"Finally, in Hands I Can Trust": Perspectives on Trust as an Enabler of Person-Centred Integrated Care

Background: Trust is a critical yet often overlooked component of person-centred, integrated care, as it enables meaningful service engagement and co-production. This presentation explores how trust serves as a foundation for delivering truly integrated, person-centred care.

 

Approach: This perspective project was co-produced with people living with Motor Neurone Disease (MND) and clinician-researchers. People with lived experience of MND were recruited through MND Australia National Lived Experience Network and a Palliative Care Service in Ireland using voluntary and snowball sampling. Contributors were offered a choice to remain anonymous or be named authors, with flexible participation options.

 

A series of in-person and online meetings, email exchanges and phone calls took place over May–June 2025. Written or verbal reflections were gathered and collaboratively organised into thematic sections through iterative drafting and feedback. The co-production process was guided by transparency, inclusion, and shared authorship, enabling the authentic expression of lived and clinical experience.

 

Results: We identified key experiences eroding and facilitating trust between people living with MND and the Health and Social Care Professionals (HSCPs). For people living with MND, trust in HSCPs is often challenged from the outset due to prolonged diagnostic delays, fragmented services, and limited provider knowledge. Establishing even one trusted HSCP (a "trust companion”) can serve as an emotional anchor and turning point, offering stability and reassurance.

Consistency, clear communication, and genuine attentiveness are critical to building trust, while impersonal or dismissive interactions can deeply undermine it. Strengthening workforce training and ensuring continuity of care are important to supporting trust-based, person-centred care for those living with MND. Key trust drivers (empathy, authenticity, and competency), alongside vulnerability and reciprocity, are essential to addressing care needs across physical, emotional, practical, and psychosocial domains. We propose a diagram of care that embeds the core values of integrated, person-centred care within the specific context of MND, which can be adapted to other health conditions.

 

Implications: Trust is a foundational element of person-centred, integrated care and must be prioritised. It is built through empathy, authenticity, and clinical competence, and is often anchored by consistent relationships with key professionals. Each interaction with a HSCP can either strengthen or erode trust, significantly shaping how healthcare is experienced.

 

 Trust must be nurtured at both individual and system levels, with planned transitions and continuity of care playing a critical role. Recognising trust as both a responsibility and a marker of success invites healthcare systems to prioritise it - not only for people living with MND, but as a standard for truly compassionate, co-produced care.