RCP calls for radical shift to people-centred care

Rather than designing services around buildings, the RCP is urging policymakers, clinicians and system leaders to focus on what truly matters to patients: personalised, integrated, and compassionate care rooted in relationships and delivered as close to home as possible.

The toolkit follows a workshop hosted by the RCP in April 2025, which brought together over 40 participants including clinicians, patient representatives, national charities, royal colleges and policymakers. The event explored how the NHS can respond to the government’s promised ‘hospital to community’ shift in care – the so-called ‘left shift’.

Sir John Oldham, GP and strategic adviser to the secretary of state for health and social care said:

‘If you bring into your mind’s eye a sheet of paper full of blue dots with one solitary red dot – the blue dots represent the hours in the year a patient manages their own condition. The red dot is the time they interface with healthcare professionals. Yet 99.99% of our system is designed around the red dot.

‘It’s time we focused on the blue dots.’

The RCP toolkit sets out five core principles for ‘blue dot’ care:

• Person-centred: starting with what matters to patients
• Integrated: care that flows across settings and sectors
• Preventative: maintaining health, not just treating disease
• Collaborative: generalist and specialist medicine as equal partners
• Connected: building trust and continuity.

This new toolkit follows the publication of Prescription for outpatients: reimagining planned specialist care, a major report from the RCP and the Patients Association that sets out a vision to reform outpatient – or planned specialist – care over the next 10 years.

The RCP is clear that outpatient reform must be central to the 10 Year Health Plan which is expected from the UK government and NHS England later this week. A significant cultural shift, as well as the necessary funding and resource, will be needed to move outpatient care away from ‘appointment-only’ care to ensure that every contact between a service and a patient adds clinical value.

Dr John Dean, RCP clinical vice president, said:

‘We must move beyond outdated boundaries between ‘hospital’ and ‘community’, ‘specialist’ and ‘generalist’. What connects the system – relationships, communication and shared purpose – must now guide how we plan, deliver and fund care.

We need an integrated approach where planned specialist care is delivered with primary care, closer to home, supported by specialist input, digital infrastructure, and well-resourced community services.’

The toolkit includes a practical checklist for change across funding, workforce, leadership, patient engagement and digital infrastructure. It emphasises the need to:

• invest in anticipatory and end-of-life care in the community
• train doctors in generalist and community-based roles
• build stronger links with the voluntary and social care sectors
• support patients to navigate services and manage their health
• use digital tools to improve access, reduce admin and support continuity.

Sarah Tilsed, head of partnerships and involvement at the Patients Association, said:

‘Patients want flexible, joined-up care that fits around their lives. The NHS must support professionals with training and digital tools and support patients with clear information, continuity and a genuine voice in decision-making.’

The need for care through outpatient services is predicted to grow as the population ages and more people live with multiple health conditions. A patient with four or more health conditions will need more than three times as many outpatient appointments as someone with only one health condition. With almost one in five (17%) people over the age of 65 expected to live with four or more long-term health conditions by 2035, reforming outpatient care must be a priority. 

The RCP says that by focusing on the value – rather than the volume – of appointments, we can ensure that patients get the right contact at the right time and determine the clinical activities that can be minimised or avoided altogether.

Professor Jugdeep Dhesi, president of the British Geriatrics Society and a consultant geriatrician, said:

‘Older people are the main users of NHS services, yet too often they experience fragmented, hospital-centred care that fails to reflect the reality of living with frailty or multiple long-term conditions. We strongly support the RCP’s call to shift the focus onto what matters most to patients – their quality of life, independence and the relationships that support them. Delivering truly person-centred care means investing in community services, integrated teams and training for all healthcare professionals to work effectively across traditional boundaries.’

Case studies illustrating successful models of care will be published on the RCP’s clinically led quality improvement hub, Medical Care – driving change.

This work is also helping to shape the RCP’s ongoing advocacy for reform of postgraduate medical training. Insights from the RCP’s next generation oversight group informed the toolkit and reflect a shared commitment to training doctors who can deliver high-quality, person-centred care across all settings. The RCP will continue to call on the government to deliver the promised expansion of medical school places, along with increased supervisor capacity and a commensurate increase in postgraduate training places.