A strong primary care system is ‘essential’ for countries to effectively tackle public health emergencies in the future, according to a review by the Organisation for Economic Cooperation and Development (OECD).

In the review, Strengthening the frontline: How primary health care helps health systems adapt during the Covid-19 pandemic, researchers from the international organisation analysed how countries utilised and rearranged their primary care services throughout the pandemic, and how primary care might be used to create more resilient health care systems.

‘For health systems to be resilient against health crises of this magnitude, strong primary and community health care – the frontline of all health systems – is essential,’ the review said.

The review explained that expanding current primary health care services - instead of adding additional services - is ‘critical’ to making health systems ‘more resilient to future public health emergencies'.

It would also better address the challenges of an ageing population and the growing burden of chronic conditions’, the review said.

It added that when faced with the pandemic many OECD countries have ‘strengthened the frontline’ and primary care services have played a crucial role in preventing hospitals from overcrowding.  

‘During the pandemic, primary health care services have a role to play through patient triage in primary health care settings by using existing relationships between family doctors and their patients, identifying patients at risk, contacting and supporting them,’ the review said.

Role of pharmacies

The review also considered how countries had strengthened their primary care system during the pandemic by expanding the role of community pharmacies – to help maintain continuity of care while hospitals prioritised Covid-19 patients.

‘The scope of practice of community pharmacists has been expanded so that they can take on some of the tasks from doctors and allow them to spend their time more effectively on the most complex cases and minimise the number of medical consultations,’ it said.

According to the study, France, Ireland, Portugal and the United States allowed pharmacists in their countries to extend prescriptions beyond what they were allowed to do before the pandemic, as well as prescribe certain chronic disease medications. 

In the United States, community pharmacists were also authorised to order and administer Covid‑19 tests.

The review also noted the extension of the Minor Ailment Service (MAS) in Scotland, which it said had helped to ‘reduce the burden across the NHS and ensure patients continue to get the necessary medicines’.

The researchers concluded that the pandemic has helped to ‘accelerate the transformation of health systems, and stimulates many innovative primary health care systems’.

To ensure cases of primary care innovation are sustained and adopted more widely in other countries, new legislation and incentives need to be put in place, they said.  

They added that ‘measurement, benchmarking, sharing good practice examples and lessons learnt from Covid‑19 will provide the basis for building blocks of resilient health care systems'.