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Primary Care and the Health of the Public


Blog headlines

  • What White people don’t see
    26 November 2020

    This year’s Black History Month (BHM) has, unfortunately, in its shadow another example of why campaigns like this exist.

  • Primary Care: Why don’t we talk about Racism?
    20 November 2020

    Rita Symons is an ex NHS leader who is now a leadership consultant, coach and facilitator. Her work is mainly in the NHS and she is an associate for PCC offering facilitation, coaching, strategy development and team development activities. She is a concerned but hopeful world citizen and combines work in the NHS with a board role in a non for profit organisation and an interest in writing.

  • Primary Care and the Health of the Public
    12 November 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • What now for primary care
    4 November 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • Boosting your resilience
    30 October 2020

    The last year has been a difficult one, who would have imagined last Christmas that we would have been in lockdown, with the NHS seriously tested by a global pandemic. So much change has happened and the resilience of people working in and with health and care services has been seriously tested. Resilience is our ability to deal with, find strengths in and/or recover from difficult situations. Its sometimes referred to as “bounceabiliy” – but bouncing in what way?

  • Link of the week: National Cholesterol Month
    23 October 2020

    Every month or week of the year seems to be an awareness week, October has more than its fair share.

  • New redeployment service offers talent pool of motivated, work-ready individuals
    15 October 2020

    People 1st International have shared some of the work they are doing to support people displaced from industries due to the Covid-19 pandemic. There is an opportunity for health and care services to benefit from this workforce.

  • Link of the week
    9 October 2020

    Article published in the BMJ looking at the ability of the health service to quickly bounce back to pre-Covid levels of activity and considers if it is desirable.

  • Virtual Consultations– the patient perspective
    2 October 2020

    This week Jessie Cunnett, director of health and social care at Transverse has shared this article.

  • Virtual Consultations– the patient perspective
    1 October 2020

    This week Jessie Cunnett, director of health and social care at Transverse has shared this article - Virtual Consultations– the patient perspective.

  • Celebrating innovation in eye research
    24 September 2020

    This week Julian Jackson from VisionBridge has shared a report on eye research.

  • Link of the week: Comprehensive Spending Review and Covid-19
    24 September 2020

    This week we are sharing a blog that outlines the funding pressures and uncertainties faced by the health and care system

  • Risk stratifying elective care patients
    10 September 2020

    This blog has been shared by MBI healthcare technologies. As services are starting to treat routine patients those on waiting lists are making enquiries as to where they are on the list, and if they are still on the list.

  • Link of the week
    4 September 2020

    This week the link we would like to share are reflections from physiotherapy students on placement at Alzheimer Scotland https://letstalkaboutdementia.wordpress.com/

  • Link of the week
    28 August 2020

    This week we would like to share a blog published on the Mind website about being a BAME health worker in the pandemic.

  • Remote clinical triage model
    20 August 2020

    This week we are sharing how a remote clinical triage model was implemented at Tollgate Medical Centre. This has been shared with us by Sarah Portway, a Nurse, and Clinical Services Manager at Tollgate Medical Centre.

  • Can the Community Pharmacy become the gateway to integrated care in the NHS?
    13 August 2020

    The NHS is a continually evolving innovative demand led public service the role of the Community Pharmacist is becoming the public face on a journey to the more responsible public engagement in the personal care of individuals and their family. There are currently over 11000 Pharmacies many are single or small chain service providers, while multiples occupy the urban shopping centres and more densely populated conurbations, the value of the rural High Street can’t be understated.

  • Crunch time for patient involvement
    7 August 2020

    There are new challenges for primary care, which could really do with patient input. Mike Etkind, chair of a PPG and founding member of his PCN’s patient group, recognises the size of the task clinical directors have managed over the last few months but identifies two particular issues where patients have a necessary and valuable contribution, that need to be addressed now – the 2020 vaccination programme and primary care from a distance- total triage, remote consultations, and the use of telemedicine.

  • Link of the week - Visionbridge
    31 July 2020

    The link we are sharing this week was submitted by Julian Jackson, Visionbridge.

  • Links of the week
    23 July 2020

    This week we are sharing two articles with you.

Thursday, 12 November 2020

Primary Care and the Health of the Public

By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

As the Covid-19 Pandemic unfolds in the UK, England’s public health system’s response when compared internationally seems to be failing us. Crises often highlight existing system weaknesses, and an over reliance on centralised decision making and equally for delivery of services such as test and trace, has arguably contributed significantly to failure. In contrast NHS centralised decision making led to the speedy transformation and high quality delivery of hospital intensive care services. Health crises although unwanted can generate expedient responses of long term benefit. Centralisation of benefit for short term emergency responses but localism for sustained benefit

Do we need a new approach to public health? A more fundamental question, has traditional public health been of value to primary care? Within the NHS, primary care is by far the most public facing service and general practice uniquely in the NHS, serves a registered population.

The author of this paper has been a lead advocate for population health – defining it as the health outcomes of a group of individuals and describing population health management as ‘a logical extension to the strong generalist tradition within general practice. GPs and primary care staff are embedded in the community and well-placed to make the most of their knowledge of patients and the factors affecting their health’. I advocate that as government policy is more primary care focused than at any time in my lengthy career, a more encompassing local approach to the health of the public is essential.

Prevention, early intervention, and health promotion all require a focused overview of a practice’s population. Current concepts of population health argue that practitioners need to have broad views of the health trends and demographic characteristics of the populations they serve even when practicing with individual patients. Managing care in any system with limited resources (which means all systems) requires that practitioners have some sense of disease patterns, costs, and benefits—not just for individual patients but for the entire cohort of patients and, when a practice is the major provider of care in an area, for the community as a whole.

Professor Barbara Starfield’s internationally acclaimed research provides the evidence of how successfully primary care has delivered care and improved the health of people. Dr Julian Tudor Hart provided early practical evidence of implementation with a clear philosophical underpinning of population health improvement in a GP population in a very disadvantaged community.

Underpinning all is the public health contribution of mainstream list based general practice from prevention advice, early diagnosis and treatment eg services for vaccination and immunisation, cervical cytology screening and improving the health of those who have a long term condition. There is also a public health component often understated, of the individual clinical consultation, the basis of ‘make every contact count’. ‘Personal health services have a relatively greater impact on severity (including death) than on incidence. As inequities in severity of health problems (including disability, death, and co-morbidity) are even greater than are inequities in incidence of health problems, appropriate health services have a major role to play in reducing inequities in health’

The overarching priority for health and wellbeing is to enhance social capital, community solidarity, resilience and sustainable development for individuals and communities. All the formal organisations within a geography contribute to social capital, only a minority engage in a wider contribution to health and wellbeing and rarely receive extra support. Can that change? And individual professionals who have ongoing contact with individuals within a community are an important source of enhancing the resilience of the individuals they serve.

Primary Care does not have to do it all. In areas beyond clinical practice where understandably it may lack the capacity or capability, it can engage with others who are best able. Primary Care Networks must be given time to develop or they will be crushed but a future primary care anchor organisation being of its community can offer much.

Anonymous says:
Nov 18, 2020 08:53 AM

Totally agree-logic of closer working between public health provider services and primary care especially stronger integration of MECC approach