Intended for healthcare professionals


Unfulfilled potential of primary care in Europe

BMJ 2018; 363 doi: (Published 24 October 2018) Cite this as: BMJ 2018;363:k4469

Re: Unfulfilled potential of primary care in Europe

Thank you so much for such a brilliantly clear summary of this important issue!

In 2015 we formed The Deep End Yorkshire and Humber group and have been working towards health equity by leading on 'Workforce, Education; Advocacy and Research' (WEAR) in our region(1).

You state in the article that "primary care colleagues believe the social determinants are not their responsibility" I would suggest that it's more that we feel powerless to make system changes in the face of unmanageable workloads. For example this week it has taken three hours of my time to engage with the local safeguarding team about just one family. We know that GPs who work in more deprived areas are more prone to burn out and resilience is a responsibility of the system not just individuals (2).

Much needs to be done to allow GPs time to come up for air (in the UK system at least) before they will have the 'headspace' to embrace the fantastic intersectoral dream we should be striving for.

1) Walton L, Ratcliffe T, Jackson BE and Patterson D.
Br J Gen Pract 2017; 67 (654): 36-37. DOI:

2) Eley E, Jackson B, Burton C and Walton E.
Br J Gen Pract 8 October 2018; bjgp18X699401. DOI:

Competing interests: No competing interests

09 November 2018
Elizabeth Walton
NIHR Clinical Lecturer and GP
The University of Sheffield & The Whitehouse Surgery.
Sam Fox House, Northern General Hospital, Sheffield, S5 7AU