Redesigning primary care: New design principles

Redesigning primary care: New design principles

How might we take the learning from these emerging models of more organized primary care, principles for high quality primary care, and our understanding of the challenges ahead to develop new models of primary care?

Partner and Chairman

KPMG in the UK

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Policy makers can try to reshape the system, but there are dangers in trying to overspecify, not least the unintended consequences of central direction which may not make sense for local context. Also, doing this precludes getting the advantages of innovation and creativity that can be unleashed where primary care is (re)designed and run locally on the basis of independent businesses and vibrant networks of enthusiastic practitioners from a range of health professions. 

The approach we propose is: 

  1. Identify the design principles that patients or the public would want to see embedded in a new primary care model. 
  2. Develop enough specificity to allow these to be applied in practice, but leaving a great deal of room for local creativity. 
  3. Create contractual mechanisms, approaches to measurement, and rules of behavior that foster the evolution of new models while managing some of the risks associated with this. 
  4. Develop new models and approaches to provision that create some tension in the system and that will promote innovation and change (or at least fill in some of the gaps in those areas where new models may not develop so quickly). 

 

Improving the design of primary care

If we are trying to improve the design of primary care it is useful to ask the question – what can we infer about the design principles of the current primary care and wider system and how might changing these produce a different result? In other words, how does primary care work (or not) for patients, the public and professionals, and how might we redesign services to address this? 

Rather than specify a particular primary care model or organization, it makes sense to determine the key attributes required.

The following present a suggested set of design principles for primary care. They will need to be adapted to local contexts and take into account the wide variety of different approaches found across Europe. At their heart, however, there is a key idea that patients have a professional who can work with them over time to manage and improve their health and that there is more standardization in the approach taken. 

New design principles:

Design principles: Access and continuity

The design principles explored in this report can be applied and adapted in various ways suggest new approaches for reshaping primary care.

Design principles: Patients and populations

The design principles for primary care support a proactive, goal-oriented approach to population health and wellness and patient-centered care mgmt.

Design principles: Information, outcomes and engagement

Primary care design principles for improved access to information, data-sharing and the use of performance and outcome measures on the patient.

Design principles: Management and accountability

Primary care design principles centered on rigorous governance, accountability for outcomes and standardized processes across networks.

DESIGN PRINCIPLES: ACCESS AND CONTINUITY

The design principles explored in this report can be applied and adapted in various ways suggest new approaches for reshaping primary care.

 
Read more

DESIGN PRINCIPLES: PATIENTS AND POPULATIONS

The design principles for primary care support a proactive, goal-oriented approach to population health and wellness and patient-centered care mgmt.

 
Read more

DESIGN PRINCIPLES: INFORMATION, OUTCOMES AND ENGAGEMENT

Primary care design principles for improved access to information, data-sharing and the use of performance and outcome measures on the patient

 
Read more
Healthcare worker with senior patient

DESIGN PRINCIPLES: MANAGEMENT AND ACCOUNTABILITY

Primary care design principles centered on rigorous governance, accountability for outcomes and standardized processes across networks.

 
Read more

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