Keynote address at the 2013 World Congress of the World Organization of Family Doctors.
Keynote address at the 2013 World Congress of the World Organization of Family Doctors.
Several ways of shaping primary care are being developed all around the world. Improving the role of nurses or giving general practitioners new competences are just a couple of ways of moving primary care towards a more comprehensive way of working.
In this post in the NHS Confederation Blog, some of the initiatives performed to change primary care are explained and some of the challenges that future primary care will face are listed.
One of the main points outstanded is the need of integrating care and workforce from different levels of health care. As it is said in this post “Patients will benefit from easy access to a single integrated, multidisciplinary team drawn from a wide range of health and social care professionals”
Workforce structure is one of the most difficult things to modulate in health systems. Current transition to new models of care could be a good opportunity to make workforce structure match actual needs of systems and populations. In this report, published by the Nuffield Trust, it is analyzed how organizations could reshape their current workforce and what the benefits would be:
There is a need to evolve from an illness-based system to a patient-centred system.
Workforce should meet future needs by incorporating professionals with a vision aligned with future models of care.
There are opportunities to develop the current workforce at all grades: from redeploying support staff, extending the skills of registered professionals and training advanced practitioners.
There is good evidence that support workers can provide good-quality, patient-focused care as well as reduce the workload of more highly qualified staff. Investment here could provide a cost-effective and rapid solution to ...
“General practice is in crisis”; that is how this King’s Fund report start its analysis, pointing to funding and workforce as two of the main problems in general practice situation. Increasing needs and complexity, trends of moving patients from hospital to communities and rising expectations in population act as factors that increase pressures in general practice.
This report identifies some immediate priorities and some future challenges in order to protect general practice and to make it can face future needs.
Immediate priorities would be: (I) providing practical support to practices, (II) accelerating the uptake of technologies that can help practice deal with growing pressures more effectively, (III) encouraging reshaping of workforce in primary care, (IV) reducing bureaucratic burdens, (V) placing primary care at the heart of sustainability and transformation plans, (VI) supporting patients to use health services appropriately.
Long-term challenges pointed by this report are: (I) solving deficiencies in ...
In this post, the author analyzes how recent changes in primary care in the National Health Services could face the purpose of moving some services from hospital to primary care settings.
The author bases her discussion on a report published by RAND corporation (“Outpatient Services and Primary Care”) that identifies five main areas to be considered when moving services from hospital to primary care:
There is not a unique way of moving these services; many studies suggest that patients’ satisfaction usually grows when services are ...
Gatekeeping is the term used to describe the role of primary care physicians or general practitioners (GPs) in authorizing access to specialty care, and diagnostic tests. Gatekeeping has crucial influences on service utilisation, health outcomes, healthcare costs, and patient satisfaction.
It was developed as a response to a shortage of specialists and a desire to control healthcare spending and has been an accepted practice in lot of countries. Yet direct access could help reduce GP workload and facilitate greater patient choice. They look in this study at the pros and cons of gatekeeping policies in various countries, and highlight the need for more evidence to devise policy.
Evidence of the influence of family physicians on health care is required to assist managers and policy makers with human resource planning in Africa. The International argument for family physicians derives mainly from research in high-income countries, so this study aimed to evaluate the influence of family physicians on the South African district health system.
As numbers of chronically ill patients with complex healthcare needs are increasing, primary care professionals will be challenged to deliver integrated care. Integrated care is about ‘delivering seamless care for patients with complex long-term problems cutting across multiple services, providers and settings.
Leaders are needed to address healthcare changes essential for implementation of integrated primary care. What kind of leadership this needs, which professionals should fulfil this role and how these leaders can be supported remains unclear.
Understanding a care coordination framework, its functions, and its effects on children and families is critical for patients and families themselves, as well as for pediatricians, pediatric medical subspecialists/surgical specialists, and anyone providing services to children and families. Care coordination is an essential element of a transformed American health care delivery system that emphasizes optimal quality and cost outcomes, addresses family-centered care, and calls for partnership across various settings and communities. High-quality, cost-effective health care requires that the delivery system include elements for the provision of services supporting the coordination of care across settings and professionals
The number of children with medical complexity (CMC) residing in regional Australia is growing, challenging the health system to provide equitable care. Families of CMC experience problems in accessing appropriate care locally and they have high out-of-pocket costs and family disruptions because of long travel distances to access care in metropolitan paediatric hospitals. The Murrumbidgee Local Health District (MLHD) in collaboration with the Sydney Children’s Hospitals Network (SCHN) partnered with families and local services to co-design a Model of Care (MoC) which better reflects the needs of CMC, their families and local services. The MoC was co-designed with families, local healthcare providers and the tertiary paediatric network.
Family integrated care (FIC), where parents are empowered through structured training to form an important component of the caregiving team, is fast becoming the standard of care across neonatal units in the UK. The Parents of Preterm Infants (POPPY) survey in 20101 found variability of practice and inadequate facilities to support even family centred care (FCC). To explore the change in the parental participatory model in the neonatal unit over the last 8 years, this article designed and conducted an online questionnaire survey. The aim was to explore current practice, understanding and strategy for FIC using the Qualtrics web assessment toolkit (Qualtrics, Provo, Utah, USA).
This cross-sectional study evaluated the adequacy of the Family Health Strategy for the primary care model for chronic noncommunicable diseases and the changes that occurred between the two cycles of external evaluations of the National Program for Improving Access and Quality of Primary Care, which took place in 2012 and 2014, in the higher coverage context of the Family Health Strategy of Brazil, in the state of Tocantins, Brazil.
The Besrour Centre for Global Family Medicine (Besrour Centre) at the College of Family Physicians of Canada (CFPC), thanks to the generous support of the CFPC’s Foundation for the Advancement of Family Medicine (FAFM) and the Fondation Docteur Sadok Besrour, is seeking proposals for a Global COVID-19 pandemic innovation response.
The initiative is a response to how the COVID-19 pandemic is disrupting the health and economic well-being of nations. There are more than six million cases, and more than 370,000 deaths, worldwide.
* The response to such a threat must be rapid and effective to minimize the harmful impact of a virus that is highly transmissible and that is affecting the most vulnerable worldwide. The primary care response to COVID-19 must support innovation that targets and protects highly vulnerable populations that lack access to primary care.
The goal of this initiative is to have the greatest impact for reducing ...
The novel coronavirus epidemic is transforming the world in which we live. This pandemic will bring sweeping changes everywhere, not least in the field of primary care medicine. Overall, this pandemic has genuinely demonstrated the medical professional’s power to adapt, evolve and thrive, even in these times of unprecedented crisis. Family medicine, dealing with both the emotional and the scientific side of medicine on a daily basis, plays a central role in tackling this pandemic. Taking responsibility for both care and research on COVID-19 will redefine the importance of family medicine for public health care.
The objective of this research is to synthesize evidence on the relationship between context, strategies and performance in the context of federally qualified health centers (FQHCs), a core safety net health services provider in the United States. The research also identifies prior approaches to measure contextual factors, FQHC strategy and performance. Gaps in the research are identified, and directions for future research are provided.
For the purpose of celebrating the 40th anniversary of Alma Ata declaration, the WHO published a successful model of integrated patient care being performed in Slovenia. After two years, the WHO experts evaluated the success in practise during a visit to the Slovenian primary care environment. This report showed that Slovenia was a notable exception regarding developing effective primary care systems. The country has an impressive primary care which performs very well.
Healthcare providers around the world are seeking to manage the rising burden of chronic conditions against a backdrop of both growing and ageing populations as well as greater expectations of health services. This paper describes the development of an integrated primary care model ‘the family medicine model (FMM)’ to deliver primary healthcare in Qatar to better address some of the healthcare challenges faced. The proposed model is an innovative approach which utilises and integrates these components to deliver holistic primary care. It is anticipated that its introduction will help redesign and integrate the way primary healthcare is delivered to the population of Qatar in helping patients manage their own health and reduce the numbers that need to be admitted to secondary care, improving patients’ independence and well-being as well as dramatically reducing the cost to the overall health system.
Although an emerging speciality in Africa, family medicine contributes significantly to African health systems. Leadership from family physicians can enable the delivery of high-quality primary health care that is accessible, comprehensive, coordinated, continuous and person-centred. This short report chronicles how family physicians from a university teaching hospital in Ibadan, Nigeria, adopted a health post located in a home for persons with mild physical and mental disabilities and changed it into a hub of comprehensive, holistic and person-centred care for residents and staff of the home, as well as individuals and families in the neighbouring communities and its environs.
WONCA Europe 2022 Conference takes place from 28 June to 1 July 2022 and will be held conjointly with RCGP (Royal College of General Practitioners) 2022 Annual Conference as one event.
The promise of personalised medicine (PM) to transform healthcare has sparked great enthusiasm in the last years. Yet, its lack of consensus around the nature and scope of the concept has ended in terminological confusion amongst the users in primary care. We aimed to investigate the perceptions of doctors and their patients in response to this evolving concept.
This is a report on Chiawelo Community Practice (CCP) in Ward 11, Soweto, South Africa, a community-oriented primary care (COPC) model for National Health Insurance (NHI) in South Africa, developed by a family physician.
A shift to capitation contracting for primary health care (PHC) under NHI will carry risk for providers – both public and private, especially higher number of patient visits. Health promotion and disease prevention, especially using a COPC model, will be important. Leading the implementation of COPC is an important role for family physicians in Africa, but global implementation of COPC is challenged. Cuba and Brazil have implemented COPC with panels of 600 and 3500, respectively.
The family physician in this report has developed community practice as a model with four drivers using a complex adaptive system lens: population engagement with community health workers (CHWs), a clinic re-oriented to its community, stakeholder engagement and targeted health promotion. A ...