English and Italian national health services: Time for more patient-centered primary care?

Published:September 29, 2018DOI:


      • Timely access to general practice has become a common issue in this era of aging populations.
      • The common response to extend the opening hours does not sort out the shortage of workforce.
      • A more pragmatic approach has been to involve public pharmacists in primary care.
      • Public pharmacists' involvement might limit the fragmentation of pharmaceutical care.
      • Larger-scale organizations are a pressing priority for modern primary care too.
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        • Kringos D.S.
        • Boerma W.G.
        • van der Zee J.
        • Groenewegen P.P.
        Political, cultural and economic foundations of primary care in Europe.
        Soc Sci Med. 2013; 99: 9-17
        • Zarbailov N.
        • Wilm S.
        • Tandeter H.
        • Carelli F.
        • Brekke M.
        Strengthening general practice/family medicine in Europe-advice from professionals from 30 European countries.
        BMC Fam Pract. 2017; 18: 80
        • Garattini L.
        • Padula A.
        Clinical governance in Italy: 'Made in England' for import?.
        Appl Health Econ Health Policy. 2017; 15: 541-544
        • Simpson J.M.
        • Checkland K.
        • Snow S.
        • Voorhees J.
        • Rothwell K.
        • Esmail A.
        Access to general practice in England: Time for a policy rethink.
        Br J Gen Pract. 2015; 65: 606-607
        • Garattini L.
        • Curto A.
        • Freemantle N.
        Access to primary care in Italy: Time for a shake-up?.
        Eur J Health Econ. 2016; 17: 113-116
        • Garattini L.
        • Padula A.
        Pharmaceutical care in Italy and other European countries: Between care and commerce?.
        Postgrad Med. 2018; 130: 52-54
        • Garattini L.
        • Padula A.
        ‘Appropriateness’ in Italy: A ‘magic word’ in pharmaceuticals?.
        Appl Health Econ Health Policy. 2017; 15: 1-3
        • Garattini L.
        • Padula A.
        Hospital pharmacists in Europe: Between warehouse and prescription pad?.
        PharmacoEconomics Open. 2018;
        • McCarthy M.
        Sustainable general practice: Looking across Europe.
        Br J Gen Pract. 2016; 66: 36
        • Taylor C.J.
        • Wright M.
        • Jackson C.L.
        • Hobbs R.
        Grass is greener? General practice in England and Australia.
        Br J Gen Pract. 2016; 66: 428-429
        • Kringos D.
        • Boerma W.
        • Bourgueil Y.
        • Cartier T.
        • Dedeu T.
        • Hasvold T.
        • et al.
        The strength of primary care in Europe: An international comparative study.
        Br J Gen Pract. 2013; 63: e742-e750
        • Roland M.
        • Everington S.
        Tackling the crisis in general practice.
        BMJ. 2016; 352: i942
        • Cowling T.E.
        • Gunning E.J.
        Access to general practice in England: Political, theoretical, and empirical considerations.
        Br J Gen Pract. 2016; 66: e680-e682
        • Monitor
        • NHS Improvement
        Walk-in centre review: Final report and recommendations.
        Monitor, 2014 (Publication code: IRRES 02/14. Available at)
        • Kmietowicz Z.
        GP surgeries will get 1500 more pharmacists after successful pilot.
        BMJ. 2016; 355i6836
        • Butterworth J.
        • Sansom A.
        • Sims L.
        • Healey M.
        • Kingsland E.
        • Campbell J.
        Pharmacists' perceptions of their emerging general practice roles in UK primary care: A qualitative interview study.
        Br J Gen Pract. 2017; 67: e650-e658
        • Stone M.C.
        • Williams H.C.
        Clinical pharmacists in general practice: value for patients and the practice of a new role.
        Br J Gen Pract. 2015; 65: 262-263
        • Garattini L.
        • Curto A.
        • Freemantle N.
        Vaccination planning in Italy: increasing vaccines while reducing coverage?.
        Expert Rev Pharmacoecon Outcomes Res. 2016; 16: 547-548
        • Mannucci P.M.
        Medici di famiglia: tra 10 anni il 70% in pensione. Sostituito uno su tre. Corriere della Sera(Inserto Salute).
        • Garattini L.
        • Italian Health Care Reform
        Yellow Paper.
        University of York, 1992
        • Garattini L.
        • Curto A.
        • Padula A.
        The puzzle of drug delivery in Italy: who wins?.
        Expert Rev Pharmacoecon Outcomes Res. 2016; 16: 331-332
        • Garattini L.
        • Padula A.
        From pharmacy faculty to pharmacy shop: still a logical pathway in Europe?.
        Drugs Ther Perspect. 2018; 34: 85-88
        • Tan E.C.
        • Stewart K.
        • Elliott R.A.
        • George J.
        Pharmacist services provided in general practice clinics: a systematic review and meta-analysis.
        Res Social Adm Pharm. 2014; 10: 608-622
        • Freeman C.
        • Rigby D.
        • Aloizos J.
        • Williams I.
        The practice pharmacist: a natural fit in the general practice team.
        Aust Prescr. 2016; 39: 211-214
        • Slack K.
        Practice with a difference!.
        Br J Gen Pract. 2015; 65: 593
        • Smits M.
        • Rutten M.
        • Keizer E.
        • Wensing M.
        • Westert G.
        • Giesen P.
        The development and performance of after-hours primary care in the Netherlands: A narrative review.
        Ann Intern Med. 2017; 166: 737-742
        • Garattini L.
        • van de Vooren K.
        • Curto A.
        Will the reform of community pharmacies in Italy be of benefit to patients or the Italian National Health Service?.
        Drugs Ther Perspect. 2012; 28: 23-26

      Linked Article

      • Seeking identity in primary care. A survey on GPs trainees in Lombardy
        European Journal of Internal MedicineVol. 64
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          The role and identity of the general practitioner (GP) in the frame of primary care have significantly changed. The article of Livio Garattini and Anna Padula [1] compares the main traditional characteristics and recent tendencies of primary care in the English and Italian National Health Services. Through a comparative analysis the authors ask for more patient-centered primary care, recommending an holistic approach to patients and full access to services. Continuing the debate opened by these authors we emphasize once more the need to think over a person-centered model of primary care, reporting also some considerations that emerged from a recent survey conducted by the Social Healthcare Academy, PoliS Lombardia, Regional Institute for Policy Support.
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