Newsletter 18
November 2022

A digest of successful transformation stories, news and other resources available on
Skill-mix Innovation, Effectiveness and Implementation: Improving Primary and Chronic Care

What are skill-mix innovations and why are they relevant? This systemic analysis of health workforce skill-mix innovations provides an overview of the evidence and lessons for implementation across multiple countries.

The authors focus on six core segments of health systems: health promotion and prevention, acute care, chronic care, long-term and palliative care, as well as access for vulnerable groups and people living in underserved areas.

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International Conference on Primary and Community Care

The Spanish Ministry of Health is organising the International Conference on Primary and Community Care, to be held in Madrid on 28 and 29 November 2022, with the theme “The contribution of primary care to health systems”.

The conference will bring together stakeholders from around the world, including WHO, EU, and diverse national health systems and institutions, to highlight the role and value of primary care, by reflecting on:

  • The value of primary care from the angle of international organisations.
  • Current international challenges and experiences of primary care delivery.
  • The Spanish Primary and Community Care Action Plan 2022-2023.
  • Valuing human resources in primary care.
  • Primary care resolution capacity.
  • Multidisciplinary teamwork in primary care.
The live streaming of plenary and thematic sessions will be available on the conference website upon free registration
Fit for the Future: a new plan for GPs and their patients

General practice is the cornerstone of the NHS, helping around 50 million people in England every year, carrying out 370 million consultations last year. So, when GPs and their patients tell us that general practice is in crisis, we should all be concerned

In 2022, the RCGP launched Fit for the Future: a new plan for GPs & their patients to put pressure on politicians and decision makers with responsibility for the NHS in England to commit to a bold new plan to provide GPs and patients with the support that they need.

This campaign follows our 2019 Fit for the Future vision which set out how, with the right tools and support, we can revitalise and reform general practice by 2030, so that it can continue to deliver world class patient care. Pressures on general practice have since intensified even further and have been exacerbated by the effects of COVID-19. Without urgent action from politicians and NHS decision makers, the ability of general practice to meet patients’ needs is in jeopardy.

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The Post-COVID-19 Case for Primary Case

Much has been written and discussed about challenges faced by the US health care system, with most of it justifiably concerning the payment system for medical services, and how that leaves an unconscionably large proportion of US residents uninsured or underinsured for quality care. Although payment systems are undoubtedly a challenge and merit substantial conversation, the structure of US health care delivery also leaves much to be desired.

Central to that problem is the paucity of primary care physicians in the US. The approximately 200 000 active primary care physicians in the US represent about 30% of all active physicians, down from 32% about 10 years ago. About 28% of men and 17% of women report they do not have a primary care physician. The Council on Graduate Medical Education recommended an increase in the proportion of primary care physicians to 40%, a recommendation now further from reality than it was in 2010 when the report was published. By way of comparison, about 50% of Canadian physicians are primary care physicians. As a result, a substantially smaller proportion of persons in the Canadian population—about 17% of men and 12% of women—report not having regular access to a physician.

The shortage of primary care physicians is not a new concern, and has been on the minds of policy makers for decades. But the issue has never quite risen to the level of policy attention that would command serious action, despite concerns about impending workforce shortages that could make the problem even worse. The COVID-19 pandemic may present an opportunity to elevate the role of primary care in the US anew, reaffirming the centrality of primary care in the practice of medicine, and in so doing reinvigorating efforts to achieve the right number of primary care physicians in the country. Three arguments make the case robustly for primary care: the importance of having a primary care infrastructure in place before a crisis to deliver care where and when it is needed; the need to build trust in health care systems; and the importance of delivering care to populations within their local context and lived realities.

Access the scientific publication

A proposal to reform general practice and enable digital healthcare at scale

General practice has always been the foundation and gateway to the NHS. However the problems are mounting up: a stretched and increasingly burnt-out workforce, no systematic reporting or analysis of activity and demand, fragmentation with secondary care, and confusing and dated contracting and reimbursement mechanisms. The status quo is increasingly unacceptable to both patients and GPs. There is now a consensus that changes are needed, including to the small-scale independent contractor model, to ensure that primary care can thrive in the future.

Policy Exchange has set out a pragmatic proposal for reform. Addressing issues around integration, workforce, digital transformation and scaled provision, we argue that a new model of general practice is required to better meet the needs of patients and the taxpayer – so it feels increasingly at their service.

Access the report

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(c) 2022 Escuela Andaluza de Salud Pública S.A. (Andalusian School of Public Health - WHO Collaborating Centre)
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