The shift away from service driven to needs lead service delivery will be explored.

The needs of the individual during the phases of disease progress will compare perceived versus actual. Contribution of the multidisciplinary team at all stages will be highlighted.

The move to patient/individual self-efficacy and the effect on relationships with health professionals provide an arena for potential conflict. The health professionals perception of the individuals needs are often not compatible with the actual needs of the individual.

The results of an in depth interview, with a patient, will explore their needs and whether they have been met. (An interview audited tool will be used).

Financial constraints, shortage of health professionals, the political agenda, compliance of the individual and “patient power” will highlight the areas of unmet needs.

The needs of carers and service providers are often neglected at the expense of the “individual”. The conflict of the carer and individual will also be addressed.

Does the individual know best?

References

1. Arthritis Impact Measurement Scales (AIMS)

2. Health Assessment Questionnaire (HAQ)

3. SF – 36 Health Survey

4. The NHS and Community Care Act 1990