The future of primary and community care in EnglandBMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a819 (Published 15 July 2008) Cite this as: BMJ 2008;337:a819
- Chris Ham, professor of health policy and management
- 1Policy and Management, Health Services Management Centre, University of Birmingham, Birmingham B15 2RT
Starting with the bold statement that “primary and community care services are regarded with pride at home and admiration abroad,”1 Lord Darzi’s plans for the future extend the process of permanent NHS revolution into the heart of general practice.
The government’s strategy for primary and community care in England acknowledges that many improvements have occurred in the past decade. Despite these achievements, the standard of primary care varies widely and needs to adapt to rising public expectations, changes in risk factors, and an ageing population. Accordingly, the strategy outlines proposals for reform in three areas.
Firstly, it argues that there is a need to promote healthy lives through a greater emphasis on prevention. The main initiative in this area is a vascular risk assessment programme for people aged 40 to 74 to be delivered by general practitioners, pharmacies, and other services, as foreshadowed in the prime minister’s first major speech on the NHS.
Secondly, the strategy sets out proposals for continuously improving the quality of care. This is to be done through refining the quality and outcomes framework to focus more on health outcomes rather than process measures, and by collecting and publishing data on service …