People-centred services

People-centred services aim to deliver individual care at a range of population levels, including primary healthcare, secondary healthcare, tertiary healthcare and rehabilitation. Approaches with a greater emphasis on primary healthcare are more cost-effective and equitable. All services aim to be evidence based and integrated and to deliver person-centred quality healthcare that is safe. Service provision reflects the main burden of diseases.

People

Components of people-centred care include:

Primary healthcare: facilities provided for each community or cluster of communities, with outreach and community workers to extend coverage for each community. Services include:

  • Maternal and child health services and family planning.
  • Communicable diseases – identification, treatment and monitoring.
  • NCDs – identification, treatment and monitoring.
  • Basic treatment and management for injuries.
  • Empowering of patients and families to be engaged in their own care.
  • Basic screening and advice given to promote health and well-being.
  • Referral to secondary services for specialist diagnosis and treatment.

Secondary healthcare: facilities provided for a range of community primary health centres, covering natural geographical population clusters (e.g. large towns, cities, islands etc.). Services are accessed via primary care referral or in emergencies and include:

  • Outpatient and inpatient services for maternal and child healthcare, diagnosis and treatment, with longer term management referred back to primary care centres.
  • Outpatient and inpatient services for communicable disease diagnosis and treatment, with longer term management referred back to primary care centres.
  • Outpatient and inpatient services for NCD diagnosis and treatment, with longer term management referred back to primary care centres.
  • Emergency and surgical services provided, including for maternal health.
  • Basic diagnostic and laboratory services and advanced screening and investigation.
  • Referral to secondary services for specialist diagnosis and treatment.

Tertiary healthcare: facilities provided for a range of secondary health services, covering natural geographical population clusters (e.g. large cities, a cluster of islands or a group of small countries). Referral is from secondary services:

  • Specialist services provided, including diagnostic and laboratory services; inpatient and outpatient services for the main and specialist diseases and injuries.

Rehabilitation: treatment of disease with cost-effective interventions to slow or reverse disease progression. Includes rehabilitation of disabilities, injuries and diseases:

  • Integrated person-centred rehabilitation programmes may be developed at all levels of healthcare, ideally with longer term care at primary healthcare level.

To go back to the systems framework for healthy policy, please click here…. Systems framework