Health systems have to meet the changing needs of an increasingly assertive population and an ever more complex health policy context. Digitalisation, population ageing, chronic diseases, new pandemic threats, and evolving expectations of what health services should deliver – and how – have raised questions of whether health systems meet the needs and facilitate engagement of the people. Agreement is widespread that a shift towards more people-centred health systems is needed. But how this is done, and what a more people-centred health system looks like, is far less settled. The OECD Framework and Scorecard for People-Centred Health Systems identifies critical dimensions of people-centredness for health systems and benchmarks the progress countries have made towards a more people-centred approach to health. It considers the implications of the COVID-19 pandemic on people-centredness, and identifies key policies – and policy challenges – to assist the development of more people-centred health systems across OECD countries.