Abstract
Better primary care has become a key strategy for reforming health systems to respond effectively to increases in non-communicable diseases and changing population needs, yet the primary care workforce has received very little attention. This article aligns primary care policy and workforce development in European countries. The aim is to provide a comparative overview of the governance of workforce innovation and the views of the main stakeholders. Cross-country comparisons and an explorative case study design are applied. We combine material from different European projects to analyse health system responses to changing primary care workforce needs, transformations in the general practitioner workforce and patient views on workforce changes. The results reveal a lack of alignment between primary care reform policies and workforce policies and high variation in the governance of primary care workforce innovation. Transformations in the general practitioner workforce only partly follow changing population needs; countries vary considerably in supporting and achieving the goals of integration and community orientation. Yet patients who have experienced task shifting in their care express overall positive views on new models. In conclusion, synthesising available evidence from different projects contributes new knowledge on policy levers and reveals an urgent need for health system leadership in developing an integrated people-centred primary care workforce.
Original language | English |
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Pages (from-to) | 1055-1062 |
Number of pages | 8 |
Journal | Health Policy |
Volume | 122 |
Issue number | 10 |
Early online date | 7 Aug 2018 |
DOIs | |
Publication status | Published - Oct 2018 |
Bibliographical note
The idea for this article is supported by material gathered from different research projects and is linked to a workshop on the primary care workforce held at the European Public Health Conference in Stockholm 2017. We wish to thank all colleagues involved in these projects as well as the participants in the workshop for inspiring discussions and our two reviewers for very helpful comments.Keywords
- Primary care workforce
- health workforce policy
- general practitioners
- patients and task shifting
- health system leadership
- comparative European research