Ways to improve Primary Care will be explored by the Institute of Global Health Innovation (IGHI).

At a recent conference Professor the Lord Ara Darzi, Director of the IGHI, discussed how developed countries could learn much from the way some developing countries provide Primary Care.

Maxine Myers caught up with Lord Darzi to discuss why primary care needs to be improved and explore the IGHI’s work programme for the coming year.

1.  What is primary care and why is it so important to get it right?

For many patients Primary Care is their first point of contact with the healthcare system.  General Practitioners (GPs) working within Primary Care have large and diverse role, from providing vaccinations and advice to ongoing care for those with long-term conditions, such as diabetes and asthma. 

The importance of the work that Primary Care does should not be understated.  Many admissions into Secondary Care  such as hospitals could be prevented through better management in a Primary Care setting – this would not only be better for the patient, who doesn’t fall ill, but also better for the health service as the expensive treatment is avoided.

The role of Primary Care is set to become even more important as our population ages and there are many more people with long-term conditions that typically require management rather than treatment.

2.  Why is it that some countries in the developing world are better at Primary Care than more developed countries such as the UK?

We in the western world typically think that the more money we spend on something the better it should be.  This is not always the case and in fact countries that spend more on health can often learn a lot from countries that spend less.   Healthcare providers in developing countries have very limited resources to try and keep their populations healthy – this can often result in more creative problem-solving and better outcomes per pound spent.

3.  What are the current challenges with primary care in the UK?

The NHS in England is going through a period of substantial reform. The reform programme is arguably having the greatest impact on Primary Care who are being asked to lead the Clinical Commissioning Groups (CCGs) that are now responsible for planning and purchasing most health services.

The NHS also faces continued financial constraint. This, combined with an ageing population, who have multiple and increasingly complex chronic diseases such as heart disease, mean it has never been more important to have high quality, affordable Primary Care in this country.

4. Can you give an example of a developing country whose approach to primary care is really successful? What are they doing better?

There is a lot that we can learn from other countries’ health systems and one of the reasons I ran the Global Health Policy Summit in London last year was to help accelerate this learning.  We brought together health ministers, academics, policy makers, and experts from industry to discuss the innovations that are taking place in different countries and how we can help spread them.

One example highlighted at the Summit was that of Mexico.  Mexico has significant healthcare-access problems in its rural areas, with patients being forced to travel huge distances to see a physician. 

Medicall, a private for-profit company, was set up 14 years ago and allows patients to get access to primary care via their mobile phone.  Telephone advisors, based at a single national call centre, use calculations developed by the Cleveland Clinic in the US to determine the priority of patients' treatments based on the severity of their condition and ensure they speak to a specialist of the appropriate level.  It has now reached over a million households. 

62% of calls are dealt with over the phone.  The process gives many more patients access to Primary Care whilst also saving money.  It is clear that many more developed countries could learn a lot from examples of innovation like this one.

5.  Can you tell us more about your plans for IGHI over the coming year?

It is an exciting time for IGHI.  We have recently received a generous grant from the Peter Sowerby Foundation that will allow us to initiate two key work programmes around primary care.  The first is a Commission that will look at how primary and secondary care data can be better shared and linked, both among clinicians and researchers, a hugely important area and one that the UK is incredibly well-placed to lead on.  The second will allow us to create a research unit within IGHI, focused on research that helps improve primary care in the UK. 

IGHI is also involved in establishing the successor to last year’s very successful Summit, the World Innovation Summit for Health (WISH), which will take place in Qatar this December.  The Summit will explore innovation in many different areas of health and will aim to help spread new ideas and learning across the world.