Unit 19: Reflective Approaches in Implementing Person Centred Practice

This report delves into the intricacies of person-centred care, examining the application of social and medical models within healthcare settings. It explores the challenges faced in implementing person-centred approaches, including difficulties in ascertaining patient wishes and navigating ethical dilemmas. The report identifies relevant legislation, such as the Health and Social Care Act and the Care Act, and discusses their impact on care provision. It also highlights the challenges encountered by healthcare professionals in adhering to these regulations, including financial constraints and political resistance. The report incorporates a reflective log, development plan, and action plan to provide a comprehensive overview of person-centred practice and its implementation within the healthcare system, ultimately aiming to improve patient care and outcomes.

REFLECTIVE
APPROACHES IN
IMPLEMENTING PERSON
CENTRED PRACTICE

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................3
MAIN BODY..................................................................................................................................4
PART 1............................................................................................................................................4
Application of social and medical models...................................................................................4
Person centred approach while giving care.................................................................................5
Challenges of persona centred care approach..............................................................................4
Dilemmas experienced.................................................................................................................5
PART 2............................................................................................................................................7
Different legislation reflects in the provision of person-centred care.........................................7
Appropriate solution to different problems when implement specific rules, legislation and
policies.........................................................................................................................................8
Challenges faces by health care professionals.............................................................................9
Themes on health and safety, safeguarding and protection to meet legislative requirements.....9
PART 3..........................................................................................................................................10
Section A: Reflective Log.........................................................................................................10
Section B & C: Development Plan and Action Plan.................................................................13
CONCLUSION..............................................................................................................................17
REFERENCES..............................................................................................................................18

INTRODUCTION
Person centred health are practice is a very innovative and extremely effective practice. The
following report will highlight the different practices that are adopted in the person centred care
practice and the challenges that arise. Further the legislations related to person centred health
care will be identified and lastly a reflective account will be presented.
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MAIN BODY
PART 1
4

Application of social and medical models
In person centred care, the care taker needs to
use both social and medical models where the
patient who requires care and treatment is a
social human being as well. The comparison
between social and medical models for person
centred healthcare practices can be ascertained
in following manner:
Social Models:
 The social models basically involve respect
of the cultural beliefs ad backgrounds to
which the patient belongs. Social models
remind the caretaker that while giving care
it is necessary to consider these beliefs in
the care practices that are being developed
and encouraged for the better care of the
patient.
 There are four major aspects related to the
social care that have been specified which a
health care worker needs to abode by in all
conditions i.e. offering dignity, compassion
and respect. In the accordance or these four
major principles, the health care workers,
ensure that they provide social care aspects
s well n the overall care plan that has been
formulated by them (Hobson, 2019).
Medical Models
 The medical beliefs are not related to the
feelings and emotions and rather focus
solely on the care related aspect. These
models state that a person should always
Challenges of persona centred care approach
While serving as a RN in NHS, there are
various challenges that I have encountered
during the process of giving person centred
care to the patients of NHS. The most
prominent challenge being the fact that it is
very difficult to exactly ascertain what is the
wish of the patient or the care plan with which
they are comfortable. This is especially more
challenging when the patient requires urgent
treatment or care. At that time, developing a
person centred care approach becomes very
difficult (Pirhonen and et.al., 2019).
Another challenge lies in the type of patient
that is being treated i.e. some patients are
extremely friendly where they understand the
need to introduce certain treatments and
medicines but on the other hand, some patients
are very rigid where even after consistent
understanding they do not understand why a
particular test, medicine or treatment is
necessary for them. Therefore, it is very
difficult to treat some patients adequately
under the person centred approach.
I think that the third most challenging that we
as health professionals face while giving
person centred care is that we do not have any
fixed protocol or guidance that how should I
act when such a such situations arise. The risk
actor is too high in the person centred care and
this increases the wariness that comes while
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feel calm and relaxed while being treated.
The focus should be on using optimum
treatment methods and techniques so that
patient can recover quickly.
 The major components of the medical care
include the offering of coordinated care,
treatment of support whenever required.
Personalised care and care plan etc. These
solely focus on the treatment that is being
given to the patients.
Collectively these help in addressing the care
needs of the patient satisfactorily.
Person centred approach while giving care
The person centred approach basically assists
in developing a care plan and treatment
mechanisms that are formulated after keeping
the person in loop i.e. their views, desires,
comforts, likes, dislikes etc. are taken into
consideration before developing a
comprehensive care plan (Britten and et.al.,
2017). This approach is counted as one of the
major contribution towards development of
high quality healthcare. The major steps that
are required in order to develop a person
centred care plan involves a series of actions
that need to be completed in order to ensure
that a comprehensive care plan has been
developed. These include:
 Understanding the thought process of
patients and recognising them as an
individual.
deciding on a course of action. If something
goes wrong then even the license to work as
medical professional might get cancelled and
the risk to life is the supreme risk that is being
faced by the patients as well (Sampson and
et.al., 2019).
Dilemmas experienced
There are a multiple dilemmas that can arise n
the workplace setting while giving a person
centred care approach to the patient.
The most common dilemma is the cultural
dilemma related to the traditional mindset of
many patients. Sometimes there are many
female patients who refuse o get treated by
male medical professionals and in majority of
cases it is fine because the female doctors or
caretakers can treat them. But in certain critical
situation, when they are not available, it
becomes difficult to treat them. The work
ethics says that the patient should not be forced
against their will but practically it becomes
difficult to treat them in such situations.
Another dilemma is that the patient has the
right to choose their own kind of lifestyle and
as healthcare professionals; they cannot
contradict it under person centred approach.
But many times that lifestyle is detrimental to
the current condition of the patient and in such
cases as well, the dilemma rises regarding the
duty that is to be fulfilled. On one hand, the
work ethics say that people must be protected
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 Recognising the fact that the patient is an
expert of his own health, the symptoms
that they are facing and the causes behind
it.
 Developing a holistic approach towards
first assessing and evaluating the needs
and exact mental state of the patient and
then developing a care plan after
consulting them.
 The families of the patients must be
included in whatever care plan or
treatment that is being planned for the
patient.
 The healthcare worker needs to ensure that
the entire process of treating the customer
is flexible and all the activities and tests
which are to be performed are easy to
navigate (Moore and et.al., 2017).
 The most critical aspect is healthier
environment and ensuring that the
facilities are clean and properly sanitised
as this can prove to be a challenging task
for the patients if they find the
environment unhygienic.
 Lastly another major aspect of giving a
person centred care is that the entire staffs
that are treating must be extremely
supportive and they must understand the
need to be well trained in communication
and caring aspect.
and guided by the caretakers but person
centred approach makes that infeasible
(Santana and et.al., 2018).
Therefore, in this manner, there are various
dilemmas that arise for the care takers while
dealing with such patients.
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PART 2
Different legislation reflects in the provision of person-centred care
National health service (NHS) offers variety of services i.e. pharmaceutical care, health
care, personal care and health information services to the people. NHS is divided into three
system so it is known as complex health system. It operates in the UK and offers it’s services
through health system. NHS provides personal centred care service to those people who needs
support to live their life effectively (Bing-Jonsson and et.al., 2018). Organization follows in their
health care practices such as provides coordinate care and support to the patient or person who
have mentally and physically disability. It gives personalised care and treatment so people can
live their life independently and meet it’s objectives over the period. It supports people to
determine and improves their own strengths and abilities to live independent and meeting life.
There are numerous legislations of person-centred care which is follows by NHS. The
regulations are described as follows:
Health and Social Care Act
Health and social care act were proposed in 2012. According to act, care provider must
ensure that individual receives appropriate person cantered care and treatment which is based on
an assessment of their requirement and preferences. The act defines person centred care in the
guidance such as puts the person who take care service at the centre of their cares, treatment and
support. NHS offers personal centred care services as well so it complies with this legislation.
Care Act
It is second act of person-centred care that was imposed in 2014 which is related to care
and support for adults. This law is related to support for carer, make sure provision about
safeguarding adults from social evils i.e. social distancing, abusing and discrimination. The law
highlights adults who needs more support and care. NHS comply this legislation in it’s practices
while offering person centred care services to adult (Buckley, McCormack and Ryan, 2018).
There are some principles of person-centred care which are act as legislation for the health
providers and follows by NHS.
Treat people with dignity, compassion and respect
When patients enter care then they loss their independence that puts their dignity in a
danger zone. Then it is duty of the person cantered care is to maintain dignity of people by
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respecting their wishes and treating them with empathy. It is important part of person cantered
care which must implement in their practice by the health providers.
Provide coordinate care, support and treatment
The principle is undertaken health and social care act which denotes that health providers must
understand needs and requirement of the patient. In other word, when patients move between
service or care in that situation health provider rebuilds understanding of their personal needs
and wants and provides outcomes-based care services to them. NHS practices the principle in
their care services while offering person centred care (Cardiff, McCormack and McCance,
2018).
Offers personalised care, support and treatment
According to the principle, it is very essential for the health care organization to
understand that which health provider is suitable for the service user or may not be suitable for
another. If a health provider who is good to offer health care service but does not have positive
attitude as result cannot offer quality service. Personalized care allows carer to retain some
independence and meets their personal wants and needs as well. NHS strictly focuses on health
providers services so that can monitor their performance at the workplace.
These are different type of legislation in the prospect of person-centred care which are followed
by NHS within workplace.
Appropriate solution to different problems when implement specific rules, legislation and
policies
There are numerous problems are faced by NHS while implementing different regulation,
legislation and policies such as Health and Social act is the main legislation of health system
which is implemented in 2008 but later on upgraded in different time schedules. Health and
social care act mean reduces inequalities in people and make them independent by offering high
support. for example, When NHS implemented this act in its organization, in that state it has to
face financial issue and uncertainty in it’s working as well. The reason behind is that they have to
change their policies as per the act, which helps company to take advantage of this legislation.
Care act is also another legislation which was imposed in 2014 by UK’s health government
centre. When NHS implements this legislation in the organization then it has face first challenge
is political because politician resists proposals to introduce act in the specific health system.
Integrated care licensed policy also introduces by organization which helps to offer wide variety
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care service to the people. While taking licensed have to face political and legal issues by NHS.
To overcome the issue can follow all the guidance that helps to implement rule effectively (Janes
and et.al., 2016).To resolve political issues can follow overall guidance that provides
understanding about norms so it become easy to comply overall rule effectively. To get licence
of integrated care has best option to keep number of authentic documents related to personal
centred care which automatically resolve this issue.
Challenges faces by health care professionals
When NHS has implemented health and social care act legislation in the organization in
that state health professionals have to face numerous challenges while working with other
employees. For example, according to legislation health providers must implement overall
principles while offering person centred care services to the patient. It causes health
professionals recruits those employees who has expertise in specific field and provide good
quality service at the workplace. So, it become major task for the health professionals in the
NHS. Care act rule is also imposed by NHS in the provision of person-centred care. The big
challenge of the act is management issue which is faced by health professional. According Care
Act, health professionals must provide personalized service to individual service user and creates
safe environment for them so that they feel comfortable and learn to live their life independently
(Kelly and et.al., 2019). So, health professionals of NHS have to change their practices which
leads complexity in the management. Personal cantered care is basically dependent on the
principles that leads big challenge for the health professional such as most of the people needs
personalized carer and other needs medical care services. While NHS does not have adequate
employees, who can offer specified services to individual one. So, health professionals have to
handle number of patients in same time. These are the main challenges which are faced by health
professionals while implementing different legislation and principles in their practices.
Themes on health and safety, safeguarding and protection to meet legislative requirements
Health and safety at work
It is important theme in the prospect of health and safety because it is primary duty of
health organization. Health professionals are the main source of organization who provides
various type of services as per patient needs such as Medicare, health care and social care. So it
is major responsibility of the company to provide healthy environment of carer whereas they feel
safe and maintains their wellbeing. In addition, organization must implement sustainable
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practices in their operation while offering personal centred care services to the patient. While
health care professional has duty to make sure patients that they are safe at the workplace and
can live their life independently without restriction. Health providers must provide outcome-
based services to patient which leads positive impact on their health and reduces health care
issues. When health care organization follows all the rules in the organization and it’s health
providers work as responsible then it becomes easy for organization to meet legislative
requirements. The theme is good and quite effective for meeting legislative requirement but
needs strictness while offering personal centred care services.
Safeguarding and protection of employee and patients
It is another theme that denotes organization follows all legislative laws effectively and
provides quality service to their employee within any discrimination at the workplace. Health
care organization must provide health care insurance policy to health providers and patients as
well so that if something happens wrong then organization recovers it. NHS follows different
type of legislations i.e. Care Act. Health and social care Act, integrated care licensed and
employment protection law etc. To meet requirement of legislation adapts various models like
outcome-based care which is basically designed for the patient (Ward and et.al., 2018). Health
professionals understand patient attitude for their health and their needs then offers care service
which improves their health and makes them feel safer. On the other hand, organizations provide
employment protection policy which ensures health providers about workplace safety and
maintains their wellbeing. These type changes help organization to meet legislation requirement.
The major drawbacks of the them is this it requires high maintenance which is more complicated
for the organization
PART 3
Section A: Reflective Log
Student name
Qualification BTEC Level 5 HND in Healthcare Practice
Unit number and title
List the assessment criteria for which the activity provides evidence
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Scenario1: Give a brief description of the patient or service user or individual in
need that you have provided person- centered care to
The person that was being taken care of here involved a pregnant woman who was a
chain smoker and was facing serious chances of developing a lung cancer. The main issue
here was that she was in her early thirty’s which is already a late enough stage for her to
become pregnant and then she could not seem to resist the desire to smoke a cigarette.
Now that she was pregnant for over two weeks, the person centered care plan for her was
a extremely critical and intricate where the threats faced were serious. This was the
scenario one that I encountered in the previous healthcare organization where I was
working as a registered nurse.
Provide evidence of how you have provided person centered care taking into consideration
the key principles of person- centered care. 1. Affording people dignity, compassion and
respect. 2. Offering coordinated care, support or treatment. 3. Offering personalised care,
support or treatment.
The approach that was mainly adopted incorporated coordinated care, support, treatment and
personalized care but the dignity and compassion lacked amongst the caretakers. The nurses
completed all their duties on time and diligently but the emotional support was lacking where
she was not listened to or sympathized with and simply treated rather than being cared for.
Description of activity and how have provided person centered care for Individual 1
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Collectively the team of all the caretakers and nurses that were caring for her developed a very
comprehensive plan for her where we worked heavily on her diet and tried to minimize the
chances of any potential threats to her baby conducting regular tests etc. The entire care plans
was discussed with the father and mother both before implementing it and the in terms of
medical aspect, we were providing as much comprehensive care and support as we could. But
the person centered care also requires the use of emotions, compassion and understanding and
this was seriously lacking in the approach that was adopted. I tired to spend at least an hour just
listening to her and giving her mental support which is critical in this stage, but such was not the
case for other care takers, where they tend to humiliate her by ignoring whatever she had to say
and being judgmental.
Scenario 2: Give a brief description of the patient or service user or individual in
need that you have provided person- centered care to
Another scenario was in the current organization i.e. NHS which involved developing a
person centered approach for an older man of 65 years who was suffering from
Alzheimer’s and often tend to forget things which is the major symptom of the disease. He
required an extensive care plan and almost 24 hour assistance including the hours when he
was sleeping because of the tendency to wake suddenly in the sleep and due to
disorientation roaming away into the healthcare facility. Therefore, this was the person for
whom I was involved in the development of a care plan.
Provide evidence of how you have provided person centered care taking into consideration
the key principles of person- centered care. 1. Affording people dignity, compassion and
respect. 2. Offering coordinated care, support or treatment. 3. Offering personalized care,
support or treatment.
In NHS we collectively used all the techniques or major attributes of the person centered care
when the care takers were compassionate towards the old man, they offered the coordinated care
and support as well as personalized care, support and treatment. The care plan involved us giving
medical treatment to him but also listening to what he has to say and understanding his emotions
even if for half of the time it is gibberish.
Description of activity and how have provided person centered care for Individual 2
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The care plan that was developed was very comprehensive where working hours amongst us
was distributed in such a manner that there could be availability of at least one caretaker at all
the times. The medicines were given to him regularly and we regular took turns sitting for him,
hearing him speak about whatever past life he remembered. There were many instances where
he even guided us whenever we were facing any serious problems. I was very happy to note that
in the person centered care plan at NHS, the patients is treated very well where he is given
emotional and medical support or I could even say emotional sup[ort more than the medical
support.
Produce a comparative reflective account on own provision of periods of person-centered
care (taking into account scenario 1 & 2)
While comparing the two different experiences that I had regarding the person centered care
plan approach, I can evidently say that the second one was much better with positive results
due to the excellently trained and compassionate staff at NHS. On comparison I can even say
that the previous organization despite having good medical team and physicians could not give
a better care to the person than the one that was given to the old man. Rather than being
judgmental towards the patients as was the case in first scenario, everyone here at NHS heard
his story and appreciated him for whatever life he had lived. We are taught that the first basic
principle of care centered approach is that an individual must not be judged or discriminated
but rather be understood compassionately.
Section B & C: Development Plan and Action Plan
Development Plan:
Goals Personal /
Professional
Development Plan
Indicate how you have
monitored your progress
.
Evaluate the effectiveness
of your personal
development plan
Short Term Goals (3
months)
 Supporting individuals
I regular value the care pan that
I have developed with my
seniors where they regularly
The short terms goals are the
ones that can be easily
developed by inculcating them
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during their pain and
comfort
 Identifying person
centered health care plan
guide me for any further
improvements that I could have
used. They also test the coping
mechanisms that I have
integrated in the care plan.
in routine and requires
familiarity rather than expertise
to complete this task. Therefore,
these have been placed under
short term goals and will help
me in completing first step
towards caretaker.
Medium Term Goals (6
months)
 Learn to recognize the
type of care that patient
seeks
 Curing patients
emotionally and
developing empathy
Here I will see for myself the
results of the care plans that I
am developing and the quicker I
am able to formulate the most
probable plan on the basis of the
current condition of the patient,
more developed this skill of
mine would be.
The medium term goals for my
development plan would help me
in becoming a better care taker
where I would be able to quicken
my decision making process and
become more confident regarding
the treatment that will be most
feasible. This will further evolve
me as a care taker sharpening my
professional skills.
Long term Goals (1 year and
above)
 Promoting dignity
 Non Judgmental Attitude
These are the ultimate goals that
a care taker can develop and
these can be evaluated by the
percentage of satisfaction of the
customers and by the percentage
of successful treatments as well.
This will be the ultimate
description of the skills that are
most critical for a caretaker and
hence help me in achievement.
These have been selected in the
longer term goals because
developing these skills take time
and cannot be developed by
practicing. Rather the would
require the experience thus
putting this in long term goals.
SWOT Analysis form:
Strengths Weaknesses
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 I am a very compassionate and
understanding person which is my major
strength as a care taker.
 I am of analytical mind and can easily
understand the situation even at critical
times regarding the best course of action
that would result in maximum benefits.
 My major weakness is that I am very
unsure of myself i.e. even if I am aware of
the best decision that should be taken, I am
not very confident that whether I should
take that decision and go forward or not.
 Another weakness is that I often tend to
mix up things when I am in a hurry and
although I am careful I am afraid this can
someday affect drastically.
Opportunities
 The major opportunity is to develop
myself in the better strategies and tactics
that could be used while communicating
with the patients.
 This will help me in gaining insight into
the mind and thinking pattern of patient
very quickly thus helping effectively in
decision making.
Threats
 The major threat that I face is that if I do
not adequately develop myself, then I can
become redundant and this can make my
knowledge worthless where I won’t be
able to use it adequately.
Action Plan:
Based in the critical analysis that I did above, it can be identified that the major areas in which I
need to develop myself mainly include the decision making, time management and self control
skills. For these, the action plan can be developed in following manner:
Skills to be
developed
Activities undertaken Resources required Time taken
Decision Making The major activities
undertaken involve the
taking of certain decisions
and then checking them with
the seniors. With time I
would be able to be
The major resources
required involve the -
evaluation sheet
where I can record
the decisions that I
took and then the
2 – 3 months
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confident enough to take my
own decisions without any
hesitation. This is the only
method through which I can
improve my decision making
skills and additionally I can
also observe my seniors and
the manner in which they
react in critical situations.
results that were
generated.
Time Management Time management skills can
be developed by ensuring
that the necessary activities
are completed on time and
distributing the time taken
properly and adequately. I
can develop proper schedules
that will guide me regarding
the time that I have allotted
for completing all the tasks
that are to be performed in a
day.
The main resources
that I would require
are development of
proper schedules and
also using a time
evaluation sheet for
analysing my
schedules.
1 month
Self Control skills The self control skills can be
developed only by
experience where I can
engage in meditational
exercises etc. which help me
in increasing the control that
I have over the different
activities that I perform. It
will also help me in
controlling my impulsive
Resources I would
require are classes
where I can learn to
control and meditate,
reading books on
ways to inculcate self
control etc.
1 – 2 month
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actions.
CONCLUSION
The brief study provided understanding about medical and social models which are applied
to personal centred care practices in health, care or support services. it has been concluded
person centred care approach when planning and implementing a program for supporting
individuals. Different legislation in the context of person-centred care has been summarized in
the report. It provided solution of different problem which could occur in implementing specific
regulation and policies in a health and care setting.
18

REFERENCES
Books and Journals
Bing-Jonsson, P.Cand et.al., 2018. Norwegian translation, cultural adaption and testing of the
Person-centred Practice Inventory–Staff.
Britten, N., and et.al., 2017. Elaboration of the Gothenburg model of person‐centred care. Health
Expectations. 20(3). pp.407-418.
Buckley, C., McCormack, B. and Ryan, A., 2018. Working in a storied way—Narrative‐based
approaches to person‐centred care and practice development in older adult residential
care settings. Journal of clinical nursing. 27(5-6). pp.e858-e872.
Cardiff, S., McCormack, B. and McCance, T., 2018. Person‐centred leadership: A relational
approach to leadership derived through action research. Journal of clinical
nursing. 27(15-16). pp.3056-3069.
Hobson, P., 2019. Enabling People with Dementia: Understanding and Implementing Person-
Centred Care. Springer Nature.
Janes, N and et.al., 2016. Weathering the seasons of practice development: moving towards a
person-centred culture in complex continuing care1. Person-Centred Practice in
Nursing and Health Care: Theory and Practice, p.225.
Kelly, Rand et.al., 2019. The experience of person‐centred practice in a 100% single‐room
environment in acute care settings—A narrative literature review. Journal of clinical
nursing. 28(13-14). pp.2369-2385.
Moore, L., and et.al., 2017. Barriers and facilitators to the implementation of person‐centred care
in different healthcare contexts. Scandinavian journal of caring sciences. 31(4). pp.662-
673.
Pirhonen, L., and et.al., 2019. Person-Centred Care in Patients with Acute Coronary Syndrome:
Cost-Effectiveness Analysis Alongside a Randomised Controlled
Trial. PharmacoEconomics-open. 3(4). pp.495-504.
Sampson, E.L., and et.al., 2019. Empowering Better End-of-Life Dementia Care (EMBED-
Care): A mixed methods protocol to achieve integrated person-centred care across
settings. International Journal of Geriatric Psychiatry.
Santana, M.J., and et.al., 2018. How to practice person‐centred care: A conceptual
framework. Health Expectations. 21(2). pp.429-440.
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Ward, Aand et.al., 2018. What matters versus what’s the matter–exploring perceptions of person-
centred practice in nursing and physiotherapy social media communities: a qualitative
study. International Practice Development Journal
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