Patient centred care: Essential but probably not sufficient

One of the many lessons to emerge from the analysis of the care of children in the cardiac unit at the Bristol Royal Infirmary is the importance of engaging patients in decisions about their health and health care. This is a message that has relevance to all healthcare professionals in all clinical settings. Patient centredness is crucial for good quality care, but achieving genuine patient centred care throughout health services will require transformation of systems as well as attitutes. In this issue (pp 186-8) we have reproduced Angela Coulter's paper "After Bristol: putting patients at the centre", first published in BMJ in March 2002.