Republic of Ireland’s Primary Care Strategy: An Analysis

Re unrestricted of Irelands patriarchal disturbance Strategy An AnalysisPrimary C ar StrategyIntroductionPrimary upkeep is the first point of contact that people have with the health and personal social services.1 This means that primary bearing must be sufficiently well developed to be able to address the just about complex and diverse range of health-related challenges and problems that will manifest in health commission service cookery, and feign the almost of opportunities to promote health and reduce morbidity, across the prevalent population in specific target groups. This essay will explore the Republic of Irelands primary administer outline in relation to key goals and targets, and also examine galore(postnominal) elements of the strategy in terms of a SWOT analysis. limited reference will be made to the manipulation of the Specialist Public health Nurse/wellness Visitor Role.Main BodyPrimary apportion can be defined as first contact, continuous, comprehensi ve, and coordinated care provided to populations undifferentiated by gender, disease, or organ system.2 Primary care is about the provision of information, diagnosis, treatment, referral and support for the majority of people who access healthcare services for the first time, and the strategic concerns of primary are related to accessibility, provision of short and long-term care which meets the needs of the population, assessment of those needs, and coordination of services to meet those needs3. This has many implications for the provision of healthcare services and the management of increasingly scarce resources.However, it is evident from the literature that in most locations, primary healthcare services dormant have a long way to go in meeting the goals of primary healthcare itself, particularly in relation to improving integration of services and reorienting services to a person-centred representative, rather than a disease-centred model. Primary healthcare is viewed as a mea ns of reducing the consumption of and demand for overall healthcare services by acting as a gatekeeper for secondary healthcare, and as a means of primary stripe of healthcare problems and disease, particularly in high risk groups of the population, but t here is ongoing evidence and debate within the academic literature that there are continuing issues about the lack of egalitarian access to such services and ongoing questions about the ways in which they are provided4. It is considered by some that the decisions which modulate the design and delivery of primary care services are potentially more found on political drivers than true patient need5. Similarly, the gateway right of the primary care service in determining which patients have access to acute care (or secondary care) services may not be based on individual need, but on other(a) factors, such as political, social and even personal factors, including prejudices on the part of healthcare professionals6. The primary ca re strategy, if it provides strong guidance which leads to strong leadership, and perhaps enhances management of care through the use of agreed care pathways which guide decision making, might help overthrow some of these factors. Making the person-centred care model central will also help to remove some of the barriers to egalitarian service provision7. However, one of the challenges of the Republic of Ireland model is the fact that two thirds of patients in primary care must pay for their care, which would mean that despite the focus on removing inequalities in access, there continue to be challenges for providing equality of access8.One of the strengths of the primary care strategy is the focus on improving interprofessional working and communications, as a means of streamlining use of services and preventing two-baser up or overlap of services9. Improving interprofessional working at the primary care level is one thing, but the strategy also needs to stop that the intersecti on between primary and secondary care is properly managed, and that patients moving from acute care settings into community settings continue to have a streamlined, person-centred model of care applied, with good continuity of care10. However, there is also a need for the provision of strong leadership, which supports the implementation of the changes associated with this re-orientation of primary care in Ireland, and which supports new ways of working and helps to break down the barriers between the professions11, 12.This is where the role of the health Visitor can be examined in a little more detail, in relation to realising some of the goals of the Primary Care Strategy, and in addressing some of the challenges of this. It has long been the case that Health Visitors work across professional boundaries, and work closely with a range of other health professionals, because within the community, specialist and generic roles are equally required in supporting individual patient need1 3. The interprofessional interface is perhaps one of the most fundamental elements of the work of the Health Visitor, but at the same time is perhaps not given enough attention or credit in terms of the impact that Health Visitors have in the prevention of illness and public health sectors of primary healthcare14, 15.The Public Health focus of the primary care strategy is inherent in much of the rhetoric it contains, particularly as it expressly cites the potential for preventive strategies to reduce overall healthcare resource use16. It is here that the Health Visitors role perhaps has the greatest scope, and should be more strongly underlined, as this is a great resource for change. Research shows that the role of the health visitor is paramount and unparalleled, in reducing risk related behaviours, improving health outcomes, promoting healthy lifestyles and engaging in the more challenging areas of the health/social car interface17, 18, 19. However, there is also some evidence to suggest that nurses and, in particular, health visitors, have a key role to play in expanding and delivering the public health dimension of primary care20. In particular, the development of improved partnerships in health and social care may be made mathematical through the role of such nurses, who have the broader community knowledge as well as specialist knowledge of key areas of public health21. These partnerships can be developed with a focus on the quality of care provision, not just the identification of need22, 23, 24. However, managing the development of improved partnerships, and achieving the goals of the Strategy, is going to be challenging during the alteration period, and there may be a degree of uncertainty over roles and boundaries25. It might be that Health Visitors are in a prime military posture to provide the leadership required during such a time.Conclusions and Recommendations.Below is a summary of a brief SWOT analysis of the primary care strategy and isome of its potential implications.Table 1 SWOT analysis of Primary Care (with Reference to the Republic of Ireland Primary Health Strategy26)This shows that while there are issues with weaknesses and threats, many of these are the kind that have been present within the primary arena for some time, and it will take good leadership, and good use of existing skills and resources, to acquire the goals of the strategy. While the primary care focus for healthcare services is laudable, there is still the overwhelming need for good resourcing, more clarity about provision, and finish off guidance on how to move forward to achieve these goals. Making use of existing roles, such as that of the Health Visitor, whose work crosses the intersections of care at so many points in the primary care sector, could improve quality of care, reduce the impact of the change and transition, and also set standards for the future to increase interprofessional communication and partnership. sure as shooting it should not be assumed that the strategy will eradicate all the existing problems about the provision of primary care in Ireland, and those problems must still be addressed in future provision30.References 213615Allen, P. (2000) Accountability for clinical governance developing collective responsibility for quality in primary care. 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(2006) Exploring person-centred care. Nursing Standard 20 (50) 49-56.Rummery, K. and Coleman, A. (2001) Primary health and social care services in the UK progress towards partnership? favorable Science Medicine 56 (8) 1773-1782Stanley, D., Reed, J. Brown, S. (1999) Older people, care management and interprofessional practice. Journal of Interprofessional Care 13 (3) 229-237.Starfield, B. (1994) Is primary care essential The Lancet 344 1129-1133.Thomas, P., Graffy, J., Wallace, P. (2006) How Primary Care Networks Can Help Integrate Academic and Service Initiatives in Primary Care Annals of Family Medicine 4235-239.Vernon, S., Ross, F. Gould, M.A. (2000) Assessment of older people government and practice in primar y care. Journal of Advanced Nursing 31 (2) 282-287.Watkins, D., Edwards, J. Gastrell, P. eds. (2003). Community Health Nursing Frameworks for Practice. 2nd ed. p.35. London, Baillire Tindall.1Footnotes1 Department of Health and Children (2001) p 7.2 Starfield, B. (1994)3 Starfield (ibid)4 Vernon, S., Ross, F. Gould, M.A. (2000)5 Vernon (ibid)6 Starfield (ibid).7 Price, B. (2006)8 McGregor, P., Nolan, A., Nolan, B. and ONeill, C. (2007)9 Stanley, D., Reed, J. Brown, S. (1999)10 Dunnion, M.E. Kelly, B. (2005)11 Carr, S.M. (2007)12 Currie, G. and Suhomlinova, O. (2006)13 Watkins, D., Edwards, J. Gastrell, P. eds. (2003).14 Ewles, L. (2005).15 Jackson, C., Coe, A., Cheater, F.M. and Wroe, S. (2007)16 Department of Health and Children (ibid).17 Barlow, J., Davis, H., McIntosh, E. et al (2007)18 McMurray, R. and Chester, F. (2003)19 Douglas, F., van Teijlingen, E., Torrance, N. et al (2006)20 McMurray (ibid)21 McMurray (ibid)22 Allen, P. (2000)23 Campbell, S.M., Roland, M.O., Middlet on, E. and Reeves, D. (2005)24 Rummery, K. and Coleman, A. (2001)25 ODowd, A. (2005)26 Department of Health and Children (ibid).27 Masterson, A. (2002)28 Mitchell, P.S., Schaad, D.C, Odegard, P.S. Ballweg, R.A. (2006).29 Thomas, P., Graffy, J., Wallace, P. (2006)30 Lordan, G. (2007)