Transforming Primary Care in Scotland and China (ScotCH)

China and the United Kingdom (UK) share many similar challenges in health and social care including ageing and wide health inequalities between rich and poor. The aim of the study is to explore and compare the effects of recent changes in primary care in Scotland and China

This is a joint application between Scotland and China. The two principle applicants, Stewart W Mercer and Harry H X Wang have collaborated effectively over the last ten years, which started during SWM's senior role at the Chinese University of Hong Kong as Acting Head of Department of Family Medicine in 2007, where HHXW completed his PhD. They have jointly published a number of high impact papers and book chapters to date. Both countries face major challenges relating to ageing and health inequalities, as do most countries, and thus the research is of great international significance. Scotland has introduced a number of radical changes in health and social care, and has recently introduced a new Scottish GP contract. Other recent changes include the development of GP Clusters and a strengthening and expansion of the primary care multidisciplinary team. These changes are several years ahead of similar changes just beginning to happen in England. China has also recently embraced radical new development in primary care, based around the formation of family doctor teams. Thus exploring the progress of these two countries in their primary care reforms, and identifying the barriers and facilitators is of great international and national importance.

Summary

Countries around the world are facing major changes, with many people living to an older age. General Practice and primary care provides much of the healthcare care needs of such ageing populations. China and the United Kingdom (UK) share many similar challenges in health and social care including ageing and wide health inequalities between rich and poor.

In Scotland, significant recent changes have been made in primary care including a new Scotland-only GP contract which includes GP Practices working together in 'clusters' (of 5-8 Practices) to improve the quality of care delivered to their local population, and significant expansion of other members of the primary care team (such as advanced practitioners in nursing, pharmacy, and physiotherapy).

In China, Community Health Centres (CHCs) have been established over recent years. These are similar to GP Practices in Scotland, though somewhat larger, led by GPs working within primary care teams. A key focus - which is much less prominent in Scottish primary care - is systematic preventive care to support people to live healthier lives and manage their own conditions better. There is an important opportunity for each country to learn from each other, as these changes in primary care develop further.

The aim of the study is to explore and compare the effects of these recent changes in primary care in Scotland and China, and to find out if these changes are meeting the needs of ageing patients with long-term conditions, as well as reducing health inequalities. To answer this we will carry out the research in two phases. The first phase will explore what the expected impacts are of the changes in both countries. The second phase will examine the actual impacts and key learning.

Full Title

Transforming Primary Care in Scotland and China to meet the needs of an ageing population - are health inequalities being tackled?

Funder

UKRI-NSFC Joint Call on Understanding and Addressing Health and Social Challenges for Ageing in the UK and China.

Funder: Economic and Social Research Council

Amount: £ 809,311

(with matched funding in China from the National Natural Science Foundation of China; PI Harry H.X. Wang, Sun Yat-Sen University)  

Timeline

Duration: 36 months from August 2020 - July 2023

Key People

Principal Investigator

Stewart Mercer (Stewart Mercer's online profile)

Co-applicants

Bruce Guthrie (Bruce Guthrie's online profile)

Martyn Pickersgill (Martyn Pickersgill's online profile)

Andrew Thompson (Andrew Thompson's online profile)

Researchers

Dr Eddie Donaghy (Eddie Donaghy's online profile)

Dr David Henderson (David Henderson's online profile)

Dr Huayi Huang (Huayi Huang's online profile)

Patient & Public Involvement (PPI) Lead

Image by Dr Qifeng Li (Dongyuan Community Health Centre of Futian, Shenzhen, affiliated with The Eighth Affiliated Hospital, Sun Yat-Sen University)