At its heart, being patient-centred means providing a health service that responds to individuals' needs, takes their preferences into account and provides interactions that are respectful and empowering to patients.1
The trend away from a paternalistic doctor-knows-best culture towards one that is more patient-centred is relatively recent and reflects wider social, cultural and political changes.
In England, both the current and recent governments have stated aspirations to provide a more patient-centred NHS, made explicit in documents such as the Patients' Charter, the NHS Constitution and the newly published NHS Operating Framework which 'puts patients at the centre of decision making'. The coalition government has been using the slogan, 'no decision about me without me' to capture the essence of a patient-centred healthcare culture.
However, working in this way requires skills of guiding and supporting patients to offer options within the restrictions of the available resources. There may be a distinction between the needs of the population and those of the individual and, as healthcare professionals, we are always potentially operating at both levels.
This conflict may become apparent when limited funds means there is a finite pot of money available for a given population, but where we wish to offer every individual patient the treatment they need.