BMHP5016 Health and Social Care Assignment

Introduction

The present report aims to analyze and describe the concepts of Person-Centered Care (PCC) and Partnership Working (PW) context of healthcare and their contribution towards the reduction of early hospital readmissions. It is also designed to evaluate practical, policy, and ethical issues that improve integrated care (Williams, 2021). This paper considers Maslow’s theory in the provision of patient care, assesses interdisciplinary practice and analyzes legislation. This paper also has crucial highlights which are the definitions, theoretical frameworks, policy assessment, and suggestions. Greenfield District General Hospital has been chosen as the health and social care setting as this is a pertinent issue where clinicians, social workers, and community partners’ contributions are valuable in the management of elderly patients with chronic diseases to minimize hospital readmissions by providing proper post-discharge care.

Definition of PCC

Person-centered care (PCC) is a model of care that caters to the person’s choice, desired goals, and values in the provision of services. As noted by McCormack and McCance (2017), PCC involves patients in their care plan, acknowledgment and reverence for their worth and value. In cases such as in Greenfield District General Hospital, PCC brings the medical, social, and psychological approaches for a patient’s better health outcomes (Taylor & Edwards, 2020). When it comes to using PCC, the pros are increased patient satisfaction, patients’ compliance with the treatment regimen, and generally, the betterment of the patient’s health (Williams, 2021). Increasing patient involvement in the decision-making process in healthcare contributes to enhanced patient compliance and higher recovery rates. In the case of patients with chronic diseases, PCC is significant in cutting the readmission rate among the elderly since the patient is hospital-bound when he or she is very ill and then afterward referred to other healthcare providers for support (Brown 2022).

However, some challenges are associated with implementing personalized care, some of which are; limited resources and personnel such as staff shortages and limited financial resources (Davies, 2019). Furthermore, the culture among some healthcare professionals against change by embracing new models might work against PCC implementation (Taylor & Edwards, 2020).

Relevant Theories

Person-Centered Care (PCC) is based on the principles of psychology and healthcare, Maslow’s Hierarchy of Needs is the most suitable, as it creates a strict framework that helps identify patient needs in the medical system.

At physiological in this level, PCC involved confirm if the patients have basic medical needs satisfied to be discharged including oxygen therapy, fluid and food intake (Brown, 2022). Patients with COPD and heart failure in the Greenfield District General Hospital ought to be closely observed on medications, food intake, and signs and symptoms to avoid situation that can lead to readmission. Discharge planning with specific instructions concerning a patient’s care as well as follow-up care corresponds with this basic level (Williams, 2021).

The safety level entails developing a safe atmosphere in healthcare facilities. This includes measures like fall risk assessment, medication review and evaluation, and the use of a structured discharge plan for the patients to reduce risks that are likely to be experienced when changing homes from the hospital. Besides, employing telemedicine and post-appointment general practitioner visits also ensures patient safety to some extent, thus decreasing patient’s rates of anxiety and unfortunate confusion after being discharged from the hospital (Brown, 2022). Possible measures that support this principle include making sure that elderly patients receive home support services, for example, community-based nursing care.

Belongingness and love need to retain the focus stands with the social interconnectedness aspect of the healing. PCC integrates the community by engaging family members, caregivers, as well as support groups to improve the overall care of the patients. In Greenfield District General Hospital, members of the general healthcare clandestine engage the families in discharge planning since they offer emotional support and coordinate the care of the patients (Smith, 2021). The result of a study indicates that patients who experienced social isolation had a high chance of being readmitted due to nonadherence to the treatment plan tailored to them (Taylor & Edwards, 2020). PCC of course redresses this by liaising with social workers and charities such as Age UK to offer company and assistance.

The esteem needs are centered on the achievement of the patient’s independence, personal self-respect, and self-efficacy concerning their health. This is practiced at PCC in Greenfield District General Hospital because patients are engaged in decisions regarding their treatment plans as well as discharge. It is also constructive because; health education, teaching self-management, and post follow-up will ensure that patients assume responsibility for their conditions, hence avoiding numerous visits to hospitals. Rewarding patients and positively affirming their progress also leads to the development of confidence and thus better keeping of patient compliance with the care plans (Smith 2021).

Lastly, self-actualization is being at a stage where the patient is fully responsible for every aspect of their health. However, because of the limiting chronic illnesses clients in this stage may not fully experience all these to the optimum, PCC will enable them to optimize their quality of life. Since it helps in identifying health care goals with the patient’s passion, such as remaining in their home or participating in social activities, most patients are satisfied with PCC. At Greenfield District General Hospital, target individualized rehabilitation goals include physical, social, cognitive, and psychological domains in compliance with Maslow’s self-actualization status (Davies, 2019).

Nonetheless, like any other theory, Maslow’s Hierarchy of Needs theory also has some drawbacks when implemented in PCC. Deliberately, patients’ needs are not always organized in a medically prescribed manner such as the need for emotional support may be wanted before physical want. Furthermore, a shortage of personnel and financial issues in NHS hospitals may delay employees from offering tailored care (Williams, 2021).

Ethical Fundamentals

The four principles used in the health and social care sector are Autonomy, Beneficence, Non-Maleficence and Justice, which are relevant to both Person-Centered Care at Greenfield District General Hospital as well as Partnership Working.

Self-determination empowers the patients to make the right decisions on their treatment. Discharge planning for elderly patients with chronic conditions in PCC must involve the patient which will be discussed in the following points (Davies, 2019). However, regarding cognitive impairment, there are predicaments; would clinicians abide by patient decisions even where they are irrational (Tierney et al., 2020).? This can be solved through partnership working since it encourages the participation of family members and social workers (Williams, 2021). Beneficence entails making decisions that will positively impact the patient’s welfare and on the other hand, maleficence involves the principle that prescribes not harm the patient. For instance, a frail elderly patient who is discharged from the hospital with no adequate care at home is likely to fall sick again. Here, Network Working and Team Working between hospitals, GPs, and community services minimize the risk associated with discharge planning while considering both medical and social factors for the patients (Taylor & Edwards, 2020). While principle of justice promotes equity in distribution of care, scarcity of resources in the NHS increases inequality. For example, limited offered home care services may lead to focusing only on the high-risk patients than the other patients. An ethical decision entails supremacy of ethic and prioritization to which healthcare professionals and social workers should be party to (Eli, 2020).

Evaluation of Partnership working

As provided by Wright and Bauld, Partnership Working (PW) is a scenario where different healthcare practitioners, social workers, community organizations, and policymakers come together to work in such a way as to offer efficient and client-centered care (Huxley, 2021). In the UK, the ICS has recently been adopted through Integrated Care Systems that would encourage inter-sector working to address health challenges and ease pressures on the hospitals (Department of Health and Social Care, 2022). PW can ensure that elderly patients in Greenfield District General Hospital with chronic diseases do not get readmitted soon after discharge through proper follow-up. PW has the advantages of improving various services, keeping care plans consistent, and resulting in the betterment of patients’ lives (Kinsella, 2020). Working together with other branches of clinical personnel, general practitioners, pharmacists, and representatives of social care allows providing the patients with multi-aspect care rather than just medical one (Williams, 2021). Some examples include discharge planning for community services that help patients with chronic diseases to be discharged to their homes so that they cannot be readmitted (Taylor & Edwards, 2020). However, certain barriers like coordination issues, communication issues and conflicts of professional roles can incapacitate the PW. Inconsistencies between the medical personnel and social care personnel may lead to the delay of services (McLaughlin, 2022). Also, the limit of available resources in the services within the National Health System can affect the access to care and the health staff availability (Eli, Huxley & Tierney, 2021)..

Policy and Legislation

The Health and Care Act 2022, Health and Social Care Act 2012, and Care Act 2014 are governing legislation for integrated care and patient-focused approaches that assist PCC and PW at Greenfield District General Hospital. These are The Equality Act 2010 and The Human Rights Act 1998 These laws offer patient rights and fair treatment from the doctors. However, some of the challenges that may affect the integration of health and education sectors include; inadequate funding and bureaucracy (Health Foundation, 2014). For instance, the Care Act 2014 provides for post-discharge assessments, better support for elderly patients but owing to scarcity of resources within the National Health Service, it will be difficult to put into practice. Integrated care of patients in England has recently been sponsored by the Health and Care Act 2022 that supports the development of ICS and the improvement of the relationship between hospitals and the community but fragmentation of care remains a common problem in cases of transfer of patients (Maruthappu, 2025).

Recommendations

As acknowledged, PCC and PW have unraveled certain lacunae such as inadequate and fragmented care continuity, scarce resources, and a shortage of health personnel (Williams, 2021). The staff at Greenfield District General Hospital finds it difficult to organize adequate post-discharge care provision for patients discharged from the health facility because of the following challenges (NHS Forth Valley, 2019).

For this reason, digital health solutions should be advanced for improved use of electronic health records and telemedicine (Taylor and Edwards, 2020). Greater attention should be paid to the development of the interdisciplinary training in order to eliminate role conflicts and focus on the patient needs (The Guardian, 2025). For instance, better collaborations with community organizations can increase social care solutions, which is a burden to the hospitals (Brown, 2022).

Conclusion

This paper focused on how Person-Centered Care (PCC) and Partnership Working (PW) in Greenfield District General Hospital could minimize high-risk early readmissions. PCC is based on Maslow’s Hierarchy of Needs to address patient’s comprehensive needs. Professional ethical principles such as the autonomy of the patient or the principle of beneficence assist in sound decision-making. However, the coordination barriers remain as presented in the following imperative questions: Thus, the recommendations propose the development of both digital health solutions and interdisciplinary training, as well as enhancing the relations with the community. Thus, PCC and PW are paramount to achieving effective, efficient, and quality health care and need policies, funds, and concerted efforts for the overall welfare of the patients in the UK.

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References

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