Introduction
The foundation of modern health education is built on the principle that a care provider’s primary duty is to meet the physical, psychological, and social needs of the patients. As the healthcare industry becomes more consumer-oriented, patient satisfaction is becoming one of the foremost indicators of its quality and effectiveness. This concept has been incorporated into the educational curriculum under the name of person-centered care, which emphasizes the cultivation of a positive care relationship between providers and patients. It is diametrically opposed to the traditional paternalism of previous generations that presumes that a professional knows better what is best for the patient. Therefore, person-centered requires a holistic approach that takes into account the patient’s autonomy and values before prescribing a specific treatment plan (Eklund et al., 2019). Fostering positive person-centered care relationships is an important aspect of contemporary NHS policy.
Factors that Influence Care Relationships
Definition
Many theorists have written about the exact definition of care in the relationship between providers and patients, with two of the most influential being Jean Watson and Madeleine Leininger. Watson was a famous American nurse theorist who valued the humanistic, metaphysical potential of science. She defined care as the moral ideal of nursing in which the aim is to protect, enhance, and preserve human dignity through transcendence and creativity (Blasdell, 2017). On the other hand, Leininger was the founder of transcultural nursing and emphasized the variability of expressions, processes, and patterns of caring among different cultures (Blasdell, 2017). She believed the purpose of professional caring was to help individuals and families improve or maintain favorable health conditions. The most optimal definition of a caring relationship is an amalgamation of Watson and Leininger’s theories. A care relationship aims to improve patients’ health outcomes by preserving their human dignity and power of choice.
Effectiveness
The effectiveness of care relationships has been demonstrated by numerous studies. Firstly, improved communication with care providers is linked to increased adherence to treatment plans and care advice by patients, which leads to lower readmission and mortality rates (Thomas, Newcomb & Fusco, 2018). Secondly, more positive relationships with patients result in better job satisfaction among employees and lower staff turnover. This yields efficiency savings and thus less expenditures for healthcare facilities and the National Health Service. Furthermore, there are more intangible advantages such as an enhanced hospital reputation due to better patient and employee experience reviews. Cultivating care relationships is morally valuable and translates to better health outcomes for patients, job satisfaction for employees, and enhanced revenue and reputations for hospitals.
Formation
While there are various theoretical frameworks for understanding the care relationship, one study identified the concrete factors that cultivate a positive one. A 2015 umbrella-review extracted six factors that formed the care provider-patient relationship: expectations of relationship, values, knowledge and skills, communication, context and environment, and the impact of the relationship (Wiechula et al., 2015). Firstly, a positive provider-patient relationship develops when both parties recognise that it is built on intimacy, trust, and deep knowledge. Secondly, values held and displayed by providers should align with the patient’s, as manifested through their attitude and behavior. Thirdly, providers should be knowledgeable about the technical and psychological aspects of care. Fourthly, they should utilize their communication skills and demonstrate the ability to handle medical terminology, notice subtle cues about the patient’s state of health, and establish a friendly rapport. Fifthly, context and environment refer to organizational and cultural factors beyond the individual provider that influence the relationship. Finally, the impact of the relationship refers to whether it fulfills the personal aspiration of the care provider and translates into improved competence for patients. In general, the formation of the care relationship depends on the provider’s communication skills, ability to foster trust, and demonstrate technical ability.
Task 2: Influence of Policy on Care
Health and social care facilities are not static entities that exist separately from other spheres of society. The relationships between patients and care providers are influenced by changes within public policy that regulate who has access to care and the principles of their treatment. Over the last two decades, legislation has focused on protecting patients’ rights and interests to make care relationships more equal. The fundamental standards of providing care such as proper staffing and duty of candour are outlined in the Health and Social Care Act of 2008. The various regulations included in this Act demonstrate the dynamism of care relationships and how they can be influenced by public policy.
From Paternalism to Partnership
Firstly, Regulation 9 of the Health and Social Care Act 2008 legally established the principle of person-centered care in the NHS. According to the legislation, treatment plans should take into account the individual needs and preferences of patients (Care Quality Commission, 2021a). This is a drastic difference to the previous model of the healthcare wherein they were expected to fit in with the routines and practices that care providers believed were most appropriate. Patients came to be recognized as individuals that are experts in their own health and care. Regulation 9 sanctified the care relationship as a holistic partnership rather than medical paternalism.
From Liability Concerns to Apologizing
Secondly, the idea of person-centred care was further developed when Regulation 20 embedded the care provider’s duty of candour into the NHS. This means every care provider must be open and transparent with patients, whether or not something has unintentionally gone wrong. A crucial part of the duty is apologizing for harm caused in a timely manner; saying “sorry” is not legally considered an admission of liability (Care Quality Commission, 2021b). This legislation changed the care relationship because it obliges providers to follow person-centred procedures such as offering a genuine apology and working in tandem with patients when it comes to medical accidents. Regulation 20 ensures that providers focus on mending the care relationship if a mistake occurs, rather than focusing on avoiding liability.
From Profit Concerns to Meeting Patients’ Needs
Thirdly, under Regulation 18, care providers are obligated to provide sufficient numbers of competent and skilled staff to meet their patents’ needs at all times. This is a particularly important piece of legislation as many health and social care facilities purposefully understaff in order to increase profit margins. As a result, providers are overworked, stressed, and do not have enough resources to fully develop the care relationship. However, this regulation ensures that care providers have the time and energy to assess each patient’s individual preferences and prescribe the best treatment plan, rather than doing the bare minimum due to a greater workload. Regulation 18 addresses the problem of staffing so care facilities prioritize the patients’ needs rather than profit.
Task 3: Key Legislation
There are three pieces of legislation that played a key role in quality of care and care activities. As discussed previously, the Health and Social Care Act 2008 established the core standards of the care relationship in the NHS. Each regulation addresses a specific principle of the care relationship, including person-centered care, dignity and respect, need for consent, duty of candour, and safe care and treatment (Care Quality Commission, 2021d). According to the Act, providers are obligated to treat their patients as autonomous individuals and tailor the treatment to the latter’s unique needs and preferences. Furthermore, patients need to be fully informed at every stage of treatment and give their lawful consent. This legislation sanctified the care relationship as a partnership of two equals.
The second key legal framework is the 2010 Equality Act that legally protected individuals from discrimination on the grounds of religion, nationality, gender, disability, sexual orientation, and age in public spaces. It combined and simplified 116 previous pieces of legislation, introducing legal definitions for concepts such as gender reassignment and the duty of employers and service providers to make reasonable adjustments for people with disabilities (Government Equalities Office & Equality and Human Rights Commission, 2015). The 2010 Equality Act established the duty of providers to treat patients as independent and autonomous equals regardless of their background.
The third key piece of legislation is the Care Act of 2014. The main principle of the Act was to take a more person-centered approach and improve people’s independence. Local councils now had a duty to promote the wellbeing of individuals by providing services to prevent, delay, or reduce them developing the need for care (Department of Health and Social Care, 2016). Furthermore, they must assess anyone who appears to require care and support, regardless of their ability to pay or qualify for state-funded care (Department of Health and Social Care, 2016). Care Act of 2014 established wellbeing as the responsibility of local authorities and that each person has the right to a care relationship regardless of their financial status.
Task 4: Care Management
Motivation
The primary motivation of care management in providing quality, person-centred care is to improve health outcomes and decrease costs. The population is aging and co-morbid chronic conditions which require more sophisticated and expensive treatment are becoming more common. The person-centred approach allows the NHS to adequately respond to patients’ complex care needs in a way that traditional models of care do not (Kuipers, Cramm & Nieboer, 2019). Organizations that prioritize care relationships have more positive health outcomes, such as greater satisfaction with care, greater job satisfaction among providers, increased quality of care, and greater well-being of patients (Kuipers, Cramm & Nieboer, 2019). Furthermore, these improvements result in less expenditures for the NHS. Fostering care relationships that assess patients’ individual profiles leads to better outcomes and is thus the best model of care for a country with aging populations.
Objectives-setting
The objectives of care relationships are based on quality indicators of person-centred care that requires knowing the patient as an individual and tailoring treatment to their unique needs. Firstly, patients should have the opportunity to discuss their health beliefs, concerns, and preferences with care providers. Secondly, they should be treated with dignity, respect, and honesty. Thirdly, they should experience care that is tailored to their needs and reflect what is important to them. Fourthly, patients should actively participate in treatment planning and feel supported by care providers to make fully informed and consensual decisions about treatment. Empowering patients and treating them as partners are the objectives of person-centred care management.
Performance Measurement
Performance measurement in care management is based on assessing whether care objectives have been met through patient and staff surveys. Surveys are the best evaluation method due to the subjective nature of patient-centred care. Patients could be asked to rate their experience of care according to the quality indicators of person-centred care discussed previously. Care providers could answer surveys to assess their experience of providing care and job satisfaction. These ratings could be supplemented with data on readmission and mortality rates, and the annual performance reviews published annually to identify weak spots and areas for improvement. The combination of surveys and hard data is the best tool for performance measurement in care management.
Conclusion
In conclusion, cultivating positive care relationships that treat patients as individuals is an integral part of person-centered care. It leads to improved health outcomes, better use of resources, and enhanced reputations for healthcare facilities. A quality care relationship depends on numerous factors such as communication, knowledge and skills, and context and environment. Furthermore, the care relationship is conceptually dynamic, and the current shift from paternalistic toward person-centered care has been facilitated by modern public policy. The three key pieces of legislation that outline the basic principles of care relationships include the Health and Social Care Act of 2008, the Equality Act of 2010, and the Care Act of 2014. The objectives of care management are based on quality indicators of person-centered care that should be assessed through a combination of surveys and statistical data and published annually.
References
Blasdell, N. D. (2017). The meaning of caring in nursing practice. International Journal of Nursing & Clinical Practices, 4(238), 1-5.
Care Quality Commission. (2021a). Regulation 9: Person-centred care. Web.
Care Quality Commission. (2021b). Regulation 20: Duty of candour. Web.
Care Quality Commission. (2021c). Regulation 18: Staffing. Web.
Care Quality Commission. (2021d). Regulations for service providers and managers. Web.
Department of Health and Social Care. (2016). Care Act factsheets. GOV.UK. Web.
Government Equalities Office & Equality and Human Rights Commission. (2015). Equality Act 2010: guidance. GOV. UK. Web.
Kuipers, S. J., Cramm, J. M., & Nieboer, A. P. (2019). The importance of patient-centered care and co-creation of care for satisfaction with care and physical and social well-being of patients with multi-morbidity in the primary care setting. BMC Health Services Research, 19(1), 1-9.
Thomas, D., Newcomb, P., & Fusco, P. (2019). Perception of caring among patients and nurses. Journal of patient experience, 6(3), 194-200.
Wiechula, R., Conroy, T., Kitson, A. L., Marshall, R. J., Whitaker, N., & Rasmussen, P. (2016). Umbrella review of the evidence: what factors influence the caring relationship between a nurse and patient? Journal of advanced nursing, 72(4), 723-734.