Primary Matters

We are keen to promote a report from The Nuffield Trust and National Association for Primary Care (NAPC), entitled ‘Reclaiming a Population Health Perspective (Future Challenges for Primary Care)’ because we believe it to be vitally important.

(View the PDF)

The foreword to the report starts by name checking “the late, great Barbara Starfield”. It quotes Barbara as being “a lifelong advocate of primary care” and reproduces her strongly held conviction that “a strong generalist construction can demonstrate value through improving access, offering quality and promoting equity of care”. (Starfield 1994)

Through our long association with Johns Hopkins University, we at Sollis are very familiar with the work of Dr Starfield. Before passing away in June 2011, Barbara was the Professor of Health Policy and Management at Johns Hopkins Bloomberg School of Public Health.

Barbara Starfield is recognised as a giant in the field of primary care and health policy. Amongst her many achievements was the development of important methodological tools for assessing diagnosed morbidity burden, including the Adjusted Clinical Groups® (ACG®) System.

There is much talk today of course about risk stratification and predictive modelling, and the ACG® System certainly plays to that agenda.

What attracted Sollis to the tool, however, was that it delivered insight and value beyond just assessing the risk of hospitalisation.

Population profiling is a technique for comparing the morbidity patterns of one or more groups or regions and this technique lies at the heart of the ACG® System. By taking into account the differences in illness burden among different patient populations, ACGs® allow one to determine variations in disease prevalence as well as resource use.

Typically, population profiling is the first step to better understanding the health care needs of a population and we believe that this is the starting point for any Clinical Commissioning Group (CCG) considering its commissioning priorities.

At a very practical level, of course, as part of the authorisation process, CCGs need to demonstrate a detailed understanding of the needs of the local population they are serving.

We share the view of The Nuffield Trust and the NAPC that general practice has a pivotal role in improving the health of a population.

We welcome the observation in the report that in pursuing a population health perspective, general practice will need access to the very best data and evidence. As the report states good quality data and risk stratification tools will be essential to support the task at hand.

We recognise the vital importance of primary care in shifting the paradigm that currently dominates the way we currently organise and deliver public healthcare services.

The ACG® System was born out of a primary care setting and Barbara Starfield was passionate in her belief that a quality primary care system was critical to the future of health care systems worldwide.

We at Sollis share the values and vision that Barbara Starfield embraced and promoted.

We exist as a company because we believe we have a role to play in helping forge a healthcare system based on quality and equity of care.