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.