Quality statement 4: Individualised care

Quality statement

People using adult NHS services experience care and treatment that is tailored to their needs and preferences. [2012, updated 2019]

Rationale

The NHS Constitution for England says that services must reflect, be coordinated around and tailored to, the needs and preferences of patients. Recognising people as individuals improves the safety, efficiency and effectiveness of healthcare. Understanding which aspects of individuality and service responsiveness are important and valued by patients ensures that the human nature of healthcare is not lost. This involves giving people opportunities to discuss their needs and preferences. Engaging people in their own care helps them to actively manage their health and wellbeing.

Quality measures

Structure

a) Evidence of local arrangements to ensure that people have opportunities to discuss their health beliefs, concerns and preferences.

Data source: Local data collection.

b) Evidence of local arrangements to ensure that people's needs and preferences are assessed, addressed and regularly reviewed.

Data source: Local data collection.

c) Evidence of local arrangements to ensure that care and treatment is tailored to people's needs and personal preferences.

Data source: Local data collection.

Process

a) Proportion of people given the opportunity to discuss their health beliefs, concerns and preferences.

Numerator – the number of people in the denominator who were given the opportunity to discuss their health beliefs, concerns and preferences.

Denominator – the number of people accessing NHS services.

Data source: Local data collection, for example patient records. The Care Quality Commission (CQC) Adult inpatient survey presents information on people staying in hospital who found someone on the hospital staff to talk to about their worries and fears.

b) Proportion of people with care tailored to their needs and preferences, taking into account their circumstances, their ability to access services and their coexisting conditions.

Numerator – the number of people in the denominator whose care was tailored to their needs and preferences, taking into account their circumstances, their ability to access services and their coexisting conditions.

Denominator – the number of people accessing NHS services.

Data source: Local data collection, for example patient records and surveys. The CQC Adult inpatient survey presents information on people staying in hospital. This includes whether people thought they were given the right amount of information about their condition or treatment and had enough emotional support from hospital staff, and if staff did everything to help them control their pain. It also surveys if people thought they had enough to drink and were given enough help to eat meals, to wash and to clean. The NHS GP patient survey presents information on the proportion of people who felt that their needs were met at their last GP appointment.

c) Proportion of people accessing NHS services who have their needs and preferences assessed, addressed and regularly reviewed.

Numerator – the number of people in the denominator who have their physical and psychological needs regularly assessed, addressed and regularly reviewed.

Denominator – the number of people accessing NHS services.

Data source: Local data collection, for example patient records and surveys. The CQC Adult inpatient survey presents information on people staying in hospital. This includes whether people thought they were given the right amount of information about their condition or treatment and had enough emotional support from hospital staff, and if staff did everything to help them control their pain. It also surveys if people thought they had enough to drink and were given enough help to eat meals, to wash and to clean. The NHS GP patient survey presents information on the proportion of people who felt that their needs were met at their last GP appointment.

Outcome

a) Evidence from patient experience surveys and feedback that people feel their care has been informed by their health beliefs, concerns and preferences.

Data source: Local data collection, for example local surveys.

b) Evidence from patient experience surveys and feedback that care was tailored to people's needs and personal preferences, taking into account their circumstances, their ability to access services and their coexisting conditions.

Data source: Local data collection, for example local surveys and records of feedback from people using services.

c) Evidence from patient experience surveys and feedback that patients feel their physical and psychological needs were assessed, addressed and regularly reviewed.

Data source: Local data collection, for example local surveys and records of feedback from people using services.

What the quality statement means for different audiences

Service providers (such as GPs, hospitals, community services and local authorities) ensure that systems are in place to provide opportunities to establish people's health beliefs, concerns and preferences and use them to offer individualised care. Service providers tailor care and treatment to people's needs and personal preferences, taking into account their ability to access services and their coexisting conditions. They also have systems in place to regularly assess, address and review people's physical and psychological needs.

Health and social care professionals (such as GPs, doctors, nurses and social workers) discuss with people their health beliefs, concerns and preferences. They tailor care and treatment to a person's needs and personal preferences, taking into account their circumstances, their ability to access services and their coexisting conditions. They also assess, address and regularly review a person's physical and psychological needs.

Commissioners (such as clinical commissioning groups and NHS England) commission services in which people's individual health beliefs, concerns and preferences are established and care is tailored to people's needs and personal preferences. These should take into account people's ability to access services and their coexisting conditions and should assess, address and regularly review people's physical and psychological needs.

People using NHS services have opportunities to discuss their health beliefs, concerns and preferences with the people providing their care. Their care and treatment take these into account along with their needs, personal circumstances, how easy it is for them to use the services and any other health problems they have. People are regularly checked and asked whether they need any extra support, for example with eating and drinking, pain relief, continence problems or anxieties.

Source guidance

Patient experience in adult NHS services (2012) NICE guideline CG138, recommendations 1.2.4 to 1.2.9, 1.3.1 to 1.3.3 and 1.1.4

Definitions of terms used in this quality statement

Needs and preferences

These relate to an individual and include:

  • health beliefs

  • concerns

  • preferences

  • personal circumstances including ability to access services

  • physical needs including nutrition, hydration, pain relief, personal hygiene and anxiety

  • psychological needs including anxiety and depression

  • coexisting conditions.

[NICE's guideline on patient experience in adult NHS services]