Published: 22 December 2023
Increasing pressures on health systems are driving changes in the design and delivery of primary and community care globally. A review of international evidence and country experiences by Public Health Wales highlights that embedding prevention and public health approaches can support primary and community care.
Pressures on primary and community care include ageing populations with increasing demand for healthcare, workforce challenges and growing inequalities and deprivation. As a result, there are increasing examples of primary and community care models embedding preventative and public health approaches, taking action to prevent diseases and health problems within a population, and enabling better self-care.
The report highlights that cross-sector collaboration and integration can support primary and community care, including in areas such as health promotion, disease prevention and surveillance. While primary and community care focuses on individuals, public health addresses the needs of the whole population, so integration is crucial. Moving primary care into the community is an international priority as it can improve efficiency, whilst reducing or stabilising healthcare costs.
International Horizon Scanning and Learning Report 47: Embedding Prevention in Primary and Community Care identifies solutions-based approaches and learning from several countries. Common approaches include integrating digital systems and sharing data, comprehensive assessment and analysis of populations health needs and assets. Integrated pathways were often used, as were incentives that support collaboration. Other approaches noted were social prescribing, multi professional practices, joint training and promoting primary and community care as an attractive career.
Mariana Dyakova, Consultant in Public Health at Public Health Wales said:
“Primary and community care is a vital pillar of healthcare services which strengthens the resilience of health systems to prepare for, respond to and recover from shocks and crises. As pressures on our health systems continue to rise there is a clear need to embed prevention and public health within this, providing an integrated approach.
The World Health Organization (WHO) supports a focus on strengthening primary and community care, calling for action across sectors, empowering local communities, encouraging health in all policies and prioritising essential public health functions across the life course.
Our work highlights the core components of a successful integration strategy. These include setting out defined populations, aligning financial incentives to enable healthcare organisations to work together, using data to improve quality, effective leadership and patient and carer engagement”.
In Wales our approach to primary and community care has been shaped by the 2018 Parliamentary Review of Health and Social Care in Wales, which outlined a vision for care in that is preventative and person-centred, empowering individuals to make decisions about their care and access seamless, high-quality care closer to home. The response from Welsh Government set out in A Healthier Wales: our Plan for Health and Social Care called for new models of seamless health and social care at the local and regional level.