Primary Care Physicians In Ten Countries Report Challenges Caring For Patients With Complex Health Needs

A compelling article that explores some of the current challenges facing the integration of primary care within the health systems of 10 high income countries. The data comes from the 18^th annual Commonwealth Fund International Health Policy Survey of Primary Care Physicians which was completed in 2015 in Australia, Canada, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. While primary care physicians reported being well prepared for multiple chronic medical conditions, several health areas such as mental health and addiction were noted for being weak points for providers. A frequent challenge was a lack of communication with other parts of the health care system as well as with social services although there was significant variation between countries. An important finding of the study was “that having an electronic health record does not ensure electronic flow of information with doctors outside of one ...

Developing care for a changing population: Learning from GP-led organisations

The way a health system is organized may influence the care this system provides. In this Nuffield Trust report some GP-led experiences are described, analyzing what are the internal characteristics and external context that have affected GP-led progress.

The intra-organizational characteristics listed are: (I) strong links between clinical leaders and GP member practices, (II) sophisticated strategic and operational management support, (III) use of multiple forms of peer-led improvement, (IV) organizations are both entrepeneurial and pragmatic, (V) linked data between the organization’s own services and other providers.

In what concerns to external context, the three characteristics listed are: (I) a receptive context for change, (II) capability to transfer some of the commissioner role to providers through capitated budgets, (III) slow pace and short-term nature of decision-making.

The slow pace and short-term nature of decision-making in clinical commissioning groups may drive emerging organisations to focus on service developments outside of their ...

Reshaping the workforce to deliver the care patients need

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 ...

Implications of interprofessional primary care team characteristics for health services and patient health outcomes: A systematic review with narrative synthesis

Interprofessional primary care (IPPC) teams are promoted as an alternative to single profession physician practices in primary care with focus on preventive care and chronic disease management. Characteristics of teams can have an impact on their performance.

Literature focused on the implications of team characteristics on team processes, such as teamwork, collaboration, or satisfaction of patients or providers. Despite heterogeneity of contexts, some trends are observable: shared space, common vision and goals, clear definitions of roles, and leadership as important to good teamwork. The impacts of these on health care outputs or patient health are not clear. So, this systematic review of extant evidence on the characteristics of interprofessional primary care teams can inform policy

SCIROCCO Exchange - Capacity-building support for integrated care

Integrated care is a recognised solution to address the challenge of ageing population. Hence, it is important to commit to opportunities that increase the readiness and capacity of regions to implement integrated care. Knowledge transfer has been greatly recognised as an effective enabler of capacity-building support. However, effective knowledge transfer and capacity-building support requires dedicated support and infrastructure to ensure that the flow of appropriate information and knowledge between adopting and transferring entities is tailored to the local context and maturity of the particular healthcare system seeking the support. This is a precondition to help health and care authorities to build their capacity for the successful transition towards integrated care.

Maturity requirements of a Good Practice – Using the SCIROCCO tool to assess them

The SCIROCCO self-assessment tool is an online self- assessment tool with an objective to assess a region’s readiness for integrated care. It builds on the conceptual Maturity Model for Integrated Care developed by the B3 Action Group on Integrated Care of the European Innovation Partnership on Active and Healthy Ageing.

The SCIROCCO tool helps regions to:

• Understand the strengths and weaknesses of their regional context for integrated care  and inform national, regional and local policy-makers about potential areas of  improvement;
• Adopt and transfer integrated care good practices by identifying their maturity  requirements and requirements for the potential transferability and scaling-up;
• Facilitate multi-stakeholder dialogues on progress towards the implementation and  delivery of integrated care;
• Facilitate twinning and coaching activities that help regions and organisations to better  understand the local conditions that enable the successful deployment of integrated care.

The SCIROCCO tool has been tested in more than 60 and organisations ...