Personalise Care

“How do we know that the public wants Realistic Medicine?” The answer is found in patient surveys showing that over a third of respondents would like to be more involved in decisions, the second Citizen’s Panel Survey found “that while 92% of people said they would feel comfortable asking their doctor about their treatment and care options, only 67% had actually spoken to their doctor about them”. Some people commented that a doctor’s attitude influenced their willingness to ask questions. Patients are best served when treatment and care options reflect what’s important to patients and their families. “It is also important to remember that doing less or no treatment can be the best option for some people.” [The Scottish Government. Practising Realistic Medicine: Chief Medical Officer for Scotland’s Annual Report 2016-17. Published 2018. https://www.gov.scot/publications/practising-realistic-medicine/]

Personalising realistic medicine emphasises a more person-centred approach as a result of a Citizen’s Jury which identified what is important to the people of Scotland regarding healthcare. Concentrating on what matters most to patients and focusing on services that avoid too much medicine or too much effort for patients. The Citizen’s Jury proposed 3 main recommendations:

1. “A programme to inform and educate patients of their right to ask questions of health professionals and which questions are useful to ask;
2. Training for all health and social care professionals on shared decision-making;
3. The opportunity for an independent person to join conversations between medical professionals and patients.”

Time is the main challenge to personalising realistic medicine and the report provides case studies where services have been redesigned or involved the whole clinical team to help free up time with patients. [The Scottish Government. Personalising Realistic Medicine: Chief Medical Officer for Scotland’s Annual Report 2017-18. Published 2019. https://www.gov.scot/publications/personalising-realistic-medicine-chief-medical-officer-scotland-annual-report-2017-2018/pages/7/]

The COVID-19 pandemic has created the most difficult circumstances and current services have been transformed to continue to deliver safe, effective and personalised care. Practice innovation has been in response to evolving knowledge of the virus and the disease it causes. Engagement workshops reinforced that continuing to build a personalised approach to care through shared decision-making is the key to delivering care that people really value. This approach also reduces harm and waste. [The Scottish Government. The Chief Medical Officer for Scotland’s Annual Report 2020-21: Recover, Restore, Renew. Published 2021. https://www.gov.scot/publications/cmo-annual-report-2020-21/ ]

Shielding patients were given support to stay at home but isolation was having a detrimental impact on their mental health so a new approach was needed. This new approach provided information, advice and tools to support people to make informed choices about how to stay safe, and protect themselves mentally and physically. This approach can also be of benefit to others who are at higher risk from COVID-19 due to age or pre-existing health conditions. [The Scottish Government. The Chief Medical Officer for Scotland’s Annual Report 2020-21: Recover, Restore, Renew. Published 2021. https://www.gov.scot/publications/cmo-annual-report-2020-21/ ]

The Person Centred Care CAB provides evidence updates on person-centred and personalised care and shared decision making. If you are looking to answer a specific question please submit a literature search request at the link above.