Patient-centred care - the House of Care model
We have awarded funds to health economies across the UK to deliver a person centred model of care; the House of Care.
This model challenges traditional styles of paternalistic medicine, highlighting the wants and needs of the individual as the heart of the model.
Why fund a person centred approach to care?
Evidence shows that this type of model could enable people to take ownership of their health and well-being - resulting in a reduction of unnecessary contacts with primary and secondary care.
We're funding a 3 year programme to implement the House of Care across 5 UK healthcare communities of practice. Each of these communities encompasses a population of 50,000 or more:
- Newcastle Gateshead CCG
- Hardwick CCG
- Health and Social Care Alliance Scotland (NHS Tayside, NHS Lothian, NHS Glasgow and Clyde)
The BHF are funding and supporting the House of Care programme in CVD. We've invested £1 million into the programme, including independent evaluation and support with training.
We are working jointly with Year of Care Partnerships who are bringing experience and expertise to introduce and embed care and support planning. This includes design and delivery principles, engagement of key leaders and professional teams, care and support planning training and advice and support, to ensure consistent delivery of the approach.
The House of Care model underpins the principles of person centred care. This is where healthcare professionals and people with CVD and other long-term conditions come together as equal partners to discuss care and support planning, addressing the needs of the individual and develop a care plan if appropriate. This conversation draws on the expertise of the individual living with their condition, taking into account their own health needs, personal goals and their limitations.
In order for this conversation to be meaningful and to ensure that both clinician and person with CVD are equal contributors, it is necessary to have all other elements of the house in place. The starting point of the conversation is “what matters to you” rather than focusing on the condition.
What is the House of Care model?
The left wall will address the issues around engagement and health literacy to ensure that people have had the opportunity to review their health/test results with the appropriate level of information provided to have meaningful discussions with their family and carers before a care and support planning conversation with the clinician.
The right wall will address the change of culture needed to shift medicine away from being paternalistic to person centred and promote collaborative working between specialists. As part of their wider role, the programme has funded the Year of Care Partnership to provide care and support planning training to healthcare professionals in all sites in order to support this shift.
The roof of the house needs to ensure that IT systems are set up to allow for test results, templates to be sent out on time and for systematic review and recall appointments offered to people and processes are in place to support the change in culture.
The foundation of the house highlights that the services commissioned should address the needs of the population, and that the wider voluntary and community assets and services can be utilised for addressing a person's holistic care needs. The foundation focus is the “more than medicine” approach, as the community assets can be social as well as clinical, which addresses issues that matter to the patient and are impacting on their health and well-being.
Proving the innovation works
The hypothesis behind the care and support planning and the House of Care is that true person-centred and good quality care does not cost more, and allows better utilisation of existing assets within the community (including people themselves). In the long run, long-term conditions, including CVD, will be managed in the community more efficiently with less burden on the healthcare system.
Our programme will end in 2018. It is being independently evaluated to assess its set up, implementation and adoption. The evaluation will highlight the benefits as well as the challenges posed in order to help communities of practice adapt to a different way of working.
If you are looking to implement the House of Care model in your community of practice then stay tuned to receive learning and updates from our pilots.