New organisational models of primary care to meet the future needs of the NHS

A brief overview of recent reports

by Teresa Bienkowska-Gibbs, Sarah King, Catherine L. Saunders, Marie-Louise Henham

Download eBook for Free

FormatFile SizeNotes
PDF file 0.9 MB

Use Adobe Acrobat Reader version 7.0 or higher for the best experience.

The NHS in England faces several future challenges for primary care, including an ageing population, increasing numbers of patients with multiple long-term conditions and a limited workforce. The Health Education England Primary Care Workforce Commission has set out to identify innovative models of primary care that will meet these future challenges. As part of this work, RAND Europe was commissioned to present a brief overview of reports from professional bodies and policy-focused organisations — from England and internationally — that describe new models for delivering primary care. These models include:

  • Models that introduce new roles, or change existing roles, in general practice (e.g. introducing physician associates and pharmacists into general practice, extending roles for allied health professionals and primary care nurses);
  • Models of collaboration among professionals and among the primary care, secondary care and social care sectors (e.g. 'micro-teams', GPs and specialists working together and/or specialists working in the community, extended roles for community pharmacists); and
  • New organisational forms for general practice (e.g. primary care federations or networks, super-practices, regional multipractice organisations, community health organisations, polyclinics and multispecialty community providers).

In addition, we present some examples of communication/information technology used in primary care and discuss recruitment and retention challenges facing health professionals in general practice. Most reports included in this overview are descriptive, and they include recommendations regarding how new models of care could be implemented. From these reports, it was evident that there is no 'one size fits all' model for delivering primary care and that the way in which new models are implemented may be as important as the models themselves.

Table of Contents

  • Chapter One


  • Chapter Two

    Included studies

  • Chapter Three

    Models that introduce new roles or change existing roles in general practice

  • Chapter Four

    Models of collaboration among professionals and among sectors (primary care, secondary care and social care)

  • Chapter Five

    New organisational forms for general practice

  • Chapter Six

    Facilitators of the adoption of new models of primary care

  • Chapter Seven


Research conducted by

The research described in this report was prepared for Health Education England Primary Care Workforce Commission and conducted by RAND Europe.

This report is part of the RAND Corporation research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity.

Permission is given to duplicate this electronic document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND PDFs to a non-RAND Web site is prohibited. RAND PDFs are protected under copyright law. For information on reprint and linking permissions, please visit the RAND Permissions page.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.