Primary Health Care during the COVID-19 pandemic: an analysis based on the HSRM

The COVID-19 pandemic has had a dramatic impact on workload and responsibilities for those working at primary health care (PHC) level in the European region - much of which has gone unnoticed relative to the focus on hospitals. Based on the PHC-relevant data extracted from the HSRM, we describe PHC models of care and the political and system levers that supported them. Three key themes emerged: (1) varied forms of PHC multidisciplinary collaboration were developed to manage the emergency response - supported by the movement of staff to areas requiring support;(2) vulnerable patients were identified and prioritized for medical outreach within PHC, and were supported through financial incentives and complementary action from centralized and local governments that used much broader definitions of vulnerability;and (3) digital solutions for remote triage, medical advice and treatment enhanced the effectiveness of the PHC response and were facilitated through centralized investment in digital technologies. Based on our analysis, we raise opportunities for the future of PHC, namely that multidisciplinary approaches to PHC service delivery are essential to future infectious and non-infectious outbreaks, and the agility and rapid pace of change that took place among PHC providers should continue. PHC providers lacked visibility during the pandemic and should work together to develop a strong voice in all health systems.