Intended for healthcare professionals


Power to the people: what will bring about the patient centred revolution?

BMJ 2013; 347 doi: (Published 08 November 2013) Cite this as: BMJ 2013;347:f6701
  1. Paul Hodgkin, chief executive officer1,
  2. Jeremy Taylor, chief executive officer2
  1. 1Patient Opinion, Sheffield S3 9EN, UK
  2. 2National Voices, London, UK
  1. paul.hodgkin{at}

We need to go beyond well meaning policies

The incoming coalition government wasted no time in declaring its intention to “put patients at the heart of the NHS” in England. The 2010 white paper Equity and Excellence: Liberating the NHS promised more choice, control and information.1 It also promised more shared decision making with “no decision about me without me” and a powerful new “consumer” champion Healthwatch to stand up for our interests. This government has continued a tradition of rhetorical lip service to the centrality of the patient and if anything has ramped up the rhetoric. “Putting patients first,” “patients first and foremost”—the patient friendly platitudes abound in every official document.

What does it all mean? Putting patients at the heart is partly about patients acting as equal and informed partners in decision making, in contrast to traditional medical paternalism. It is partly about patients as consumers of services, empowered through greater choice, better information, and the opportunity to give feedback and rate services. It is also about patients exercising their rights and responsibilities as citizens, as set out in the worthy but little known NHS Constitution. Those who advocate for people with long term conditions increasingly see patients as …

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