Full engagement in health

BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7476.1197 (Published 18 November 2004) Cite this as: BMJ 2004;329:1197
  1. Angela Coulter, chief executive (angela.coulter@pickereurope.ac.uk),
  2. Deborah Rozansky, director of strategy and communications
  1. Picker Institute Europe, Oxford OX1 1RX
  2. The Health Foundation, London WC2E 9RA

    Needs to begin in primary care

    In his review of future funding needs for the British NHS, Derek Wanless called for a new focus on moderating demand by investing in effective health promotion and disease management with the active involvement of individual patients and local communities.1 The fully engaged scenario, which entailed a radical change in professional and public roles, was the most ambitious of the three alternatives modelled by his team, but they concluded that it offered the best and most cost effective means of matching demand to supply of health care in the longer term. Achieving this involves promoting self care—for example, by encouraging patients to adopt healthy behaviours and to diagnose and treat minor ailments, involving them in treatment decisions, and supporting them in active self management of chronic conditions. This strategy is now enshrined in official policy for the NHS in England,2 but to what extent is it being implemented in primary care?

    A new international study …

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