Reflective Approaches in Implementing Person-Centred Practice in NHS

This report provides a comprehensive overview of reflective approaches in implementing person-centred practice within the National Health Service (NHS). It begins by comparing the medical and social models as they apply to person-centred care, emphasizing patient knowledge, beneficence, and therapeutic alliances in the medical model, and societal barriers and pathways to healthy living in the social model. The report then discusses how to adopt a person-centred approach, including self-awareness, understanding patient values, engagement, shared decision-making, empathy, and holistic care. Challenges in applying person-centred care, such as challenging behaviours and conflicts, are reviewed, along with an evaluation of how dilemmas affect consistency in approach. Furthermore, the report explores how different legislations, including the Health and Social Care Act 2008 and data protection acts, are reflected in the provision of person-centred care, and suggests solutions to address various problems. It also includes a comparative reflective account of the author's own provision of person-centred care, an interrogation of their effectiveness in managing their workload, and a critical evaluation of their practice. The report concludes with the construction of short, medium, and long-term plans to improve the author's practice, and a critically reflective action plan.

REFLECTIVE
APPROACHES IN
IMPLEMENTING
PERSON CENTRED
PRACTICE

Table of Contents
INTRODUCTION...........................................................................................................................1
PART 1............................................................................................................................................1
LO 1.................................................................................................................................................1
P1. Comparison of how the medical and social models apply to person centred practice in
health services........................................................................................................................1
P2. Discussion of how to adopt a person centred approach...................................................2
M1. Reviewing of challenges with applying person centred care..........................................3
D1. Evaluation of how dilemmas experienced affect consistency in approach.....................4
PART 2............................................................................................................................................4
LO 2.................................................................................................................................................4
P3. Discussion of how aspects of different legislation's are reflected in provision of person
centred care.............................................................................................................................4
P4. Suggestion of appropriate solutions to different problems..............................................5
M2. Assessment of challenges in interpretation of different legislation's..............................6
D2. Critical evaluation of effectiveness of health and safety and safeguarding systems.......7
PART 3............................................................................................................................................7
LO 3.................................................................................................................................................7
P5. Producing a comparative reflective account of own provision of periods of person centred
care.........................................................................................................................................7
M3. Interrogation of own effectiveness in managing own workload as part of a team.........9
D3. Critical evaluation of own and others’ practice in enabling a consistent approach to high
quality care.............................................................................................................................9
LO 4...............................................................................................................................................10
P6. Constriction of short, medium and long term plan to improvise own practice and skills10
P7. Analysis of practicality of own plans in relation to contribution to collective effectiveness
of own workplace team........................................................................................................12
M4. Implementation of own short term plan........................................................................13
M5. Monitoring own implementation plan..........................................................................13
D4. Production of a critically reflective action plan.............................................................14

CONCLUSION..............................................................................................................................15
REFERENCES..............................................................................................................................16

INTRODUCTION
Reflective practice in health and social care refers to an activity under which an individual
appropriately and effectively reflects their own working and past experiencing while providing
care to patients in a healthcare setting (McCormack and McCance, 2016). On the other hand,
person centric approach is a method adopted by healthcare organisation, wherein they emphasise
on individual’s personal needs and consider them quite central in terms of treatment and care
process. This is a highly appropriate practice which is being followed by several healthcare
organisations throughout the world.
The report below is divided into three parts and it focuses on National Health Service, which
is one of the most prominent healthcare organisations of the world. The first part of the report
addresses promotion of a holistic approach to person centred practice. Moreover, the second part
of the report emphasises of reviewing current policies, legislations and regulations, in relation to
effective person centred practice. In addition to this, the third part addresses reflection of own
practice within health settings, moreover, exploration of ways to develop own professional skills
and behaviours.
PART 1
LO 1
P1. Comparison of how the medical and social models apply to person centred practice in health
services
Person centred practice is the one wherein patients actively participate in their own treatment,
along with emphasis on their personal desires, rather than fulfilling the carers’ own personal
agendas (McCormack, 2017). However, there are several medical as well as social models which
apply to person centred practice within health services like NHS and thus, they are required to be
appropriately compared.
In terms of medical models, one of the most evident frameworks is related to the ones
provided by Mead and Bower, known as five dimensions of patient centeredness. This
appropriately and effectively addresses several dimensions which apply effectively in patient
centred practice. Hence, these factors are discussed below effectively:
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Patient Knowledge: One of the most evident dimensions of this medical model is that it is highly
important for an individual to appropriately and effectively acquire a complete and proper
knowledge about their patients (Wald, 2015).
 Beneficence: This dimension is related to how best the care givers provide
comprehensive help and assistance to the patient after gaining knowledge about their
health related problems.
 Power and Responsibility: Within this stage, the power imbalance is significantly
reduced, wherein the patients’ autonomy is highly respected by involving them into
decision making.
 Therapeutic Alliance: An alliance is formed within this stage, which witnesses a strong
relationship between clinicians and patients in order to work to improvise their health
conditions.
 Self Awareness: This dimension addresses the issues of how emotional responses and
biasness must be completely eradicated to ensure a complete and effective treatment.
As reflected above, the medical model pays a significant amount of emphasis of how knowledge
and bonding between patients and care givers must be confined to providing appropriate
treatment for their ailments. This model does not effectively focuses upon their personal needs
and strengths, rather just involve them in decision making, without analysis of their wants
(Kitson and Harvey, 2016).
However, in context with the social model, it effectively witnesses the society, as well as
barriers in relation to progression of aspiration of people. One such model is the social model of
disability. Within this model, the person centred practice is more focused on finding a better way
for disabled patients to lead their lives, by removing several social barriers, along with providing
high quality treatment for their physical betterment.
Thus, in terms of comparison, while the medical model focuses on aspects like physical
betterment, the social one is more considerate towards providing effective pathways to lead a
healthy and safe life, which adopts internal and external improvements that could positively
influence a patient’s health.
P2. Discussion of how to adopt a person centred approach
It is quite important for a care giver, particularly support workers to adopt person centred
approach when planning the delivery of care and support for individuals with needs. However,
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there are several steps as well as considerations, which are required to be appropriately assessed
by care givers in order to adopt this practice effectively (Zoffmann and et. al., 2016). All these
variables are presented as under:
 Self Awareness: Self concept is one of the first stages which must be inculcated within a
professional practitioner in order to adopt person centred care. A prime consideration
which the carer must possess at this stage is the Duty of Care. These are ethical codes of
conduct which reflect adherence to standards of appropriate and reasonable practice.
 Patient’s Values and Beliefs: This part of the process is related to effectively acquiring
knowledge related to the beliefs and values within patients. It helps the care givers in
appropriately support them and promote a healthy lifestyle.
 Engagement: It is related to engagement of carers with patients, where the latter is
required to appropriately instil trust and transparency, along with appropriately respecting
the rights, choice and privacy of patients. Furthermore, the engagement does is not
confined to patients along, rather their families, friends and communities associated with
them are also included.
 Shared Decision Making: This step is related to providing patients with equal
responsibility of taking their own decisions associated with their treatment. Moreover,
professionals are required to empower the patients through an appropriate recognition of
their own requirements for the treatment.
 Empathy: One of the major aspects, this step is related to empathising the patient through
an active demonstration of respect, promotion of partnership, along with taking
appropriate feedbacks from the patient (Brooker and et. al., 2016).
 Holistic Care: The last step of the process while planning delivery of care and supporting
individuals is to implement a holistic approach in context of enhancing the overall care
provided to patients. For this, the carer must adopt professional approaches to care, which
includes effective compassion, competence, appropriate channels of communication,
transparency and effective commitment.
M1. Reviewing of challenges with applying person centred care
While providing effective person centred care to patients, there are several challenges
which could be faced by a care giver within their organisational settings. As a support worker, in
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community nurse with children, there have been several challenges which have been faced by
me, which are discussed below:
Challenging Behaviour: One of the major challenges I faced while providing person centred
care to patients has been their constantly challenging behaviour (Mudge, Kayes and McPherson,
2015). This is because their wants and requirements sometimes repeatedly change, which makes
it quite difficult to support them or provide appropriate care.
 Conflicts: Another challenge which I faced was related to conflicts between values of
others and principles of good practice. Reason for such practice is that the values tend to
be quite dynamic, which sometimes gets challenging to align with principles of good
practice, hence, arising conflicts.
D1. Evaluation of how dilemmas experienced affect consistency in approach
It is highly necessary to ensure consistency within approach while appropriately and effectively
providing person centred care to patients. However, dilemmas tend to refrain this consistency in
care professionals (Cheng and et. al., 2016). In my case, while there was evident impact of
challenging behaviours on my consistency, my performance was more affected by conflicts
within values and principles. The reason for the same is that I failed to appropriately interpret the
changes in values, which broke my consistency in a very harmful manner.
PART 2
LO 2
P3. Discussion of how aspects of different legislation's are reflected in provision of person
centred care
Health and social care act 2008, regulations 2014 describes the action that providers must take to
make sure that each person receives appropriate person-centered care and treatment that is based
on an assessment of their needs and preference. Application of legislation's differs in provision
of person-centered care for example supporting workers in community of nurses with children
plays primary role is to provide treatment to patients. Together with this community health
nurses offers education to community members about maintaining their health so that occurrence
of diseases and deaths can be minimized (Tobiano and et. al., 2017). Regulation 9 is
implemented to make sure that people using a service have care or treatment that is personalized
specifically for them. As per this regulations actions that needs to be taken by nurses for
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providing personalized services to children are described. The regulations must describe the
action that providers must take to make sure that each person is receiving services based on the
assessment of their needs and preference. As per person centered care legislation’s when nurses
are providing care services to children then their must be someone who is giving law full consent
to review of the care treatment. For health and care of children implementing hygienic services is
one of the primary concern. As per health and safety regulations safe practice is very important
for the promotion of dignity in care (Sargeant and et. al., 2015). There are number of
legislation’s to support health and safety at workplace. With implementation of health and safety
hygiene can be maintained which is beneficial for nurses and children. When person centered
care is provided than manual handling operations regulations 1992 is considered. It is involved
with care providers as people with limited mobility needs to be assisted safely to move and
transfer. As per health and safety regulations proper hygiene and sanitation facilities must be
present when services of person center ed care is provided to individuals.
Safeguarding in the field of care setting needs to be done in terms of all the information
provided to other for a particular patients. As per data protection act 2018 an individual is
protected for transferring any information by the law. Information in relation to a particular
individual is transferred when demanded with the consent of individual who is going to affected
with the information. Sharing of information also done as per law and with orders of courts. Data
protection is one of the primary concern in care setting. In an organization when information
transfer process is not followed by any superior person then policy of whistle blowing helps in
identifying the culprit. A positive partnership must be their among patients and NHS
organization so that issue of data protection is implemented most productively. When a effective
communication system is applied through the organization then desired results for health and
safety and safeguarding is received (McCormack and et. al., 2015).
P4. Suggestion of appropriate solutions to different problems
Their are several problems that are created for not implementing health and care facilities
in community of support worker that provides service of nurse with children. The common
barriers that leads to compromise in the quality of services are insufficient staffing, inadequate
training, environmental constraints and unsupportive staff attitudes. When implementing
regulations for health and safety which results in clean and hygiene environment is faced with
the issue the individuals do not aware regarding importance of hygiene and are not adoptive with
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the process. Staff which is appointed are not sufficient to introduce all the requirement of
hygiene which leads to safe environment. Appropriate solutions to resolve the issue of health and
safety is to provide proper training to all the staff members who are involved in person centered
care. Together with training legislation as per health and social care act 2008 is followed by all
the employees providing personal care services. Attitude of employees needs to be developed in
such manner so that health and safety becomes one of the primary concern for them (Surr and et.
al., 2016).
Unlawful transfer of data this is stored in NHS organization is one of the primary issue
that is faced while implementing safeguarding policies in the care setting. Safeguarding of all the
data that is stored in NHS will be achieved through following the data protection act and through
implementing health and social care act. All the policies that are defined in the data protection
act is important to protect data. Individuals who are receiving treatment form a organization must
have security towards security of information regarding treatment. The problem of data
protection in NHS will be resolved through implementing strict rules and regulations for
providing services. Implementing electronic surveillance on the data protection system will
provide effective results. Together with this employees in organization must be introduced with
their duties and reprehensibility for data protection (Mellor-Clark and et. al., 2016). Enhancing
whistle blowing and rewarding employees for the same will help NHS to implement
safeguarding towards data protection.
M2. Assessment of challenges in interpretation of different legislation's
Challenges faced by health care professionals and others in interpretation different
regulations in relation to planning and provision of person centered care in NHS is based on
three themes. These themes are traditional practices and structures, stereotypical attitudes form
professionals and factors that are related to the development of person-centered interventions.
When legislation are implemented then traditional practices followed and structured by
professionals restricts implementing new rules and regulations that helps in enhancing quality of
person centered care. Stereotypical behaviour of professionals do not allow them to try and
involve in new practices for better results of all the services and meeting the requirements of the
changing environment (Baldwin, 2016). Their are various factors that are implemented in
relation to development of person-centered interventions and considering all the factors is quite a
challenging task.
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D2. Critical evaluation of effectiveness of health and safety and safeguarding systems
Three themes that acts as a barrier to implement person-centered care services to
professional needs to be turned positively so that objectives can be achieved. Health and safety
system that is implemented at NHS is quite effective because professionals that are appointed for
providing their services are trained with new structure of care setting so that productive results
can be achieved. In the process of training employees are developed in such manner so that they
become adoptive to new system and effective health and safety system is introduced in
organization. Interventions of various factors for development of person-centered care services
helps in providing safeguarding services so that data protection can be achieved (Coady and
Lehmann, 2016). In the current phase NHS organization is adopting these themes and working
towards establishing a efficient person centered care organization.
PART 3
LO 3
P5. Producing a comparative reflective account of own provision of periods of person centred
care
INDIVIDUAL 1
Brief Description of Patient
One appropriate individual to which I provided person centred care to was a 14 year old male
suffering from Dementia. He had this problem for quite a while and his condition was worsening
gradually even after heavy medications. There were radical and drastic changes in his behaviour,
such as anger, anxiety and depression, which enhanced the ineffectiveness of the treatment
(Scolobig and et. al., 2015).
Evidence of provision of person centred care
There are several ways through which person centred care was provided to him by me. For
instance, I acted as a counsellor to help him understand the seriousness of his health condition
and why he requires complying with the treatment. Furthermore, I transparently explained him
the treatment which could be given to him, to which he himself adopted the kind of treatment he
wished to take. Furthermore, as a support worker, I coordinated the treatment processes, along
with giving personalised attention to the patient.
Description of Activity and how person centred care was provided
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In context of providing an appropriate person centred care, a customised care approach was
adopted by me, which was supported by my seniors. The idea was to dynamically engage the
patient into several group activities and medical procedures, which would surely be helpful in
their cognitive development. Furthermore, it also could have helped me appropriately and
effectively enhance the scope of improvement. However, while I was appropriate in empathising
with the patient and persuading him to effectively indulge within the treatment; I was quite
ineffective in terms of coordinating the care staff, resources and medical procedures, which
unnecessarily delayed the whole process. This made me realise that I require further practice to
enhance my management skills further (Moore and et. al., 2017).
INDIVIDUAL 2
Brief Description of Patient
Another patient to which the person centred care was provided was a 10 year old female with
Autism. Due to her mental and physical underdevelopment, she suffered quite a severe issue with
communication, along with enhanced aggressive behaviour, which was a cause of concern that
required appropriate person centred behaviour to ensure betterment in her condition.
Evidence of provision of person centred care
The patient was quite insufficient of keeping up her own demands, for which, her parents and
some community members were approached and coordinated with in order to give her the best
treatment possible. Furthermore, medical professionals were also approached to ensure a
collective attention to the patient. Thus, as part of person centred approach, she was
communicated by me regarding her medical condition and procedures that the hospital was
willing to provide her with. However, along with her, each of her peers, along with other
professionals were appropriately involved within the whole treatment (Brooker and Latham,
2015).
Description of Activity and how person centred care was provided
The case of this patient was quite challenging as the direct communication from the patient was
very much difficult. Moreover, this further enhanced the barriers in provision of a desired
medical procedure. However, due to involvement of her family, the treatment was quite
appropriately and effectively provided to her in a sound manner. While in this period of time I
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was very much effective in decision making, I realised that there is a serious need of
enhancement within my communication skills. Moreover, I also figure out that another skill
which must be increased to enhance my effectiveness is critical thinking.
COMPARATIVE REFLECTIVE ACCOUNT
Both the scenarios were very much helpful for me in context of implementing person centred
approach in case of both the patients. Moreover, it also made me realise my competencies in
relation to provision of a similar care in future. For instance, while the scenario one made me
realise that I am effective in terms of persuasions, I still lack in management and coordination.
On the other hand, scenario 2 appropriately allowed me to witness my effectiveness in terms of
teamwork and decision making, whilst making the scope of improvement evident for
competencies like communication and critical thinking skills. Thus, I realised, that within person
centred care, there are still many areas of expertise which are required to be explored and
implemented by me to ensure an overall effective pathway in context of person centred
approach. Moreover, in case next time this situation arises, it would be quite effective for me to
enhance my limitations and provide better care to patients through person centred care.
M3. Interrogation of own effectiveness in managing own workload as part of a team
Person Centred approach requires individuals to work as an effective part of the team, which is
composed of several medical professionals, care staff, peers and community (Britten and et. al.,
2017). Hence, it is quite necessary to appropriately interrogate one’s own effectiveness in
managing the work load. As a support worker, while I was quite effective in terms of sharing
effective responsibility, I am quite ineffective when it comes to care coordination. Furthermore,
with weaker communication skills, I was quite ineffective in managing my own workload. In
addition to this, since my management skills are week, I was somewhat inappropriate in
managing my work as part of a team through ineffective planning.
D3. Critical evaluation of own and others’ practice in enabling a consistent approach to high
quality care
As mentioned above, consistency within person centred care approach is a necessary
requirement. Throughout both the scenarios, I had appropriate cooperation and effective
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