who collaborating centre imperial college london ref 212/2011 primary care the uk experience...
TRANSCRIPT
![Page 1: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/1.jpg)
WHO Collaborating CentreImperial College LondonRef 212/2011
Primary CareThe UK Experience
Professor Salman Rawaf MD PhD FRCP FFPH
Chile Primary Care Conference, Santiago 6-7 Dec 2011
![Page 2: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/2.jpg)
Content:1.Four Questions2.The evidence 2. Primary Care led NHS in the UK3. Current & Future Trends in Primary
Care4. Chile: the context
© WHO C Centre, Imperial College London
![Page 3: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/3.jpg)
© WHO C Centre, IC London
Four questions to address:
How to improve users satisfactions with the services?
How to ‘develop’ skilled personnel & guarantee its permanence at PHC?
How to guarantee access to medicine; provide problem-solving therapeutic
and Dx technology?
Ch Diseases: which community development strategies that PHC should integrate?
1
2
3
4
![Page 4: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/4.jpg)
WHO C Centre, IC London
The Evidence
![Page 5: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/5.jpg)
© WHO C Centre, IC London
Why PHC?
Modern Society expect that:
- Health is a human right
- Access to quality & comprehensive services near home
- Personal & Continuity of Care My Doctor - Financial Protection (free at time of Delivery)- Competent Health Professionals
![Page 6: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/6.jpg)
WHO World Health Report 2008
WHO C Centre, IC London
![Page 7: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/7.jpg)
© WHO C Centre, IC London
High Performi
ng Systems
Less Well Performi
ng Systems
vs
Principles: Coverage, Equity, less defined Financial Protection
Structure:Structure: Primary Care-led Primary Care-led Hospital-ledHospital-led
Focus: People-centred/ Physician-centred/ Population Health Disease orientated
Sustainability:Sustainability: High LowHigh Low
HRH: Competency-based No. Based
![Page 8: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/8.jpg)
40%Healthy
40%Healthy
With Risk Factor(s)
10% Acute Illness
10% Disability
Rawaf’s Model for Burden of Disease - 2001
In Any Given Population
© WHO C Centre, IC London
![Page 9: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/9.jpg)
Weak PHC Countries
Strong PHC Countries
1970 1980 1990 2000
500
0
1000
OECD Countries: Potential Years Life Lost (PYLL)
© WHO C Centre, Imperial College London Source: B Starfield
![Page 10: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/10.jpg)
Universal Coverage Total Population A Whole System Approach Equity Social Protection Solidarity (Social Contract) Choice Engagement
![Page 11: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/11.jpg)
• Telephone Call (NHS Direct) £16
• Family Physician £15
• Walk-in-Centre £55
• GP with Special Interest £75
• Hospital Outpatient £150
• Day Care £500
• One-Day Admission £1,000
• Inpatient (2ndary Care) £5,000
• High Specialist Care £20,000
PHC
Hosp C
Cost-Effectiveness (Intervention cost/case):
© WHO C Centre, IC London Source: Wandsworth PCT 2006
![Page 12: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/12.jpg)
WHO C Centre, IC London
Universal Coverage through PHC
![Page 13: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/13.jpg)
![Page 14: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/14.jpg)
© WHO C Centre, Imperial College London
Professor S Rawaf
The System Its Foundation Structure Operation & Management Financing Performance Challenges The Future
![Page 15: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/15.jpg)
© WHO C Centre, Imperial College London
Professor S Rawaf
Nye Bevan (1897-1960)
The Architect of the British NHS 1946 (July 1948)
![Page 16: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/16.jpg)
© WHO C Centre, Imperial College London
Professor S Rawaf
A National Health Service…
“…to secure equal access to comprehensive healthcare for every individual across the country regardless of their ability to pay”
N Bevan, 1946
![Page 17: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/17.jpg)
Strong Founding Principles:
1. Funded through Taxation2. Free at the point of Delivery3. Comprehensive4. Equitable5. Public Involvement
© WHO Collaborating Centre, London
Professor S Rawaf
![Page 18: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/18.jpg)
Strong Health System(1948-Present)
Primary Care Hospital Care
Public Health
© WHO C Collaborating Centre, London
Professor S Rawaf
![Page 19: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/19.jpg)
© WHO Centre, Imperial College London
H
P C
PublicHealth
Fully integratedHealth System
![Page 20: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/20.jpg)
© WHO C Centre, IC London Source: RCGP 2010, WONCA 2010
The UK General practice
Population Registration GP (Family Physician)-Based (0.6/1000 p) A single portal entry to the HS; Available 24 hours a day; The first and vital contact A gate-keeping function (selective referrals); Long term & the continuity of personal and family care; Health, Clinical morbidity, Social problems, local needs, small population Stakeholder to local public health
![Page 21: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/21.jpg)
GP
HOSPITAL
1 2 3 NHS Direct
100%Registration
10% 10%
© WHO C Centre, Imperial College London
Professor S Rawaf
A & E
![Page 22: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/22.jpg)
GP
HOSPITAL
1 2 3
Cost: 10% + 11% 50% Acute, 20% MHContacts: 80% - 90% 10-20%
NHS Direct
100%Registration
10% 10%
HV
PN
DN
CPN
Patients Group
Home Visits
Source: S Rawaf 2007
Midwives
© WHO Centre, Imperial College London
![Page 23: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/23.jpg)
GP
HOSPITAL
1 2 3 NHS Direct
100%Registration
10% 10%
© WHO C Centre, Imperial College London
Professor S Rawaf
A & E
Power
Resp
onsibili
ty
Contro
l
![Page 24: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/24.jpg)
FP
HOSPITAL
1 2 3
Cost: 10% + 11% 45% Acute, 20% MH +Contacts: 85% - 90% 10-15%
Health Line
© WHO Collaborating Centre, London
Professor S Rawaf
![Page 25: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/25.jpg)
© WHO C Centre, Imperial College London Source: Commonwealth Fund, 2007
Australia Canada Germany NZ UK
Overall Ranking 2007 3.5 5 2 3.5 1Quality Care 4 6 2.5 2.5 1
Right Care 5 6 2.5 2.5 2
Safe Care 4 6 3 4 2
Coordinated care 3 6 4 2 1
Pt Centered Care 3 6 2 1 4
Access 3 5 1 2 4
Efficiency 4 5 3 2 1
Equity 2 5 4 3 1
LH Productive Life 1 3 2 4.5 4.5
Health Expenditure
Per Capita, 2004 $
2,876 3,165 3,005 2,083 2,546
High Performing systems
![Page 26: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/26.jpg)
© WHO Centre, Imperial College London
Professor S Rawaf
Challenges to UK Health System
![Page 27: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/27.jpg)
20% 18% 16% 14% 12% 10% 8% 6% 4% 2% 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% 20%
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-8990+
-20 -18 -16 -14 -12 -10 -8 -6 -4 -2 0 2 4 6 8 10 12 14 16 18 20
Men Women
20% 18% 16% 14% 12% 10% 8% 6% 4% 2% 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% 20%
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-8990+
-20 -18 -16 -14 -12 -10 -8 -6 -4 -2 0 2 4 6 8 10 12 14 16 18 20
Men Women
Wandsworth London
Source: ONS Mid 2002 Population Estimates
DPH Independent Report 2004
Professor S Rawaf
1. Huge Variations in Population’s needs Accurate Health Needs Assessment
![Page 28: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/28.jpg)
© WHO Centre, Imperial College London Source: ippr 2008
2. Ageing PopulationHealth + Social Care (Joint Needs Assessment, Joint Commissioning)
Professor S Rawaf
Proportion of a single-person households, UK 1971-2021
![Page 29: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/29.jpg)
© WHO Centre, Imperial College London Source:McCrone eat al 2008 ippr 2008
Projected Number of People with Depression, UK 2007-2026 Professor S
Rawaf
85+
75-84
3. Changing Burden of DiseasesFlexible Service Delivery
![Page 30: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/30.jpg)
© WHO Centre, IC London
Efficiency – GP Commissioning Groups
Public Health & Primary Care
Addressing Health & Risks - Advanced QOF
How to shift Power? HC to PC Incentives
OH & PC: full integration, partial, embed, collaborative..
![Page 31: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/31.jpg)
© WHO Centre, Imperial College London
Professor S Rawaf
Medical Education & Training
![Page 32: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/32.jpg)
MBChBMBBS
They Need: Structured Training
© WHO Centre, Imperial College London
Professor S Rawaf
![Page 33: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/33.jpg)
12345
F1F2
123
2345
1
A-level University
University(Medical School)
FoundationSchool (Virtual)
Med/Surg/PH/Diag General Practice
PMET Board +R. Colleges(Standards)
GMC
CST Principle GP Consultant
© WHO Centre, Imperial College London
Professor S Rawaf
![Page 34: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/34.jpg)
Developing Family Medicine
EquitableCommunity-basedInfrastructure
EquitableCommunity-basedInfrastructure
Strong Postgraduate Training
Strong Postgraduate Training
Solid UndergraduateLearning
Solid UndergraduateLearning
© WHO Centre, Imperial College London
Professor S Rawaf
![Page 35: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/35.jpg)
1
2
New Entrance:Introduce A structured Training ProgramFamily Medicine 3-5 Years .. Iranian BoardCurrent PHC DoctorsOne Year on-the-Job Training Program Postgraduate Diploma in Family Medicine
![Page 36: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/36.jpg)
WHO C Centre, IC London
Some key Observations
![Page 37: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/37.jpg)
It is the most important factor to convince people
about the value of FM
Training Competencies Attitude PCM Personal-relationship Public involvement
1. Quality in Family Medicine
![Page 38: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/38.jpg)
© WHO Collaborating Centre, London
Professor S Rawaf
0
20
40
60
80
100
120
140
160
180
1993/4/5 1995/6/7 1997/8/9 1999/2000/1 2001/2/3 2003/4/5 2005/6/7 2007/8/9
England: Deaths due to Vascular Diseases
![Page 39: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/39.jpg)
Page 39
Change in antibiotic prescribing 1995-1998: GPRD
Age Males (%) Females (%)0-4 -22 -235-15 -26 -2316-24 -15 -1625-34 -18 -1535-44 -16 -1545-54 -13 -1255-64 -9 -1065-74 -9 -675-84 -9 085+ -10 -1
![Page 40: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/40.jpg)
Page 40
% P
atie
n ts
Re f
erre
d /Y
ear
UK
US Health Plans
![Page 41: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/41.jpg)
Page 41
National Prevalence (England)
![Page 42: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/42.jpg)
Page 42
Percentage of patients with diabetes with HbA1C <=7.4% in
last 15 months
![Page 43: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/43.jpg)
Page 43
GMS quality indicators (process) - median practice achievement
0
10
20
30
4050
60
70
80
90
100
BMI
Smok
ing st
atus
Smok
ing a
dvice
Hb1Ac
Blood
pres
sure
Retina
l scr
eenin
g
Pulses
Choles
tero
l
2003
2005
![Page 44: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/44.jpg)
Page 44
GMS quality indicators (outcome) - median practice achievement
0
10
20
30
40
50
60
70
80
90
100
HbA1c < 7.4 HbA1c < 10 Cholesterol < 5 BP < 145/85
2003
2005
![Page 45: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/45.jpg)
WHO C Centre, IC London
2. Incentives
![Page 46: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/46.jpg)
Incentive vs No incentivein Family Medicine
WHO Centre, IC London
Campbell et al. Effects of Pay for Performance on the Quality of Primary Care in England, NEJM 2009
QOF
![Page 47: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/47.jpg)
WHO C Centre, IC London
Addressing the 4 Questions:
![Page 48: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/48.jpg)
© WHO C Centre, IC London
Four questions to address:
How to improve users satisfactions with the services?1
Quality, Person-Centre Med, Continuity
![Page 49: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/49.jpg)
© WHO C Centre, IC London
Four questions to address:
How to improve users satisfactions with the services?
How to ‘develop’ skilled personnel & guarantee its permanence at PHC?
1
2
Incentives Based Training on FM (Quality), Competent Workforce (CPD, Revalidation etc)
![Page 50: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/50.jpg)
© WHO C Centre, IC London
Four questions to address:
How to improve users satisfactions with the services?
How to ‘develop’ skilled personnel & guarantee its permanence at PHC?
How to guarantee access to medicine; provide problem-solving therapeutic
and Dx technology?
1
2
3
Strategic & Op Management, Health Model, Integrate with public health and hospitals
![Page 51: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/51.jpg)
© WHO C Centre, IC London
Four questions to address:
How to improve users satisfactions with the services?
How to ‘develop’ skilled personnel & guarantee its permanence at PHC?
How to guarantee access to medicine; provide problem-solving therapeutic
and Dx technology?
Ch Diseases: which community development strategies that PHC should integrate?
1
2
3
4
Understanding H Needs (HNA), Integrate PH and PHC
![Page 52: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/52.jpg)
WHO C Centre, IC London
........ and Finally
![Page 53: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/53.jpg)
© WHO Collaborating Centre, London Source: BMJ, 2008
![Page 54: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/54.jpg)
© WHO Collaborating Centre, London Source: BMJ, 2008
![Page 55: WHO Collaborating Centre Imperial College London Ref 212/2011 Primary Care The UK Experience Professor Salman Rawaf MD PhD FRCP FFPH Chile Primary Care](https://reader035.vdocuments.us/reader035/viewer/2022062409/56649e605503460f94b5af20/html5/thumbnails/55.jpg)
Thank you