Reinvigorating relationship-based care is a 2020-23 policy, and a campaigning priority for the RCGP. We want to increase understanding of the benefits of relational care, and to ensure members have the time and space to deliver it. We have developed two policy reports:
Fit for the future: relationship-based care (June 2022)
Fit for the future: relationship-based care is the second RCGP report on relationship-based care. It builds on 'The power of relationships'. In this we explored the benefits it offers, as well as the challenges to delivering good relational care.
In this report, we explore the change levers that can embed and strengthen the relational elements of care, within the modern general practice landscape. General practice teams must be given the resources and support required to deliver effective therapeutic relationships, and realise the value that they bring. Our new report therefore makes the following key recommendations:
- Ensure relationship-based care is fully integrated within medical curricula and teaching. Trusting relationships should be a core element of the General Medical Council's (GMC) standards and medical school curricula.
- Ensure there are enough GPs to meet rising demand. New recruitment and retention strategies are required across the UK.
- Make relationship-based care a national priority in primary care. Funding and support should be provided to assist practices in embedding ways of working which facilitate relationship-based care. These include longer consultations, multidisciplinary team working, and a focus on continuity in appointment and triage processes.
- Develop IT infrastructure to support relational care and continuity. Investment is needed to enable seamless sharing of information between practice teams, and to develop online booking systems that support continuity.
- Free up staff time for patient care. NHS bodies should cut unnecessary workload and bureaucracy. This will give GPs more time to build relationships with patients.
- Incentivise relationship-based care. Metrics and system incentives, including the Quality and Outcomes Framework (QOF). The Quality Assurance and Improvement Framework (QAIF) and clinical guidelines should be developed and reviewed to ensure they support relationship-based care.
- Engage and inform patients about getting the care they need. This supports good relationships between patients and all members of the general practice team. Public education campaigns explaining the different multi-disciplinary team roles should be renewed and expanded.
The power of relationships: what is relationship-based care and why is it important (June 2021)
In this initial report, we define what we mean by relationship-based care. We say it's care in which the processes and outcomes of care are enhanced by a high-quality relationship between doctor and patient. The report explores what the evidence tells us about its benefits. These include for patients, GPs, and the wider health system. We also discuss why it needs to be reinvigorated.
COVID-19, and particularly the rise of remote consulting, has posed challenges for the delivery of effective relationship-based care. Relationships between GPs and patients must be prioritised as we make choices about what the service should look like post-pandemic.
More widely and starting long before the pandemic, a combination of societal sifts and new models of care have made doctor-patient contacts more transactional. They are often focused on issues which are narrow in scope and time-limited.
Relationship-based care is essential to delivering patient-centred care and to revitalising the profession. It’s vital, therefore, that the value of the relational aspects of care are not only recognised but consciously designed in as new models of care and policy frameworks are developed. We need to cultivate an environment in which GPs and their teams are enabled and supported to deliver relationship-based care.