The need to develop community based health and personal social services so as to better meet the needs of local communities and ensure that services are provided in the most appropriate settings is a matter which is being addressed in the context of the implementation of the primary care strategy. The strategy document, Primary Care: A New Direction, recognises that primary care is the first point of contact for the majority of people who use health services. Furthermore, with appropriate development and enhancement of capacity, primary care can meet 90%-95% of all health and personal social service needs.
Primary care, planned and organised on the basis of delivery of a comprehensive range of services by interdisciplinary teams, will lessen the current reliance on specialist services and the hospital system, particularly accident and emergency and out-patient services. Based on available evidence, it will have the potential to reduce the requirement for specialist services, reduce hospitalisation rates, reduce lengths of stay for those who are hospitalised, promote more rational prescribing and improve efficiency.
The provision of a wide range of services in this way will allow a higher percentage of patients to be cared for in the community, thus reducing hospital admissions. Furthermore, as the strategy is implemented on a national basis, many services will be provided on an extended hours basis and out-of-hours cover for defined services will be greatly enhanced. The strategy also recognises the need to provide improved and expanded facilities from which primary care teams can deliver services in an integrated way.
Primary care reform is central to the overall process of health service reform, which is progressing with a view to the development of structures which best facilitate the implementation of the interdisciplinary model of primary care as an integral part of a whole system approach to service delivery. As part of the reform plans, therefore, the system for the planning and delivery of primary care services, at national, regional and local level, will be reorganised in order to facilitate implementation of the model described in the primary care strategy.