Family Medicine

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World Book of Family Medicine – European Edition 2015 http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ . But what should a European Observatory for Primary Care Development monitor and display? Some possibilities might include medical education, e.g. medical schools offering a well-designed and internationally approved programme for a higher degree in Family Medicine; data on obesity, child mortality, teenage pregnancies and other parameters that reflect the impact of family medicine on a community. Other starting points might include; the correlations that Barbara Starfield published (6) demonstrating one way forward to better quality and better health. In terms of existing organisations, cognisance needs to be given to what role they might play and how the varying interests and foci of these organisations could facilitate the development of a European Observatory. Such organisations might include: European Observatory of Medical Demography UEMO, EQuiP, EFPC. Next, the question of who, where and how the Observatory should be hosted? It is argued here that any host organisation would need sufficient drive and endeavour and a commitment to working with the politics and practicalities of the existing field. Also it would need the vision and resources to take the work forward. From the limited work done in 2005-6 my view was that a FD College with a desire to take a European perspective would be well-placed to lead the establishment of an Observatory with a possible link into WONCA Europe and WHO Europe. Perhaps at this time a better approach would be to consider how a consortium of Colleges might be able to develop sufficient mutual support and pooled resources to develop a vision of an Observatory and consider what first steps might be necessary to make the vision reality. Another consideration might be how other potentially interested parties (e.g. research bodies, local government, charities, etc.) might wish to contribute at an early stage. It is argued here that early stage involvement of ‘other parties’ in health and care development greatly assists sustainability. An example of this is the involvement of a city authority in the Heartwatch Programme in the UK. Here, local government worked together with primary care and the NHS to link-up sport and leisure services to the Heartwatch Programme. Finally, one way forward would be for an interested party (a College?) to identify resources to initiate a scoping exercise that identifies interested organisations and the resource that they would be prepared to offer the development of a consortium. Also, it could help to establish common areas of health concern where systematic and coordinated data could be collected. This could be done from 2 perspectives: focus on where existing work has already been done at a national level; or, areas where little work has been done but there is an international recognition of the importance of particular health concerns. A good example of this second (and preferred) option is that of dementia. In a report in 2011(7), it was recommended that it is necessary to ‘build more cooperative networks across Europe’ in order to create ‘greater coherence and synergy in research and understanding and opportunities for developing new comparative methodologies...and the harmonisation of data’. It is hoped that this essay will provide the incentive for the latent idea of a Primary Care Observatory to be reestablished on the European primary care agenda and challenge a critical mass of organisations to fund some further work to scope and develop plans for coordinated activity. Take home messages: An Observatory would facilitate the coordination of data and shared learning; Its development needs a critical mass and a ‘lead partner’ to ‘kick-start’ the work. A scoping exercise would provide the development agenda. Original abstract http://www.woncaeurope.org/content/cf102-european-observatory-primary-care-development-interim-findings-feasibility-study References 1. http://www.galaxyzoo.org/ 2. BMJ 2005; 331: 1199 ‘What do patients and the public want from primary care?’ 3. CF10.2 A European Observatory For Primary Care Development: Interim Findings Of A Feasibility Study, Wonca Europe, 2006 4. https://www.irishheart.ie/media/pub/heartwise/2006/heartwatchnationalprog.pdf 5. Leigh A, Wolfers J. Abortion and Crime, AQ: Journal of Contemporary analysis 72, 4 (2000) in: Levitt S, Dubner S. Freakonomics, 2005 298
World Book of Family Medicine – European Edition 2015 6. Starfield B. Family Medicine Should Shape Reform, Not Vice Versa. Family Practice Management. 28/05/2009 7. The European Dementia Research Agenda; www.ilcuk.org.uk, 2011 299
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Family Medicine

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