Core skills and how they link into person centred care

The National Institute for Health and Care Excellence, in its quality standard on end-of-life care, makes a clear commitment to holistic needs assessment. This requires healthcare professionals to take into account all of the needs of the patient, whether they are physical, psychological or spiritual. To do this, the health care professional will require excellent communication skills. Communication skills are essential to the function of the whole workforce, they are relevant to everyone. They are as important to interactions between staff as to those with patients and those important to them. The new Person-Centred Approaches core skills education and training framework (commissioned by Health Education England [HEE] and published in 2017) describes core communication and relationship building skills, and the impact they have in practice.

Key components of the Person-Centred Approaches core skills education and training framework are core communication and relationship building skills, relevant to the whole workforce, including communication between staff at all levels in an organisation. The framework describes the behaviours, knowledge and skills required to put a person-centred approach into practice.

Within each step, the framework provides behaviours and learning outcomes – the behaviours aim to illustrate what people receiving care and support and their carers would see in practice.

At the core of person-centred approaches are:

• Values
• Core communication and relationship building skills
• Conversations to engage with people
• Conversations to enable and support people
• Conversations with people to manage the highest complexity and significant risk.

Attitudes are the way a person applies their values and is expressed through their behaviours and what they say and do.

Core communication skills

Communication is about much more than the words used. Meaningful communication depends on how and when we say things, how we listen, our non-verbal communication and the dynamic judgements we make as communication takes place.

An awareness of cultural differences, an understanding of our own individual communication styles and how we are perceived by others is also key. This below list illustrates the core communication skills described in Person-Centred Approaches: A core skills education and training framework.

• Active listening: Making a conscious effort to hear what is said, feeding back by restating what has been heard.
• Environmental awareness: How a room is set up, who is taking part, public or private.
• Use of non verbal language: Posture, proximity, touch, body movements, facial expressions, eye behaviour, vocal clues, use of time, physical presence, use of pausing and silence, gentle cues such as nods.
• Summarising: Deliberately and explicitly providing a verbal summary, either as part of conversation or at the end.
• Clarification: Confirming and checking, making more understandable and accurate.
• Signposting: Introducing and drawing attention to what is said or to other resources.
• Ask before advising: Check what is known, what they would like to know, if information required and how it should be given, format.
• Hello, my name is: Introduction and scene setting.
• Use of open ended questions: Invite broader responses and a more equal conversation.
• Open > Focused > Closed questions: Use of open focused questions, moving to focused questions, to close questions (cone), value and place of closed questions.
• Screening: Checking if there is something else or anything else.
• Reflection: Using words to let the other person know that they have been heard.
• Empathy: Deep reflection to show that they have been heard and emotional understanding.
• Affirmation: Positive statement and acknowledgement offering emotional support and encouragement.
• Normalisation: Acknowledging that the experience (e.g. feeling, process, symptom) is normal and reported by others.
  
   

Relevant e-learning

Recommended for all staff

Skills for Health, Skills Platform

Person Centred Approaches

The aim of this free course is to enable staff to behave in a person-centred way, based on the Person-centred Approaches Framework, which aims to distil best practice and to set out core, transferable behaviours, knowledge and skills.

In particular, please note Module 4: Core Communication and Relationship Building Skills.

Useful for all staff

Stand By Me – Dementia

Free online e-learning developed by Skills for Health, the Association for Dementia Studies and key partners to improve the communication and person-centred care for people with dementia. This course has a communication module.