Coulter A, Rozansky D. Full engagement in health. BMJ. 2004 Nov 18;329:1197.
In his review of future funding needs for the British NHS, Derek Wanless called for a new focus on moderating demand by investing in effective health promotion and disease management with the active involvement of individual patients and local communities. The fully engaged scenario, which entailed a radical change in professional and public roles, was the most ambitious of the three alternatives modelled by his team, but they concluded that it offered the best and most cost effective means of matching demand to supply of health care in the longer term. Achieving this involves promoting self care — for example, by encouraging patients to adopt healthy behaviors and to diagnose and treat minor ailments, involving them in treatment decisions, and supporting them in active self management of chronic conditions. This strategy is now enshrined in official policy for the NHS in England, what to what extent is it being implemented in primary care?