The World Health Report 2008 Primary Health Care (Now More Than Ever) states that, in addition to effectiveness and safety, features of healthcare systems to ensure better health and social outcomes include:
‘… person-centredness, comprehensiveness and integration, and continuity of care, with a regular point of entry into the health system, so that it becomes possible to build an enduring relationship of trust between people and their health-care providers.’ 1
General practice is predicated on these qualities. Against this background, the recently-published Lancet Oncology Primary Care Commission report, entitled The Expanding Role of Primary Care in Cancer Control, is a welcome and timely initiative.2 It presents broad, thorough, and compelling arguments for the recognition and strengthening of engagement of general practice with cancer control, from prevention through post-treatment follow-up and into survivorship or end-of-life care. The Commission report is authored by a distinguished group of primary care clinicians and researchers who have built a strong evidence base for the centrality of primary care in good cancer control. The Commission report highlights the need for integrated models of care with agreed care pathways; effective primary prevention strategies that target known cancer risk factors such as exercise and obesity; new models of access to facilitate earlier diagnosis; the incorporation of electronic clinical decision support tools into clinical software; and support through appropriate undergraduate and postgraduate training.
PRACTICAL IMPLEMENTATION
Implementing the Commission report recommendations will require recognition that health care is a complex system that is continuously adapting to changing environments. There are times when transformational change is possible as multiple reasons for change coincide. This is currently the case in cancer control. Governments and service …
