Editorial: Advancements and Challenges in Patient-Centred Health Systems

Euan Sadler^*Anne Elizabeth Rogers

• University of Southampton, Southampton, United Kingdom

These transformations unfold against broader social currents: consumer dissatisfaction with existing models of care, engagement with alternative approaches to health and disease management, and heightened expectations of autonomy. Patients now demand greater alignment of power, knowledge, and relationships between themselves and health professionals.The four papers presented in this collection illuminate both the promise and the fragility of patient-centred advances. They highlight progress, but also areas of regression, reminding us that policy aspirations can be easily undermined. Walker et al. (2025), in GPs as Stranger, examine the impact of changes in primary care access on long-term condition management. Their findings reveal a troubling loss of relational continuity and trust between patients and professionals. Patients report feeling excluded and burdened by navigating care. As primary care undergoes redesign, preserving trusted relationships must be central to reform. 2025) report findings from the CICADA project, which sought to develop person-centred practices for underrepresented groups. Participatory methods proved effective in fostering authentic engagement, but persistent challengesnotably inadequate and inconsistent funding -limit sustainability and equity in participation.Collectively, these studies convey a clear message: while the rhetoric of advancing patient-centred care remains strong, actual progress is fragile. System redesigns that fail to prioritise patient-centred approaches, alongside crises and shifting policy priorities, risk eroding gains. The path to truly sustainable patient-centred systems requires deliberate investment in relationships, workforce support, and resilience against systemic shocks. Without these foundations, patient-centred care will remain an aspiration rather than a sustained reality.