Editors Choice

A New Vision for People-Centred Health Systems

The Lancet Global Health Commission on People-Centred Care for Universal Health Coverage (UHC) was announced on May 29, 2024. The Commission aims to operationalise the concept of people-centred care to help achieve universal health coverage and health equity by 2030 and beyond.

People-centred care represents an essential evolution from patient-centred care, which “restores a functional life”, to person-centred care, which “promotes a meaningful life.”[1] As the authors explain, “People-centred care expands the scale and scope of person-centred care to the level of health systems and populations. People-centred care requires a whole-of-government approach that engages patients, carers, families, and communities in shared decision-making to ensure health services are provided ‘at the right time, in the right place, in the right way’.”[2]

The Commission seeks to fill crucial gaps by defining how people-centred care can be “operationally defined, rigorously measured, and effectively implemented across various settings and income levels.”[2] Achieving this will require determining the current state of people-centeredness in different contexts, developing optimal measurement approaches, and identifying best practices for the co-production of health systems and services through “shared partnership and leadership alongside people with lived experience.”[2]

Notably, the Commission is grounded in participatory principles, using “community-engaged methods and shared governance models”[2], starting with an open call for commissioner nominations. The authors emphasise, “Such a shift toward transparency and shared decision-making is crucially needed in publications with such global influence as the Lancet, which can intentionally contribute to dismantling unequal power structures in global health.”[2]

The open call aims to recruit a “diverse, independent group of multidisciplinary experts on people-centred care including people with lived experience, academic researchers, policymakers, health-care providers, private sector actors, and civil society.”[3] Commissioners will be selected rigorously based on their experience, impact, commitment to equity, networks, and availability.[3] Selection will ensure an appropriate mix of skills and diversity across gender, geography, income-level and inclusion of marginalised groups.[3]

Over 2.5 years, the Commissioners will formulate research questions, synthesise evidence, and conduct new research to inform policy and practice recommendations for operationalising people-centred care in diverse settings.[3] Working groups will use participatory, community-engaged methods aligned with people-centred principles.[3]

Through this innovative and inclusive approach, the Commission aims to “forge a new way of knowing and practicing health care in the post-Sustainable Development Goal era, using people-centred care as our guide to achieving Universal Health Coverage”[2]. If successful, this could help reorient health systems worldwide to be for and with the people they serve truly.

References:

1. Håkansson Eklund J, Holmström IK, Kumlin T, et al. “Same same or different?” A review of reviews of person-centered and patient-centred care. Patient Educ Couns 2019; 102: 3–11.

2. Duong DB, Holt B, Munoz C, Pollack TM. For and with people: announcing the Lancet Global Health Commission on people-centred care for universal health coverage and a call for commissioner nominations. Lancet Glob Health 2024; published online May 29.

3. Supplementary Appendix to Duong et al. Lancet Glob Health 2024.

Christopher Nial

Christopher Nial is an accredited journalist (NUJ, IFJ, AHCJ) whose reporting focuses on global public health, climate, and the role of technology in healthcare. He is also a Senior Partner at FINN Partners, leading public health strategy across EMEA for clients spanning global institutions, non-profits, and the pharmaceutical sector. With over 30 years’ experience, he bridges journalism and practice, making complex health issues clear and accessible to diverse audiences.

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