Comment

We need to talk about primary care

For too long the absence of a universally understood definition of primary care has limited the clarity of the debate on these essential services

For too long the absence of a universally understood definition of primary care has limited the clarity of the debate on these essential services.

Health service reform in Scotland is being carried out on an ambitious scale. Over the past year health and social care professionals have come together in integration authorities, the government has unveiled new trauma centres and health targets have come under the spotlight.

A mature debate has emerged looking at how services are designed. Services must be delivered in a multidisciplinary way, with genuine teamwork and, where appropriate, multi-agency work too.

Primary care is too often defined, and overshadowed, by what it isnt and it isnt hospitals. The lack of a precise and strong definition of primary care that is universally accepted and understood by professionals

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For too long the absence of a universally understood definition of primary care has limited the clarity of the debate on these essential services.

Health service reform in Scotland is being carried out on an ambitious scale. Over the past year health and social care professionals have come together in integration authorities, the government has unveiled new trauma centres and health targets have come under the spotlight.


Working together to promote a clearer understanding of primary care
Picture: Alamy

A mature debate has emerged looking at how services are designed. Services must be delivered in a multidisciplinary way, with genuine teamwork and, where appropriate, multi-agency work too.

Primary care is too often defined, and overshadowed, by what it isn’t – and it isn’t hospitals. The lack of a precise and strong definition of primary care that is universally accepted and understood by professionals and the public has limited the clarity of the debate on these essential services.

Working with colleagues across health and social care, the RCN has called time on this ambiguity. Clinicians wanted to build a clear picture of the nature of services which constitute primary care in Scotland.

Mutual understanding 

We joined with colleagues from Allied Health Professions Foundation Scotland, Community Pharmacy Scotland, Optometry Scotland, the Queen’s Nursing Institute Scotland, the Royal College of General Practitioners and the Royal Pharmaceutical Society Scotland. We worked on a joint understanding of what professional leaders mean by primary care.

That joint working produced a clear definition of what primary care is, how it is delivered and who delivers it. It produced 21 principles to build a vision for primary care in Scotland. This is a unique piece of work in Scotland. The report The Future of primary care in Scotland: a view from the professionals encapsulates the multi-professional and multi-agency approach which the RCN has championed. It sets out what is central to maintaining the integrity of primary care.

This shared vision is important and the report states that ‘without this, we risk fragmentation, misunderstanding and conflict.’

Inspiring willingness

Building consensus with professionals from different disciplines was a challenging and eye-opening process, allowing all involved to view primary care through a different lens, considering the concerns, challenges and operating models of different health professionals.

This willingness to see the other clinicians’ perspectives is essential if patients are to be at the centre of the care they receive. During group discussions it was inspiring to hear every professional body reflect that clinicians want to put individuals and quality at the centre of what they do. It was reported that members were frustrated when they felt disempowered to deliver high quality, patient centred care.

The dialogue by professional leaders on the future of primary care in Scotland has opened communication channels and challenged all members of the multi-professional, multi-agency team to think about their roles. The group has built a vision of primary care understood by those who deliver services. Most importantly, perhaps, our work has underlined that to remove care barriers for patients, clinicians must first break down professional barriers, finding ways to support and enable each other, and discovering a voice to speak for the whole primary care team.

Continue forward

In Scotland multi-professional working must become part and parcel of a clinician’s psyche if services are to be sustainable enough to deliver to patients and communities in future. And that means we all need to continue to talk about primary care.


 About the author

Theresa_Fyffe

Theresa Fyffe @TheresafRCN is director of the Royal College of Nursing Scotland 

 

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