Letter from the President and Chairman of Council of the ESPCH

It is an honour to be invited to the Inaugural Presidency of the European Society for Person Centered Healthcare. I accept this responsibility wholeheartedly and look forward with no small enthusiasm to serving the Society to the best of my ability and in every way I can.

The foundation of the new Society comes at a critical juncture in the development of international healthcare. In every country, the demands placed on health services continue to rise inexorably and the costs of service provision and of access to new therapeutic modalities are increasing with them. Globally, the world is faced with a major shift in the nature of human disease from acute presentations to long term chronic illnesses and these are actively exerting an unsustainable drain on economic and human resources. What can we do in the face of such developments? How do we respond to the challenges with which the long term illnesses confront us? The answer must surely be to change - and to change quickly - since to do nothing in the face of an emergency of this type is no longer an option.

Chronic illnesses, by their nature, require altogether different methods of management and support to those which existing systems currently provide. Indeed, our present systems are now all but defunct as adequate mechanisms with which to address, successfully, the new clinical and social needs of long term illnesses. Here, I refer of course to the community and home-based setting that has become clearly requisite for the new environment. New systems require new models of care to function as their fundamental units of construction - without them, it becomes impossible to design, commission and operationalize services for the benefit of patients, their carers, families and friends. We need, for sure, to move ‘beyond the pill’ and to develop our services accordingly.

In recent years, while the academic and managerial rhetoric of person-centered care has had its place and has functioned to increase the awareness of the problems we face and their attendant imperatives for action, no amount of continued oratory or organisational position statements or declarations of policy intent can substitute for the genuine strategic vision and compelling inspirational leadership that is now required to move the field forward with the energy and urgency that is needed. The order of the day here is as follows: research, education, professional skilling, research transfer, imaginative implementation, evaluation and audit.

We know that person-centered, relationship-based approaches to care increase patient adherence to both simple and complex medication regimens; that they maximise desired clinical outcomes; that they reduce the frequency of primary care presentations, that they decrease the frequency of symptom exacerbations and distress; that they reduce frequency of hospitalization and that they decrease length of hospital stay following admission. Further, they are associated with increased patient and clinician satisfaction with care and, by virtue of these modifications of illness trajectories, satisfaction and service use, are positively correlated with decreased economic and human resource utilization. It is, for me, exciting, personally exciting, that such clear and direct benefits are increasingly demonstrated by rigorous empirical studies and that, therefore, solid quantitative data are now being added to the results of so much qualitative research conducted over recent years.

It is with these urgent developmental necessities in mind that I am greatly encouraged to have been able to approve as my first act as President the creation of some 80 Special Interest Groups (SIGs) which will constitute the ongoing driving force of the new Society. The professionals that will lead these engines of activity within the Society have a very important role - to collect and review the current knowledge of the specific field of their SIG, to identify and recommend research and educational priorities and to write and submit research grant applications to this end.

And let me say this. While the new Society has been constituted as a professional body of clinicians, researchers and scholars, it in no way excludes from its work the essential and indispensable voices of those whom it serves: our patients, their carers, their families and their friends. Indeed, far from representing what some unenlightened professionals may consider to be an existential threat to professionalism or an irritating distraction, the new political environment of patient advocacy, education and empowerment represents a real opportunity that healthcare professionals must grasp tightly with outstretched hands.

As a nurse by training and as a former government ‘Tsar’ for patient and public involvement in healthcare in the United Kingdom, I have long since become convinced of the inestimable value of the involvement of patients in healthcare development and delivery - and in the evaluation and audit of healthcare  services  on  an  on-going  basis.  Such involvements codify the dialogical partnerships between clinicians and patients that form the bedrock of empathic and compassionate healthcare. They provide us with the salutary lessons that directly inform the pursuit of excellence in our clinical practice.

In conclusion, let us all be clear that person-centered care is here to stay. It is anything but a passing fad or fashion. On the contrary, its re-emergence in healthcare, after so many decades of absence, is invigorating. It certainly leads me to believe that we are, at last, preparing to return to humanity and common sense in the exercise of our respective professions and in recognising and discharging our moral commitments to those who are ill.

I have little doubt that the new Society will drive forward the solid principles of excellence that I have referred to above - and with dynamic vigour. I am proud to have become associated with a Society of such vital and contemporary importance.

Yours sincerely

Professor Sir Jonathan Asbridge DSc (hc) London, United Kingdom