Child health general practice hubs: increasing access to paediatric care in the community

Developing paediatric capabilities of GPs and other healthcare professionals facilitates more healthcare delivery in community setting; "Whole-population approach" also addresses difficulties patients have in obtaining a GP appointment, as well as promoting self-care where appropriate; Attendance at A&E in relevant areas has declined, and patients feel more satisfied with care delivery in a community, as opposed to hospital, setting.

“Year of care:” GP delivered packages of care for long term conditions in inner-city London

In 2007, the borough became a pilot site for the “Year of Care” Project. This involved clinics “redesigning” the annual review that they undertook with patients. The newly-redesigned annual review took the form of a co-productive care plan, where patients were asked what was important to them, and what health outcomes they themselves would like to achieve.                                                 

In 2010, it was decided that ALL general practices in the borough should offer a core Service to people with type-2 diabetes. This involved creating additional packages of ideal care for people with type 2 diabetes across four clinical subgroups: newly diagnosed, controlled ...

The House of Care: Re-imagining primary care in Scotland

“House of Care” is a sequence of several interrelated, synergistic strategies, at the core of which is a patient-led care programme design; patients design their own care plan in consultation with practice nurses; patients report having more agency. Some patients report an improvement in biomedical markers, as well as overall wellbeing; Staff morale appears to have increased.

Strengthening primary care in Voznesensk, Ukraine

The district of Voznesensk experimented with initiatives, such as provider payment mechanisms, designed to align service delivery with the principles of family medicine, becoming an example for broader primary care reform across Ukraine; effective local leadership, combined with political and financial support, created a stable platform from which bottom-up reforms were built; aligning local initiatives with national priorities proved valuable for gaining legitimacy and support for the initiative; availability and capacity to collect and share data was fundamental for improving communication between health providers and increasing continuity of care. A district-wide electronic patient registration and medical records system was created ...

Strengthening disease prevention services in Albania

The government, which was strongly committed to establishing universal health coverage, launched a four-year Free Check-Up Programme to introduce free screening services for chronic conditions; adopting a proactive approach to prevention was essential for reaching and engaging the target population (all citizens aged between 40 to 65 years); significant efforts were made to improve the systematic collection and monitoring of population health data; government support for activities, and a key partnership with the Health Insurance Institution to reimburse health check-up services, helped embed the initiative into the health system.

Integrating nutrition programmes in primary care in Kyrgyzstan

A programme to distribute micronutrient sprinkles, locally known as “Gulazyk”, was introduced with donor support. Following successful piloting of the programme, activities were scaled up nationally in 2011; aligning with existing infrastructure and services helped support and stabilize reforms implemented under the initiative; building trust between primary care providers and patients was essential for ensuring uptake of micronutrient supplementation; community health volunteers aided trust building; developing a consistent message across all providers, even those not directly involved with the initiative, safeguarded changes against being undermined at different care levels; encouraging participation of mothers and community members proved valuable in overcoming ...

Designing a national diabetes plan for Slovenia

The Ministry of Health convened a working group to develop a national diabetes strategy. After several years of deliberation among working-group members, the finalized National Diabetes Strategy was approved by the government in 2010; an active patient association supported patient engagement and involvement throughout the initiative’s planning and implementation process; meaningful stakeholder engagement across professions and institutions helped develop a common vision for the initiative; building trust between stakeholders took time, but was necessary to allow functional teamwork and effective plan development; oversight from the Ministry of Health fostered important linkages across activities, ensuring that changes to service delivery ...

Exploring new provider-payment models to incentivize performance improvements in Hungary

The Care Coordination Pilot was launched in 1999 to explore ways to improve the coordination and quality of health services. Under the pilot, Care Coordinator Organizations (run by health providers from general practices or polyclinics) acted as virtual fund holders for capitation-based health care budgets within their local catchment areas; carefully chosen financial incentives guided performance improvements by rewarding efficiency, incentivizing preventive care and encouraging treatment in lower-level settings; empowering professionals with new responsibilities helped to overcome provider dissatisfaction; extensive data collection supported analysis and comparison of local organizational arrangements.

Developing guidelines to reduce under-five child mortality in the Republic of Moldova

The government developed an under-five child mortality reduction initiative and established new standards and protocols for the observation of childhood illness; research conducted prior to the initiative identified the root causes of problems and provided evidence of the need to act; guidance and support from the Ministry of Health led to coordinated intersectoral action Educating and expanding providers’ competencies challenged pre-held attitudes regarding the detection and treatment of childhood illness; joint-sector delivery by health providers and social workers facilitated more comprehensive and coordinated care for patients; national ownership over the initiative was important; activities were fully integrated into national standards ...

Strengthening the response to noncommunicable disease in Turkmenistan

The government developed the National Health 2020 Action Plan 2014–2020 to guide action on noncommunicable disease; international attention on key issues helped generate national momentum and political will for health reform; a strong understanding of key challenges, supported with baseline population health data, facilitated the development of the Plan and allowed tailoring of activities to population needs; intersectoral partnerships across government ministries helped to keep the Plan on the political agenda and safeguarded health reforms against being undermined by other sectors’ policies; aligning with the existing primary care infrastructure facilitated the adoption of the Plan; a strong public communication ...