Core Values and Tasks of Primary Care in Changing Communities and Health Care Systems

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Background

In many countries general practice delivers accessible, adequate and affordable healthcare for all inhabitants. Continuity of care, person centered care, covering a broad variety of health problems for the whole population, are central features of primary care in most countries where general practitioners are available. In the last decades, the ageing of the population and changes in both medicine and health care systems have major consequences for the workload, the tasks and the organization of general practice. General practitioners face challenges such as new technologies, ‘too much medicine’ and ‘superspecialization’ combined with an increasing commercialization, an increasing social gradient, and the emergence of opportunistic “screen doctoring” companies. These challenges and the ever-increasing workload have led to reflection on core competencies in several countries. Recently, both in the Scandinavian countries and in the Netherlands a reorientation on both core values and core tasks has taken place, leading to a reaffirmation of core values such as continuity of care, person-centered care, and generalist care. Also, in the Netherlands the core tasks of general practice have been more sharply delineated in order to protect the GP from an overload of expectations and tasks. In other countries, for example Belgium and Germany, a reorientation process is being set in motion or going on at the moment. In England general practice faces serious problems in providing primary health care for all inhabitants. In eastern European countries general practice is gaining more ground and is rapidly developing.

The recent Covid-19 epidemic puts a huge burden on societies and healthcare systems all over the world. Both continuity of care and person centered care, two important core values of general practice, are challenged when health care systems transit to a survival mode during an epidemic. Is general practice able to deal with these challenges and still foster its core values? Which are the consequences for the core tasks of general practice?

Outline of the series:
• WONCA mission and relevant activities concerning core values and tasks
• Process and outcome of reorientation process in the Scandinavian countries
• Process and outcome of reorientation process in the Netherlands
• Core values and tasks of general practice in countries where primary care is developing
• Review/overview of effects and effectiveness of continuity of care in primary care (prevention of overdiagnosis and overtreatment)
• Review/ overview of effects and effectiveness of person-centered care in primary care
• Review on the essence and necessity of generalist competencies
• The role general practice in complex health care systems
• How do core values help me to make choices in my own practice? (a practice based article on the relevance of having core values)
• Discussion and activities about core values across `Europe (Equip)
• Commentary: threats and opportunities of core values in a changing world

Keywords: Core values, primary care, person-centered care, continuity of care, generalistic competencies

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