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Report calls for adoption of Primary Care at Scale

With contributions from industry leaders in optometry, the report highlights the role for primary care in delivering care in the community

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Pexels/ Karolina Grabowska

A new report has been launched calling for the scaling of collaborative primary care provision in the UK, with contributions from industry leaders across optometry.

Launched by Public Policy Projects and Healthworks, the Stronger Together: Collaborative Primary Care at Scale report advocates for a shift away from an approach to primary care that is dominated by contractual processes, to one defined by “quality improvement metrics and population health.” 

The four contractor services making up primary care – optometry, general practice, pharmacy and dentistry – are covered in the report.

The report calls for the adoption of Primary Care at Scale, which aims to extend the provision of services within a community-based setting delivered through a team-based approach.

It highlights the need to acknowledge the “mixed nature” of the health economy in the UK, identifying that three of the core primary care services, including optometry, “rely heavily on their continued existence on non-NHS contract funding.”

Despite this, the report notes, there is “significant distrust and misunderstanding” around ‘profit-driven’ healthcare amongst both members of the public and in healthcare.

Local Optical Committee Support Unit (LOCSU) clinical director, Zoe Richmond, contributed to and launched the report, commenting: “The report highlights that we all have a duty to better understand what each of the four contractor services of primary care do. There is so much to be gained from this enhanced understanding and collaboration.”

Richmond shared that significant behaviour change is needed “if we are to truly optimise primary care,” adding specifically, “data sharing and increased digital connectivity has been long overdue for optometry.”

The report was formally launched through a digital event, which can be viewed online.

Offering an insight into optometry’s role within primary care, Richmond highlighted the challenges facing the provision of optometry, including funding and inconsistencies in commissioning.


Reflecting on optometry’s position in primary eye care, the report finds “significant potential for community-based eye care services to provide diagnostic and preventative treatment which may currently be provided in hospitals.”

However, authors note that it is not possible, yet, to “communicate a universal message” on this due to a historic lack of understanding about the sector amongst some commissioners.

Author recommendations in the report suggest that healthcare contractors and commissioners should seek to develop a culture of co-production of care throughout primary care, confront the challenges of addressing inequalities by adopting population health principles and techniques, and acknowledge the mixed economy supporting the NHS.

Authors also recommended adopting a “more meaningful mantra” than that of ‘building back better,’ suggesting instead: “achieving fair and sustainable health improvements,” and also highlighted the importance of national consistency in the design and delivery of some services, but while enabling “acceptable variability” to tailor services at local levels.

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