Activity 2.2: Critical thinking

Consider how these changing approaches to care across the Western world might impact upon service provision in your local area.

  • Do you think care might be delivered differently in the future?
  • How might you prepare for these changes?

Healthcare is in an almost constant state of flux. Drivers of change may include economic pressures, public health needs, political policies, consumer interests, improving technologies, and workforce demands, as well as the seemingly ever-present desire for reform. National Voices (2015) advocated PCC approaches as the central ambition for improving health and social care over the five years leading to 2020. It is clear that PCC has a strong role to play in moulding national policies, and strengthening the provision of choice and shared-decision making within the healthcare sector.

As information has become more readily available to every citizen through the Internet, there has been a gradual erosion of the esteem with which many experts are held. People are more able, and willing, to research information and come to their own opinions on various issues. Social media allows groups of people with similar interests to make contact with each other and share information, stories and advice. Increasingly, the growth of online peer support is seen by healthcare strategists as a significant means of low-cost support for individuals. This also chimes with the desire to hand back responsibility for health to the individual, and away from the government. There are dangers, of course, because people online who appear to know what they’re talking about have not necessarily been educated in their field, or be qualified to give individual advice.

Another issue is that for an individual to be properly empowered to make their own healthcare decisions, albeit supported by doctors and nurses, it is important that they have access to all the relevant information. We might consider providing them with a targeted volley of helpful information about their condition, and appropriate treatments, which would be entirely appropriate. But although this is a necessary condition, it is not sufficient. All relevant information should be made available, implying a need for timely access to one’s own health records, and all the gathered medical evidence (Brennan et al. 2015). The vast majority of people are simply not in a position to make valued judgements from this information, without a consultation with some who is qualified to analyse the information, and advise them on the best way forward. Artificial intelligence and other technological advances may allow for many of these analytical processes to be mechanised, through complex algorithms and consumer-facing computer programs.

These potential developments may be further exacerbated by the shift in focus from hospital-based secondary healthcare, towards primary provision. As Western populations age, and people live longer, often with long-term conditions, their healthcare needs will also change over time towards interfaces and mechanisations that enable them to maintain their independence at home, with minimal professional support. This will likely provide a fresh series of challenges for the nurses of the future.


  • Brennan, P. et al. (2015). ‘Patient-centred care, collaboration, communication, and coordination: A report from AMIA’s 2013 Policy Meeting’. Journal of the American Medical Informatics Association, vol. 22, p. 2.

  • National Voices (2015). Person-centred care 2020: Calls and contributions from health and social care charities. London: National Voices