The future of primary care in Europe: the Nuffield Trust summit


The Nuffield Trust summit on the Future of Primary Care in Europe was an interesting event. You can read all about it, including videos of conference speeches at In some ways it emphasised the differences between countries more than the similarities. The contrasts were certainly stark, from Romania with very little funding in primary care, through Germany with very little interest in primary care and Lithuania which has just disinvested in primary care to fund better hospital services, through to Scandinavian countries which have introduced reforms to strengthen primary care.

As always, the UK is an outlier, and no-one else is planning to give the specialist budget to GPs. However, if you refer to the Commonwealth Fund surveys, our primary care does pretty well compared to many other countries.

Some of the things that I took away from the Nuffield summit were that we need to:

  • Break down the barriers between primary and secondary care – e.g. more geriatricians working across the interface to help us keep old people out of hospital
  • Reduce incentives for hospitals and specialists to admit patients
  • Put more decisions about care in the hands of patients
  • Continue to invest in primary and community care

The challenges for these are very different in different European countries and it’s hard to see European policy emerging in these areas.

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