scholarly journals Wellbeing Agencies in the High Street: The Rebirth of Primary Health Care?

2016 ◽  
Vol 9 (1) ◽  
pp. 31-37 ◽  
Author(s):  
Geoffrey Meads

The rapid increase in frontline service outlets offering Wellbeing services offers new opportunities to promote public health. However, driven by both economic and social policies closely linked to the needs for both new business development and cultural integration, the expansion in organisational practices also carries it with some risks to public health. In more market oriented health systems these include possible negative consequences for both the longitudinal care provided through general medical practices and the application of evidence based medicine. In this context the scoping review draws on indicative findings from fieldwork in two international exemplar sites in the UK and Australia, where the concept of Wellbeing is being embedded, to identify priorities for future health policy and management research. The analysis is framed by the WHO’s enduring core principles for Primary Health Care, with the data capture employing an ethnographic approach that includes key informant interviews in Melbourne over a six months period in 2015/16. The findings include an unexpected emphasis on the need for knowledge in respect of the communities of interest and practice forming around novel therapies and interventions that assert public health values.

2019 ◽  
Vol 69 (685) ◽  
pp. e537-e545 ◽  
Author(s):  
Cara Kang ◽  
Louise Tomkow ◽  
Rebecca Farrington

BackgroundAsylum seekers and refugees (ASR) face difficulty accessing health care in host countries. In 2017, NHS charges for overseas visitors were extended to include some community care for refused asylum seekers. There is growing concern that this will increase access difficulties, but no recent research has documented the lived experiences of ASR accessing UK primary health care.AimTo examine ASR experiences accessing primary health care in the UK in 2018.Design and settingThis was a qualitative community-based study. ASR were recruited by criterion-based sampling through voluntary community organisations.MethodA total of 18 ASR completed face-to-face semi-structured recorded interviews discussing primary care access. Transcripts underwent thematic analysis by three researchers using Penchansky and Thomas’s modified theory of access.ResultsThe qualitative data show that participants found primary care services difficult to navigate and negotiate. Dominant themes included language barriers and inadequate interpretation services; lack of awareness of the structure and function of the NHS; difficulty meeting the costs of dental care, prescription fees, and transport to appointments; and the perception of discrimination relating to race, religion, and immigration status.ConclusionBy centralising the voices of ASR and illustrating the negative consequences of poor healthcare access, this article urges consideration of how access to primary care in the UK can be enhanced for often marginalised individuals with complex needs.


2018 ◽  
pp. 67-87
Author(s):  
John Fry ◽  
Donald Light ◽  
Jonathan Rodnick ◽  
Peter Orton

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tingting Zhang ◽  
Xingrong Shen ◽  
Rong Liu ◽  
Linhai Zhao ◽  
Debin Wang ◽  
...  

Abstract Background In China, the primary health care (PHC) system has been designated responsible for control and prevention of COVID-19, but not treatment. Suspected COVID-19 cases presenting to PHC facilities must be transferred to specialist fever clinics. This study aims to understand the impact of COVID-19 on PHC delivery and on antibiotic prescribing at a community level in rural areas of central China. Methods Qualitative semi-structured interviews were conducted with 18 PHC practitioners and seven patients recruited from two township health centres and nine village clinics in two rural residential areas of Anhui province. Interviews were transcribed verbatim and analysed thematically. Results PHC practitioners reported a major shift in their work away from seeing and treating patients (due to government-mandated referral to specialist Covid clinics) to focus on the key public health roles of tracing, screening and educating in rural areas. The additional work, risk, and financial pressure that PHC practitioners faced, placed considerable strain on them, particularly those working in village clinics. Face to face PHC provision was reduced and there was no substitution with consultations by phone or app, which practitioners attributed to the fact that most of their patients were elderly and not willing or able to switch. Practitioners saw COVID-19 as outside of their area of expertise and very different to the non-COVID-19 respiratory tract infections that they frequently treated pre-pandemic. They reported that antibiotic prescribing was reduced overall because far fewer patients were attending rural PHC facilities, but otherwise their antibiotic prescribing practices remained unchanged. Conclusions The COVID-19 pandemic had considerable impact on PHC in rural China. Practitioners took on substantial additional workload as part of epidemic control and fewer patients were seen in PHC. The reduction in patients seen and treated in PHC led to a reduction in antibiotic prescribing, although clinical practice remains unchanged. Since COVID-19 epidemic control work has been designated as a long-term task in China, rural PHC clinics now face the challenge of how to balance their principal clinical and increased public health roles and, in the case of the village clinics, remain financially viable.


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