The following design principles for primary care focus on earlier, improved access for patients and a more tailored patient experience that minimizes the number of separate consultations necessary.
Rather than speaking to an administrator there is a senior clinician, capable of making decisions about the correct course of action available to patients as early in the process as possible.
Patients can benefit from access to primary care advice and support that is underpinned by systematic use of the latest electronic communications technology.
Many systems have struggled with this. Recent work by KPMG in the Netherlands has looked at the creation of 24 hour primary care urgent care centers as one response.
Case in point: The Nairn Healthcare group in Scotland uses its community hospital as the base for 24/7 advice by its nursing team.
Patients should have the minimum number of separate consultations necessary, with access to specialist advice in appropriate locations.
Care for frail older people is tailored to individual needs, especially for those in nursing or residential homes.
Community Health Centre Botermarkt, Belgium offers patients with co-morbidities a long first consultation at which the patient’s individual care goals are explored and agreed.
Case in point: ParkinsonNet in the Netherlands enables patients to use an interactive tool to locate services in their area. These services are supported by specialists, but delivered in primary care wherever possible.
Primary care practitioners have immediate access to common diagnostics, guided by clinical eligibility criteria.
Case in point: In Kaiser Permanente (US) sites, they aim to provide primary care, specialist care, pharmacy, some laboratory tests and x-rays under one roof, as the norm.
Continuity of relationship with their health professional should be offered for patients for whom it is important, and access at the right time when it is required.
Care plans, agreed between relevant professionals, to coordinate care during transfers between organizational settings and between health, mental health and social care.
Case in point: Community Health Centre Botermarkt in Belgium offers a tailored service for people with co-morbidity, with longer consultations, and a range of services deemed to meet the needs of the individual. The health center provides ‘standard primary care’ services to other patients who do not have multiple long-term conditions.