Transformations in the landscape of primary health care during COVID-19: Themes from the European region

Abstract

The Covid-19 pandemic has dramatically impacted primary health care (PHC) across Europe. Since March 2020, the Covid-19 Health System Response Monitor (HSRM) has documented country-level responses using a structured template distributed to country experts. We extracted all PHC-relevant data from the HSRM and iteratively developed an analysis framework examining the models of PHC delivery employed by PHC providers in response to the pandemic, as well as the government enablers supporting these models. Despite the heterogenous PHC structures and capacities across European countries, we identified three prevalent models of PHC delivery employed: (1) multi-disciplinary primary care teams coordinating with public health to deliver the emergency response and essential services; (2) PHC providers defining and identifying vulnerable populations for medical and social outreach; and (3) PHC providers employing digital solutions for remote triage, consultation, monitoring and prescriptions to avoid unnecessary contact. These were supported by government enablers such as increasing workforce numbers, managing demand through public-facing risk communications, and prioritising pandemic response efforts linked to vulnerable populations and digital solutions. We discuss the importance of PHC systems maintaining and building on these models of PHC delivery to strengthen preparedness for future outbreaks and better respond to the contemporary health challenges.

Preparedness and management during the first phase of the COVID-19 outbreak - a survey among emergency primary care services in Norway

“…This means that for many of the EPC services, the primary way to examine patients with suspected COVID-19 symptoms was in an airway clinic staffed with personnel who usually work at the EPC. Though it was not shown in this study, it may be fair to assume that in many cases this resulted in EPC personnel working more than usual, as demonstrated by others [ 37 ].…”

International examples of primary care COVID-19 preparedness and response: a comparison of four countries

“…Lack of involvement of PC and poor integration with PH in the COVID-19 response has been identified in other countries. This was a key theme in a 2020 international study looking at the pandemic response in 111 countries,16–18 and has also been recognised in a number of European studies 19–21. PC frequently demonstrates agility and innovative capacity in the face of limited resources and a changing environment22 contributing to the resilience required in the face of pandemics.…”

Primary care and COVID-19

“…These results underline the importance of collaborative teamwork, digital solutions, identification of vulnerable groups, and improving access to address health inequalities magnified by the pandemic. The authors concluded with a declaration of an urgent need to capture learning from the pandemic that is specific to PHC services and to turn these into strategic action plans to strengthen preparedness for future outbreaks and better respond to the contemporary health challenges (Kumpunen et al, 2021). We hope that this collection goes some way to providing such learning to support the development of pandemic-ready PHC services.…”