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Biomedical subjects

Steve Gillam

Publications and source records attributed to Steve Gillam.

5 recordsLinked to original sources

How is patient-centred care understood by the clinical, managerial and lay stakeholders responsible for promoting this agenda?

AIMS AND OBJECTIVES: This study explores how the term patient-centred care is understood, particularly by those who are involved in translating the concept from a theoretical idea into a practical application. It examines the ways in which intermediate level stakeholders such as health service managers, educationalists, professional leaders and officers of patient bodies understand and promote patient-centred care among health professionals actually delivering patient care. DESIGN: Qualitative interview study. SETTING AND PARTICIPANTS: Interviewees were drawn from groups and organizations from four categories: health agencies and regulatory bodies, Royal Colleges and other professional bodies, educational institutions, patient and user groups and consumer organizations. MAIN VARIABLES STUDIED: The meanings and understandings of patient-centred care, commitment to implementing patient-centred care and barriers and opportunities to implementation. RESULTS AND CONCLUSIONS: Patient-centred care covers a range of activities from patient involvement in individual care to public involvement in health policy decisions. Current Department of Health policy has made patient-centred care a priority, but has not clarified exactly what it means. Thus, health professionals, educationalists, managers and patient representatives have all developed different meanings of patient-centred care to reflect their own particular backgrounds and roles. The individual aspects of patient-centred care have been neglected in policy terms and important research findings have not been incorporated into policies to change the attitudes and behaviours of health professionals. Developing a shared understanding of patient-centred care which encompasses all its components is an important role for the new Commission for Patient and Public Involvement.

Administrative Personnel↗

PCTs/health improvement. The object of the exercise.

A study of six primary care trusts showed that those most successful in tackling health improvement had certain common characteristics. Strong board-level support and leadership, combined with development funding, were the most effective. Successful PCTs also showed a corporate recognition of local health and socio-economic inequalities.

Community-Institutional Relations↗

Organization and financing of British primary care groups and trusts: observations through the prism of US managed care.

There are many parallels between the UK's new primary care commissioning organizations and the managed care organizations and integrated delivery systems that have evolved in the USA over the last three decades. Those building primary care groups and trusts (PCG/Ts) can learn from the American experience with health maintenance organizations and other similar entities. These lessons should also be relevant to those in other countries interested in establishing innovative primary care led organizations within the broader structure of a socialized health care system. Following an overview of US managed care and an update of the progress of the UK's PCG/Ts, we go on to suggest how new consortia of PCG/Ts might be developed and how budgets and provider incentives could be structured. This international comparison suggests that the resources needed to support the development of effective PCG/Ts will be considerable, as will the need to maintain organizational flexibility. If primary care organizations are to thrive, it will be essential to develop truly integrated budgets for primary and secondary care.

Budgets↗