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Person-centred services

An occupational therapist working with a patient

For many years now, national policy has emphasised the importance of care services focusing on meeting people’s individuals’ needs.

Person-centred care puts people at the centre of the design and delivery of the services they use. It means organising healthcare around patients and providing timely and convenient services.

We found a great deal of variation across England in providing greater personalisation of services.


of councils assessed showed strengths in helping people to remain independent.

Some of the areas this affected were:

  • direct payments and personal budgets were available to more people but there were wide variations across the country.
  • councils’ attention to carers’ needs at first contact, especially when redirecting people to other organisations. It is recommended such referrals are followed up on to discover the outcomes.
  • mixed progress in avoiding unnecessary hospital admissions and ensuring effective discharge.
  • the support available for people when leaving hospital after a stroke varied significantly across England.

Claire's story

Two musicians: one plays the keyboard and the other plays the guitar
Claire is the ward manager of a psychiatric intensive care unit for male patients in North London. The unit cares for those who have become so distressed as a result of their acute illness that being on other types of wards might increase their distress or cause danger to themselves or others.

Many of the unit’s patients are detained there under a section of the Mental Health Act.

Despite their often challenging work, the ward staff are committed to seeing each patient as a unique individual and tailoring their care accordingly. This person-centred approach extends to the therapeutic activities for patients.

If you don't feel like joining in OT, you don't have to. But if you suddenly felt like a particular activity, the therapist would do his best to organise it for you.

Patient on Claire's unit

“We have a dedicated occupational therapist who takes a flexible approach that increases patients’ enjoyment and motivation to take part”, Claire said.

“When a patient arrives on the unit, we make sure that we find out very quickly what kind of activities they like or dislike. Our therapist tends to work with small groups or on a one-to-one basis, tailoring the programme according to patient’s interests on the day.

“For example, we had lots of art last month as the patients in the unit then were really keen on it, but this month we have a different set of patients who prefer music, so we’re now focusing on that. But all of our patients like the outdoor sport activities, such as football or tennis.

“Our patients nearly always have complex individual needs in additional to – and often as a result of – their illness. Things like family issues, housing, financial problems, educational and employment issues.

“We focus on thinking positively and creatively about solutions with each individual, both in terms of their treatment and care and lives outside hospital.

"The culture on the ward is one of respect for others, and treating others as you would wish to be treated yourself. This also applies among the staff – we’re all different grades, but everyone’s suggestions and ideas are respected, including by the most senior staff. As a result our staff get real satisfaction from their work with patients and stay a long time.”

One of the patients on the unit Claire manages said: “If you don’t feel like joining in OT, you don’t have to. But if you suddenly felt like a particular activity, the occupational therapist would do his best to organise it for you…so things fit your mood more.

"The therapist is really artistic and a good teacher – and he makes it fun. Without these activities we’d get more bored and agitated. My favourites are music and tennis – I’ve improved my tennis skills a lot here.“