One of the core features of Dudley’s new care model is a change in relationship between professional and patient. In essence, and especially for patients with long-term conditions, there is a need to move away from a conversation based on the question of ‘what is the matter with you?’ to one based on consideration of ‘what matters to you? How can we achieve that?’. This change is not easy. It requires changes in both professional and patient behaviour. This presentation, given at a public engagement event, outlines some of the starting considerations implied by this.