Time to deliver patient centred care.

Patient centred care is central to the mission of healthcare, yet traditionally neither patients nor the public have had the power to shape the services they use and pay for, or define their value. As a result, many patients find services difficult to navigate, disempowering, burdensome, and seemingly designed to frustrate. There have been repeated calls to enlist patients’ help to reform systems poorly geared to meet current health challenges, subject to political meddling, and permeated by competing interests that fuel overdiagnosis and overtreatment UK and US policy supports person centred care and shared decisionmaking, 7 and the World Health Organization champions it. We know it improves the quality of care and promotes appropriate use of services. There is broad agreement on what it is, and guidance on how to deliver it. 11 The challenge remains one of overcoming “system” inertia and paternalism. This Spotlight series, developed in partnership with members of The BMJ’s patient advisory panel and enlivened by a roundtable debate and interviews with discussants in the US, India, Uganda, Equador, and mainland Europe, seeks to inform, inspire, and spur change. There is wide support for measuring and incentivising person centred care. 13 In New South Wales districts are competing to provide it, with promising results. Robert et al describe how to codesign services with patients and carers.And the familiar message that strong leaders who ensure that all staff are responsible for patient partnership and person centred care can transform failing services fast is repeated in a podcast. It’s agreed that feedback from patients and their families should be more rigorous and used to inform practice, not merely collated for research. Nelson illustrates the value of systematically collecting information on patients concerns and priorities at the point of care and using outcome measures that they identify. Care should promote self management, not dependency