person-centred approach, compared with some specialist disciplines or hospital settings.

Central principles

Although the priorities of patients, their families and carers will differ according to culture and medical condition, all these elements are fundamental to person-centred health care:^2,5,9

• Respect for the individual’s values, expressed needs and preferences.

• Patient-based evidence Patient organisations are urging people to take responsibility to ensure that their health care is based on evidence by asking the following questions at every management decision point.10 1. What are my treatment options? 2. What are the possible outcomes of those options? 3. How likely is each of the outcomes to occur?

  Choice – patients have the right and responsibility to participate in health care decisions including treatment and management. To do this responsibly they need the options and probable outcomes carefully explained. Patient-centred care doesn’t mean the subjugation of science to patients’ uninformed demands. Clearly, it is counterproductive to provide health care that simply reflects patient demands without first offering choices that are well informed by available evidence.
• Access to services required by the person’s medical condition, including preventive care.
• Support – acknowledging and addressing the person’s emotional and social needs. This means involving the person’s family and friends (as the patient desires) and considering educational, cultural and personal factors affecting the person’s ability to manage their condition.
• Education and information that is accurate, relevant and answers the person’s concerns. Information must be given in a mode appropriate to the person’s level of understanding of their condition, educational status, language, age and culture.

Related and enabling principles

Putting these principles into practice requires a focus on health promotion and healthy lifestyles, rather than just on specific medical conditions, and effective communication between provider and patient. Health professionals’ ability to deliver person-centred health care depends on factors that link these approaches at the level of health policy and government (Figure 1). These enabling principles include:^3,5,9

• coordination and integration of care across boundaries of the health care system

• supportive community-based services and programs

• planned and systematic involvement of patients in health policy – both individually and through patient organisations.

Figure 1 The foundations of person-centred health care in primary care

Person-centred primary health care involves practices being organised around the principles of informed choice, respect, partnership, a holistic approach and good communication. Primary care providers’ capacity to offer this type of care is supported by a health system designed to ensure access, patient involvement in policy making, and coordination between levels and types of health services.

Content Updated June 2007