{"id":49619,"date":"2021-02-18T16:14:14","date_gmt":"2021-02-18T15:14:14","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=49619"},"modified":"2021-02-18T16:14:14","modified_gmt":"2021-02-18T15:14:14","slug":"wheres-the-integration-between-public-health-and-primary-care-in-the-response-to-covid-19","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2021\/02\/18\/wheres-the-integration-between-public-health-and-primary-care-in-the-response-to-covid-19\/","title":{"rendered":"Where’s the integration between public health and primary care in the response to covid-19?"},"content":{"rendered":"

Despite NHS England\u2019s focus on the importance of health system integration, the government spent \u00a310 billion on a largely outsourced Test and Trace system, which has been plagued with criticisms about poor integration with the rest of the health system, poor performance, and opaque procurement processes. [1-3] With a budget close to the combined annual spend on public health (\u00a34.3 bn) and general practice (\u00a37.8 bn) in England, this begs the question of whether this money could have been better spent on strengthening existing public services infrastructure in response to covid-19? [4]<\/span><\/p>\n

Until the rollout of the covid-19 vaccination programme, the potential contribution of primary care had largely been overlooked in the UK\u2019s response to covid-19. [5] Notably, the potential contribution of better resourced and better integrated local public health and primary care teams has been neglected. Public health and primary care look after communities throughout their life course and deliver care close to where people live. Primary care clinicians know who the most vulnerable people are on their lists and largely enjoy the trust of their patients. [6] Through the electronic health record, general practice has access to patients\u2019 full medical history, contact details, and household members. Almost the entire population is registered with a general practice in the UK. With adequate consent and information governance, the electronic health record allows data extraction at national level. These features enable an understanding of and access to local communities that an outsourced contact tracing centre or, as is becoming evident, mass vaccination sites cannot, and which could support a more effective response. With public confidence in the UK government falling, local public health and primary care teams can help rebuild trust with local communities providing locally tailored responses. [7]<\/span><\/p>\n

Evidence demonstrates that, together, public health and primary care create synergies which improve population health and health systems performance. [8-10] There are various ways to do so and opportunities extend beyond the potential response to covid-19, to the domains of health promotion and other forms of disease prevention, through:\u00a0<\/span><\/b><\/p>\n