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Introduction

Tanya McCance1, Brendan McCormack2, Donna Brown1, Cathy Bulley2, Ailsa McMillan2, and Suzanne Martin1

1 Ulster University, Northern Ireland, UK

2 Queen Margaret University, Edinburgh, Scotland, UK

Dear reader, welcome to our book on the fundamentals of person‐centred practice. We are delighted to work with you through the chapters of this book to enable you to explore the essence of practice and to enhance your understanding of person‐centredness within a wide variety of healthcare contexts. You might be a student starting out on your professional journey and excited to learn about your discipline; a newly qualified professional grappling with the realities of practice; an established practitioner or healthcare worker with many years of experience wanting to reaffirm your passion and commitment to trying to make a difference; or a leader aiming to harness a shared vision for your team or organisation that transcends day‐to‐day professional differences. Whilst we have framed this book in the context of the fundamentals of practice, we believe it has something to offer everyone, regardless of your healthcare discipline or where you might be on your career pathway. But why bother, you might ask, as person‐centredness in healthcare has been a focus for many years and is now firmly embedded in the language of healthcare. However, it is our contention that despite a continuous focus on developing healthcare services and practices that place the person at the centre of decision making, the reality and rhetoric of practice are sometimes difficult to dissect!

Let's imagine that someone you love becomes very unwell and has to be admitted to hospital. As a professional, you will have an expectation of the kind of care you want them to experience and what's more, you will instinctively know when their care meets your standard. It might not always be clear what members of that healthcare team are doing that makes it a good experience, but it will feel right and you will feel your loved one is in safe hands. Now let's go to a place in your mind where your loved one is getting sicker and no‐one seems to know what is happening, nor does there seem any sense of urgency to find out, and, worse still, it gives you a sense that no‐one cares.

Understanding what makes the difference between these two scenarios and how you can improve the experience of care for everyone is at the heart of this book. If you want to make a difference to practice that ensures all service users and families have a positive experience of caree, and that you and other staff are also recognised as persons rather than cogs in a wheel, then this book is written for you!

Our desire for all service users and staff to experience person‐centredness in their daily contact with healthcare systems may seem like idealism, given that no system is perfect. As a multiprofessional editorial team, we are highly aware that there are challenges in healthcare systems that impact on the development of person‐centred workplace cultures. This book is grounded in the realities of practice and our aspiration is to offer a common language that will create a shared understanding of person‐centred practice, in the hope that it will generate an impetus for practice change. A shared language is essential if we are to bring about system‐wide change. Whilst person‐centredness permeates healthcare strategy and policy, the reality is that often stakeholders aren't actually talking about the same thing. We also see this dilemma in the published literature with interchangeable use of terms such as family‐centred, patient‐centred and relationship‐centred, leading to arguments that person‐centredness is ‘too difficult to define’.

Furthermore, we see this very issue reflected in the campaigns calling for a refocusing on compassion, caring and kindness. Whilst these are important values within healthcare systems, the challenge is how they manifest in our and other people's behaviours and the influence of attitudinal and moral factors. A shared language is the foundation that supports the development of a shared understanding of person‐centred practice and the issues that need to be addressed in order to bring about sustainable change. At the level of principle, the understanding of person‐centredness is well rehearsed and involves treating people as individuals, respecting their rights as persons, building mutual trust and understanding, and developing therapeutic relationships. Central to this is our explicit focus on all people as persons and the promotion of workplace cultures that promote the well‐being of those providing as well as receiving services. This shared understanding, however, needs to be more than an emphasis on the commonly agreed principles that underpin person‐centredness. There needs to be an understanding of how these principles can be implemented in practice in order to bring about a positive outcome, that being the development of healthful cultures that enable flourishing for all.

We believe this book offers a unique perspective on person‐centredness viewed through the lens of the Person‐centred Practice Framework of McCormack and McCance, which is a theoretical model developed from practice, for use in practice. The framework has evolved over two decades of research and development activity and has made a significant contribution globally to the landscape of person‐centredness. Not only does it enable the articulation of the dynamic nature of person‐centredness, recognising complexity at different levels in healthcare systems, but it offers a common language and a shared understanding of person‐centred practice. The Person‐centred Practice Framework is used in this book to illuminate the different components that make up person‐centredness but, more importantly, how these different components connect to develop a deeper understanding of person‐centred practice.

This book is presented in four sections, reflecting different constructs of the Person‐centred Practice Framework. The first section focuses on the person in person‐centred practice, respecting the centrality of all people as persons. The second section focuses on being person‐centred and reflects the person‐centred processes. The third section focuses on the many different contexts in which health and social care is delivered, not only recognising the practice context but also the organisational and system issues that can influence practice. The final section brings our focus back to how we equip the workforce to engage effectively in developing this agenda through approaches to learning and development for person‐centred practice. Chapters 1–3 form a strong foundation to enhance engagement with the content of subsequent chapters, with Chapter 3 in particular serving as a reference for describing components of the Person‐centred Practice Framework. The book, however, is structured in a way that will enable you as the reader to dip in and out as directed by your own learning needs. All the chapters are peppered with activities, encouraging you to reflect on your learning and supporting your development as a person‐centred practitioner.

The many contributors to this book have shared their expertise freely and offer a wide range of interesting perspectives on person‐centredness. As an editorial team, we are passionate and committed to developing person‐centred cultures across health and social care systems, and our wish is that your engagement with the ideas in this book will help you grow as a person and as a healthcare professional. Person‐centredness and person‐centred practice are not static concepts. Richard Holloway asserted:

We will go on producing myths, ways of explaining ourselves to ourselves but, like everything else about us, they are in constant transition and we must not fundamentalise any of them.

(Holloway 2001)

It is important that we don't allow person‐centredness to become static or fundamentalised. As persons, we are always in a state of becoming and thus, how we engage in person‐centred practice also needs to be constantly explored, challenged, questioned and open to change. We hope this book makes an important contribution to that change‐making, ensuring that we continue to challenge ourselves and others, as well as coming to know more effective ways of engaging so that all persons receiving healthcare have their personhood reinforced and are able to flourish as persons.

Reference

1 Holloway, R. (2001). Doubts and Loves: What Is Left of Christianity. Edinburgh: Canongate Books.