#FAP_ICSCC Primary care pharmacists, support for patient-centred care

Josep Vidal-Alaball

For writing this post, Josep Vidal-Alaball has shared authorship with Anna Maria Bonet Esteve and Aïna Fuster Casanovas.

Health systems have always been more disease-oriented than patient-oriented. In a paternalistic way, the patient's medication has been managed, indicating what he or she has to take and how they have to do it. What consequences has this had? Discomfort in those patients for whom the medication does not suit them, with the consequent interruption of the treatment and the frustration of the professionals for not obtaining results, in addition to the high cost associated with the health system. The social profile of the Catalan population is characterized by progressive ageing and, therefore, by an increase in chronic pathology and associated comorbidities. Fragmented health care among multiple health providers in the system can complicate treatments that are already complex per se. In a context of excessive medicalization of daily life due to the use of medication as one of the main therapeutic resources in the provision of health care, there is an acute need to change the paternalistic management model to promote care that takes into account all stakeholders (1)(2).

Social agriculture

Josep Vidal-Alaball

In this section, we talked about the benefits for the community and public health of things as diverse as including health in all government policies, having community health agents, implementing telemedicine services, or using neighbourhood pharmacies or drug stores and public markets to carry out social and community actions. On the same topic, I would like to relate another initiative aimed at enhancing the community’s capacities such as agriculture and social farms. Social farming is the practice of participating in family farms as a form of social support service. In return, farmers have the opportunity to increase their income by developing the provision of social services, thereby further exploiting their agricultural skills. Participants can go to the farm one to five days a week. Each social farm is unique and offers its program of activities and opportunities. Similarly, participants confirm the activities they want to participate in.

Improving health takes a lot more than exercising, dieting and quitting smoking

Josep Vidal-Alaball

In 2014, Ryan Meili, a Canadian family doctor, wrote a provocative article criticizing the health promotion policies implemented since the 1970s in most developed countries. With the title "Improving our health is about more than diet, smoking and exercise", Meili reviewed the determinants of a population’s health.

As is known, among the elements that determine  population’s health, health care is the least important when compared to the weight of social factors such as, for example, income and distribution, education, housing, employment or the social support available to the individual. Although the importance of these factors is evident, and although study after study has shown the differences in health caused by social inequalities, health policies continue to be largely committed (and budgetary priorities demonstrate this) by allocating available resources to improve health care of the population, often forgetting the other factors that are also determinants.

What can we learn from primary care in Finland?

Josep Vidal Alaball

Finland is a leader in many aspects of the welfare system. It’s well known that they have one of the best educational systems in the world; but what can we learn from their primary care system that can be useful for our area? With this article I want to convey some personal reflections about some peculiarities of the Finnish health system and a comparison with our own model.

Finland is a northern European country with 5.5 million inhabitants and a member of the European Union since 1995. Its health system provides universal coverage and it is noteworthy that health and social services are managed from the same government department.

Adjusting contracts to the value provided by services

'Commissioning for value'bona iniciativa del NHS per identificar els millors programes d millora de la salut http://t.co/7whaXuF2d4
— Dr J Vidal-Alaball (@jvalaball) noviembre 22, 2013

Dr. Josep Vidal-Alaball is a family doctor trained in England and passionate about public and community health. He’s a keen Twitterer, very active in innovation.

The link in Dr. Vidal Alaball’s tweet, directs us to the English National Health Service’ website, named "Right Care", where it is stated that the purpose of the health system is to deliver more value to people’s health and, according to this statement, proposes that service contracts should be adjusted in-line with this value (Commissioning for value) and clarifies that the NHS adopts Michael Porter’s definition of value: clinical outcomes in relation to costs.