Consumer-centred Care: Consumer-centred Care: Implications for Service providers and Health Professionals 2011 Biennial Conference Stephen Leeder.

Consumer-centred Care:Consumer-centred Care: Implications for Service providers

and Health Professionals

2011 Biennial Conference Stephen Leeder

Carers’ contribution to the coffers!

• Carers contribute 1.2 b hours of care a year in Australia

• This ‘saves’ $30.5 b in caring costs each year.

• The Australian Government Productivity Commission draft report Caring for Older Australians, published January 21, 2011 reveals the extent of informal care in the community – it is an excellent discussion document. (Informal carers receive about half the pages in the document!)

Care needs of chronically ill patients

• Chronic illness can require different approaches to care to that of patients with stable care needs

• Chronic conditions are complex often with co-morbidities

• Care needs change as illnesses progress.

SCIPPS* - fragmentation of services• Chronic conditions often require multi-disciplinary care:

– GP– Medical specialist– Community and allied health services– Social services

• This fragmentation was highlighted by the SCIPPS study, and identified by patients carers and service providers.

*Serious and Continuing Illness Policy and Practice Study – NHMRC Program Grant five-year research project into the lives of people with chronic illness, their carers and professional support. Joint project between ANU and USyd.

Patient/Consumer Representation

• Over the past decade there has been an increase in patient/consumer representation on boards and committees (e.g., GP Networks); however this has been largely ad hoc.

• We are now at the stage where we are beginning to move toward patient/consumer-centred care.

Care Integration• Groups such as Health One and the Care

Navigation team are aiming to improve patient journeys

• Service providers are beginning to work closely to coordinate care

• Patient-centred rather than service-centred.

Challenges of Care Integration

• Case management, care planning and patient conferences all require high-level sharing of information

• eHealth has a growing role to play here and the challenges of sharing complex patient data are significant.

Impact on Carers• Complex care needs of chronic illness

and co-morbidities can create confusion for patients and their carers regarding symptoms and medications (SCIPPS)

• Fragmented service provision creates a high burden for carers.

Self-Management Partnership (Essue et al., 2010)

• Carers have multiple roles– Home helper– Lifestyle coach– Advocate– Technical care manager– Health information interpreter

• Negative impacts on carers– Difficulty juggling multiple roles– Carer self-neglect– Conflict with patient and other carers (formal and informal)– Economic burden of care.

• Often it is hard for carers to obtain financial support because it comes through a puzzling array of agencies!

Responses to the challenge

• The role of carers should receive more attention in the education of doctors and other health professionals

• Training and support for carers should be expanded and targeted to specific conditions (in some instances)

• The arrangements for financial support for carers should focus on the carer and less on the person being cared for

• Success in informal caring should be rewarded and recognised.