2. While your model doesn’t sound “complicated”, it does, as you acknowledge, contain many inherent challenges and pitfalls.

3. Consider the seemingly innocuous word ‘level’, for example. It’s difficult not to interpret your levels as ranks in the system according to ‘importance’. That is, people responsible for delivery of “level 5” care, the “super-specialists”, are deemed to be of the highest rank. Conversely, those administering “level 1” care (i.e. self-care), by definition, are perceived to be at the foot of the ladder/bottom of the pile. Here patients certainly know their place.

4. Your usage of the verb ‘delegate’ reinforces this sense of the levels as ranks. For when a boss delegates, he/she gives responsibilities to his/her staff: the staff then act for the boss. Such delegation, of course, is predicated on a difference in rank/grade/status between boss and staff.