The good care framework has been developed based directly on what local people have told us.
In the summer of 2023, as part of the Big Conversation project, we asked local people open-ended questions about what good health and care means to them. At community events and in focus groups we helped local people to draw out what their own vision of good care would look like, using Liberating Structures and Participative Appraisal tools.
We took what they told us and and started to use qualitative data coding to identify themes, these themes eventually developed into the good care framework and our four pillars of good care, or four aspects of what makes the difference between good care and inadequate care. We also looked at the wider issues that impact good care at a society level.
The resulting framework is now being used by the North East London Integrated Care Board as as a success measure for a wide variety of health and care projects.
Imagine the following scenario:
You contact your GP surgery as you recently experienced some unpleasant acute symptoms. You believe you may need antibiotics, or a referral for further investigations. Within a number of hours, you have a telephone appointment with a GP, who advises you to rest at home, take paracetamol, and get back in touch if your symptoms persist.
Do you feel relieved and reassured? Or do you feel fobbed off and even more worried? The Good Care Framework can explain what makes the difference between the two.
Care is accessible
You know you can get an appointment when you need to, and you are sure that if you return later with persistent symptoms you will be seen again, in an appropriate way. Access needs related to disability or language are catered for.
Care is person-centred
You have a choice about how you are being seen; in this case you had a telephone appointment because you are comfortable with it and find it convenient. The doctor who called you knows your medical history well.
Care is competent
You believe that you have been correctly diagnosed after receiving adequate consideration; that the doctor seeing you is knowledgeable of your condition and giving advice based on your best clinical interest.
Care is trustworthy
You feel listened to; you understand why you received the advice you did; you rely on follow-on to be available if you won’t feel better after resting at home. You trust there is no better answer you could have gotten elsewhere at this point.
... and so, you feel reassured.
Care is not accessible
You find it difficult to make an appointment with your GP. The booking system is user-unfriendly and you struggle to get trough on the phone. You expect that if you need to be seen again, it will be a long and frustrating process.
Care is not person-centred
You feel that you should have been been in person, but you got a telephone appointment anyway. The doctor doesn’t seem to know your medical history; you feel like all you received is a boilerplate answer.
Care is not competent
You believe the diagnosis process has been overly superficial. In the past, you may have received the same type of advice from the same GP, only to access A&E or a private GP and find you did need antibiotics after all.
Care is not trustworthy
You suspect that the advice you received is motivated by budget constraints, not your best interest. You feel like you are receiving not the best possible care, but the bare minimum they can get away with.
