Viewpoint: CCGs can learn primary care integration from China

I recently had the privilege of visiting China to look at their healthcare system - it's the fourth time I've been abroad on similar fact-finding missions.

This time our team were looking to establish research partnerships with organisations struggling with the demographic changes wrought by population and lifestyle changes.

Every trip is different. Sometimes I see details which can be incorporated into the way the NHS functions, sometimes I see pitfalls that we have or should avoid.

China has traditional medicine, people, money, hospitals and beds galore. It lacks general practice, general practitioners and a national health service.

Relief to return to the NHS but...

There was a lot to see and much work to be done but returning to the UK came with a sense of relief to be back in a system which does not have a payment office opposite reception, in which access to general practice is plentiful and free.

However, there is one aspect of the Chinese system of which we should take note. Seamless integration of out-of-hospital services centred around units which combine diagnostics, outpatients, primary care and public health, alongside a general practice which also managed the equivalent of the integrated nursing home.

We have all of those components but their function is fragmented by organisation. Even our practices are fragmented into small units swimming against a rising tide of demand.

Soon many of us will be commissioning that element of the system, along with secondary care. Change will be needed, but care is required. Remember, don't push too hard because your dreams are like China in your hands.

  • Dr Chris Mimnagh is a GP and co-director of clincial strategy at Liverpool Health Partners.

Photo: UNP

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