Clinician |
Strong identification with expert role Perception of already delivering person-centred care Concerns about increasing length of consultation, decreased control and managing clinical risk More emotional investment required
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Patient | ‘Expect to be fixed’ and devalue own resources and potential for change More psychological effort required in recognising reality Threat to potential secondary gains associated with being unwell
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System | Structure – working in silos, more demand than capacity Competing priorities – increasing workloads, fire-fighting, short-term thinking, change fatigue System instability – reorganisation and recommissioning Primacy – person-centred care skills not prioritised, not measured routinely and poorly resourced
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