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Person-centred practice
McCormack & McCance (2006, 2021, 2025) & 2020–2026 Relational AI Scholarship — five concentric domains leading to a healthful culture for patients and staff.
Does this AI tool help me know the person and share decisions, or does it merely make them faster to process?
Pair with the 5-Check AI Note Audit and Values Clarification Builder.
The Person-centred Practice Framework was developed by Brendan McCormack and Tanya McCance from research in nursing practice. It was first published in 2006 and has been revised since, most recently in 2021, and formalised explicitly as a mid-range theory for nursing practice in 2025. It is widely used in practice development in the UK and internationally, including by the Foundation of Nursing Studies.
This page describes the framework in our own words to show how it applies to AI. For the framework itself, go to the original sources in the reading list below.
Interactive 5-Ring Framework Explorer
Explore the Five Concentric Rings of Person-Centred Practice & AI
Click any concentric ring in the diagram or use the buttons to move from the outer macro-context to the central Healthful Culture outcome.
Click any ring to inspect its AI guardrails
Ring 4: Person-Centred Processes
McCormack & McCance (2006, 2021, 2025) · Stokes & Palmer (2020) · Locsin (TCCN)Framework constructs: Working with the person’s beliefs and values, engaging authentically, being sympathetically present, sharing decision-making, and providing holistic care.
The five concentric rings of the framework
The wider context
Policy, strategy, leadership and workforce decisions that shape what is possible.
Prerequisites
The qualities of the practitioner: professional competence, interpersonal skill, commitment, self-knowledge and clarity about their own values.
Practice environment
The conditions of the workplace: skill mix, systems for shared decisions, relationships between staff and organisational support.
Person-centred processes
Working with people's beliefs and values, engaging authentically, being sympathetically present, sharing decisions and working holistically.
The outcome
A healthful culture, for people receiving care and for staff.
AI through this lens
| Part of the framework | Questions to ask about AI |
|---|---|
| Wider context | Who decided to introduce this tool, and why? Were staff and the public involved? |
| Prerequisites | Do I understand the tool well enough to use it competently? Am I clear about my own values when I use it? |
| Practice environment | Has the tool freed time for people, or added work and surveillance? Can staff raise concerns about it safely? |
| Person-centred processes | Does it help or hinder me working with this person's values, being present and sharing decisions? |
| Outcome | Is care, and the culture of care, healthier because of this tool? |
A warning sign
If an AI tool makes a person easier to process but harder to know, it is working against person-centred practice, however efficient it is.
Does this tool protect your eye contact, preserve the person's own words, and leave decisions genuinely shared?
Contemporary theoretical developments (2020–2026)
Between 2020 and 2026, nursing theorists and digital health scholars expanded person-centred theory to address multi-professional systems, workforce pressures, and the rapid arrival of generative and ambient AI in clinical spaces:
Ethics of Caring & Task Division (Stokes & Palmer, 2020; Buchanan et al., 2020–2021)
Early AI-nursing scholarship established a foundational moral boundary: because AI lacks lived vulnerability, empathy, and moral agency, it cannot “care” in the nursing sense. Dividing tasks between nurses and AI is only ethical when automation lifts administrative burden to protect human touch, therapeutic presence, and compassionate care, never to substitute for them.
Macro-Context & Multi-Professional Refresh (McCance & McCormack, 2021)
The 2021 refresh repositioned the framework across interdisciplinary health and social care, explicitly framing the outer Macro-Context ring (health and social care policy, strategic leadership, workforce development, and strategic frameworks) and pairing the model with validated cultural evaluation tools such as the Person-Centred Practice Inventory–Staff (PCPI-S).
Formalisation as a Mid-Range Theory (McCance & McCormack, 2025)
In the Journal of Research in Nursing (2025), McCance and McCormack formalised the Person-centred Nursing Framework as an explanatory mid-range theory. It sets out testable propositions showing how strengthening practitioner prerequisites and the care environment directly counteracts “system inertia”, moral distress, and task-focused drift to sustain a healthful culture for both patients and staff.
Relational Augmentation & Fundamentals of Care (Kitson et al., 2021–2026; NHS England, 2025–2026)
Contemporary socio-technical scholarship aligns McCormack and McCance’s framework with Alison Kitson’s Fundamentals of Care (FoC) framework (Relationship, Integration of Care, and Context) and Relational Augmentation (2025–2026). Rather than judging AI by speed alone, these models warn against “infocratic care” (serving the digital screen rather than the person) and require nurses to co-design and govern AI so that every tool strengthens dignity, narrative voice, and shared power.
Evolution of the theoretical lens (2006 to 2026)
Go deeper: full milestone table with sources (5 rows)
| Period | Theoretical milestone | Key scholars / sources | What it adds to evaluating AI in nursing |
|---|---|---|---|
| 2006–2017 | Foundational Person-Centred Nursing Framework | McCormack & McCance (2006, 2010, 2017) | Establishes the concentric rings (Prerequisites, Care Environment, Person-Centred Processes, and Person-Centred Outcomes) and shifts focus from isolated tasks to workplace culture. |
| 2020–2021 | Ethics of Caring in AI & Scoping Reviews | Stokes & Palmer (2020); Buchanan et al. (2020, 2021) | Defines the moral rule for AI task division: AI may assist with data synthesis and administration, but relational presence and moral accountability remain non-delegable nursing duties. |
| 2021–2024 | Multi-Professional PCPF & Cultural Measurement | McCance & McCormack (2021); PCPI-S international validation studies | Adds the outer Macro-Context ring (policy, digital strategy, and workforce governance) and provides empirical tools (PCPI-S) to audit whether digital change supports or erodes psychological safety. |
| 2025 | Mid-Range Theory for Nursing Practice | McCance & McCormack (2025), Journal of Research in Nursing | Formalises testable relationships between the rings, explaining why introducing technology without addressing system inertia and care environment power dynamics fails to achieve a healthful culture. |
| 2025–2026 | Relational Augmentation, Fundamentals of Care & Ambient Governance | Kitson et al. (FoC, 2021–2026); NHS England Ambient Voice Guidance (2025); DHSC National Commission Response (2026) | Evaluates AI as a structural mediator of relationships: asks whether ambient scribes, triage algorithms, and generative drafts preserve eye contact, patient language, and co-produced care plans rather than creating "infocratic" task throughput. |
A clinic introduces an approved ambient AI scribe to reduce typing during consultations, and managers immediately shorten appointment slots from 20 minutes to 10 minutes so staff see twice as many patients. Through the Person-Centred Practice Framework, what is the primary concern?
Related pages
Reading
- McCormack, B. and McCance, T. (2006) Development of a framework for person-centred nursing. Journal of Advanced Nursing, 56(5), pp. 472–479.
- McCance, T. and McCormack, B. (2021) The Person-centred Practice Framework. In McCormack, B., McCance, T., Bulley, C., Brown, D., McMillan, A. and Martin, S. (eds) Fundamentals of Person-centred Healthcare Practice. Chichester: Wiley-Blackwell, chapter 3, pp. 23 onwards.
- McCance, T. and McCormack, B. (2025) The Person-centred Nursing Framework: a mid-range theory for nursing practice. Journal of Research in Nursing, 30(1), pp. 47–60.
- Stokes, F. and Palmer, A. (2020) Artificial intelligence and robotics in nursing: ethics of caring as a guide to dividing tasks between AI and humans. Nursing Philosophy, 21(4), e12306.
- Buchanan, C., Howitt, M.L., Wilson, R., Booth, R.G., Risling, T. and Bamford, M. (2020) Predicted influences of artificial intelligence on the domains of nursing: scoping review. JMIR Nursing, 3(1), e23939.
- Kitson, A., Conroy, T., Kuluski, K., Locock, L. and Lyons, R. (2013; updated International Learning Collaborative scholarship 2021–2026) Reclaiming and redefining the Fundamentals of Care: nursing's response to meeting patients' basic human needs. Adelaide: School of Nursing, the University of Adelaide.
- NHS England (2025) Guidance on the use of AI-enabled ambient scribing products in health and care settings.
- Department of Health and Social Care (2026) Government response to the National Commission into the Regulation of AI in Healthcare.