Health systems strengthening through person-centred care: development of a feasible and acceptable theory-based workforce approach to improve quality.

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What is the problem we want to address? Serious illness has major effects on both the patient and family. In low and middle income countries these can be physical (such as pain and their symptoms) psychological, social (with additional stressors on income, children's school fees, stigma) and spiritual. This can affect both the wellbeing of the patient and family and their ability to access and stay in care. Health systems must address more than just the disease- they must become more "person centred". Person-centred care means that the health system is organised to meet the needs of the individual in ways that respond to their preferences, values and beliefs, offering dignity and respect. Being person-centred is seen to be a way to ensure that care services are high quality. By improving the health system through the workforce (the health care staff) the information it holds (on the individual's needs and preferences) and the way things are delivered, we can make care more person-centred. What will we do? In this study, we want to do some of the important initial work to inform a larger study to improve person-centredness. We will use our partnership across the UK, Zimbabwe and Uganda to find out what best person-centred care looks like from the view of patients and families facing serious illness, and very importantly from those who would be responsible for delivering (health care professionals). We will use this new information to work with health care teams to develop a strategy that is acceptable to patients and staff that can be put into practice in these countries as examples of health systems strengthening. We will also look at the best way to measure person centredness, so that when we conduct a larger study we have an accurate way to knowing if we have achieved our goals. What will be the outputs?The World Health Organisation has a strategy to improve person-centredness of care for all- this study will provide a practical way to deliver this from an African perspective. We will also deliver an adapted way to measure the experience of care from the patient & family perspective. Our proposed strategy will be led by the views of patients, families and health professionals- making it more likely to achieve success. We are working with health organisations in the community and with Governments to make sure that we can achieve better care through stronger health systems.