Intended for healthcare professionals


Just 3% of patients with long term conditions have a written care plan, study finds

BMJ 2017; 358 doi: (Published 21 September 2017) Cite this as: BMJ 2017;358:j4396
  1. Abi Rimmer
  1. The BMJ

Just 3% of patients with long term conditions have a written care plan and large numbers of people are not as involved in their healthcare decisions as they want to be, a study has found.

A study by National Voices, a coalition of over 160 health and care charities, collated patient and service user reported data from 19 England-wide surveys.

It found that just over half (54%) of the 808 332 respondents to the 2017 General Practice Patient Survey identified themselves as having one or more long term conditions and, of these, 3% said they had a written care plan.

Just over a third (39%) of respondents to the survey said their GP was “very good” at involving them in decisions, the study found.

The study also found that just over half (56%) of the 77 850 respondents to the 2016 Adult Inpatient Survey said that they were definitely as involved as they wanted to be in decisions about treatment.

National Voices said that there had been some improvement in the extent to which people were involved in health and care decisions but that more needed to be done.

Don Redding, director of policy at National Voices and lead author of the study, said, “Although people with chronic conditions are now the main users of care, there is little evidence of proactive care planning to help them live their lives and manage their conditions in the best ways they can.”

He added, “The research shows that the available measures of people’s experience are unable to tell us if person centred ambitions are being achieved. How will we know whether we are getting there?

“It is time for a strategic overhaul of the measurement of person centred care. This is vital to plug the quality gap and to help local systems to succeed.”

Niall Dickson, chief executive of the NHS Confederation, said the study showed a “worrying trend” which reflected the relentless pressure under which many services are operating.

“The health and care system is short of money and people, and that can make it difficult to give patients the time and attention they need,” Dickson said.

He added, “At this stage there is only so much that can be done but at the heart of it will be effective planning at local level and good co-operation between health and social services and between community and hospital services.

“In the longer term we will continue to push the government for a comprehensive review of the funding of health and social care and how we meet the ever growing demand on these services.”

Rachel Power, chief executive of the Patients Association, said the study showed that there was still a long way to go to achieve person centred care as standard. “While there has been some good progress, it has not amounted to the fundamental shift in care delivery that policy makers have often promised, and that patients need and deserve,” she said.

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