Care that meets each person's own needs

We believe that health care and social care should meet your needs not the needs of the system. This is called person-centred care.

Person-centred care means you are being fully involved in planning your care, having the information you need to make choices, and being supported to live as independently as possible.

Person-centred care makes sense.

• people getting it get better more quickly
• people with learning difficulties or physical disabilities get more independent
• people's day-to-day lives get better.

The importance of the right kind of information

We want everyone who uses care services to have a say about the care that they need.

But to make good choices you need information that is:

• right
• with enough detail
• in a format you can understand, and
• there at the right time

Organising and buying your own support

Self-directed support gives people more control over their care if it is funded by the council. This means control over their care, their support plan, and the money to pay for it.

You decide for yourself what you want, with help if you need it. You then have an amount of money to spend on your service.

We found:

• only 1 in 3 councils are doing well on giving people the choice of having money paid straight to them to buy their own care
• only 4p out of every £1 that councils in England spend on care is paid straight to people to buy their own care.

Advocacy

If a person wants support with making choices about their care or saying what they think, they should be able to get a free and independent advocacy service.

Their job is to support you to make your own decisions and speak up for yourself, or speak up for you if that's what you want.

Good advocacy can be a great help with self-directed support by helping you say what you want and getting any problems sorted out.

Advocacy is even more important for people with learning difficulties or people being treated under the Mental Health Act.

We found:

• councils have been spending more money on advocacy, but
• only 1 in 3 councils have got advocacy services that are really good at supporting people in making choices and descisions.

Being able to get care when you need it

One of the big differences between health care and social care is that the NHS is free. But, because the NHS has to spend money where it is most needed, sometimes people get services in one area and not in another.

You should be able to see your GP in 2 days.

• in 2009, in some areas 3 out of 4 people could do this. In other areas nearly everyone could.

Health trusts and social services are trying to make sure people with higher needs are getting what they need.

• this means health care was doing less to keep people healthy or to stop their health problems getting worse, and
• 3 out of 10 social services would not pay for people in independent living who did not have high needs.

Making things fairer

People living in poor areas or from some ethnic groups were not as healthy as others. But they also got worse health care than others, despite needing it most.

• people living in poor areas die younger than others and it is getting worse
• people living in poor areas do not get as much help to give up smoking.

Respecting people's dignity and rights

Respecting people's dignity and rights is really important for all good health care and social care.

We found that:

• 9 out of 10 NHS trusts passed the checks we have on looking after people's rights and treating people equally and fairly
• some people from ethnic groups said they did not like the way they were treated by GPs and outpatients. This is because they were not involved in their care and doctors and nurses talked in front of them as if they were not there.
• councils did not do quite as well in this area as they did in 2008.

Using local people's views to help make services better

All health care and social care services have to make sure that local people are helping to make their services better.

This gives people the chance to say what they think about how services are doing and what happens when they use them.

We found:

• nearly all the NHS trusts passed our checks for including people
• nearly half the councils were marked as "strong" at including people, but
• some trusts and councils were not involving some groups of people well enough. Like, people who were very ill, those from some ethnic groups, children and older people, and people who are in prison.