There is a growing imperative to place people and communities, and what matters to them, at the centre of health and care services. The World Health Organisation (WHO) emphasises the need to engage and empower people as partners in creating and maintaining their health and wellbeing. The Astana Declaration (2018) advocates for policies that embed integrated care in strong, community-oriented and community led primary care. This is particularly important for people with multiple health conditions and/ or care needs managed by different providers, often through many unconnected episodes of care. Continuity and collaborative care, through planning, monitoring and review are essential if we are to achieve what really matters to the person, their family and carers. This requires the right information, advice, and health literacy support to help people to understand their conditions and how to live well. However, the realisation of these aspirations remains elusive. Professional culture and practice ...