A new model of primary health care is to be laid out in another major document to be published by the Department of Health tomorrow. The document will be followed in January by the establishment of a National Primary Care Task Force.
The national health strategy published yesterday sets out the framework for the development of primary care services. It envisages 40 to 60 "primary care teams and networks" being in place by the end of 2006, and 400 to 600 such teams by the end of 2011.
These teams are intended to serve population groups of about 3,000 to 7,000 people. Members of the team will include GPs, nurses, midwives, healthcare assistants, home helps, physiotherapists, occupational therapists, social workers and administrative personnel. They would effectively offer patients a "one-stop-shop" to cater for their health needs without setting foot in hospital.
Individual patients will be encouraged to enrol with one primary care team and with a particular GP within the team. The locations for the first 40 to 60 teams will be decided over the next two to four years. The changes are part of a new model for primary care, full details of which will be published tomorrow in a separate document Primary Care: A New Direction.
However, many of the changes planned for primary care, the first point of contact most people have with the health service, are outlined in yesterday's health strategy document. The aim is to have "a team-based approach" to service provision in this sector .
The strategy notes there are many positive aspects to the current system of primary care but it has "significant weaknesses".
"Primary care infrastructure is poorly developed, services are fragmented with little teamwork; there are insufficient numbers of trained staff in key areas; liaison between primary and secondary care is often poor; and many services provided in hospitals could be provided more appropriately in primary care. GPs can be isolated from many other community services. Communication and work-sharing with other primary care professionals is not always readily facilitated or supported. There is also an underdevelopment of primary care services out-of-hours," the document states.
The aim is to develop the capacity of primary care which will involve "significant enhanced funding". Community-based diagnostic centres will be piloted to support primary care. They will be evaluated on the basis of their ability to provide more accessible services and their cost effectiveness in terms of reducing pressure on hospital-based diagnostic facilities.
Arrangements for GPs to have direct access to local hospital diagnostic facilities will also be enhanced. This access, together with an extension of the number of 24-hour GP co-ops, is expected to reduce the pressure on hospital casualty departments. It is planned to also extend services offered by the co-ops to include nursing and home help services, leading to the development of primary care co-operatives.