TY - JOUR
T1 - Optimising individual and community involvement in health decision-making in general practice consultations and primary care settings
T2 - A way forward
AU - MacFarlane, Anne E.
N1 - Publisher Copyright:
© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2020
Y1 - 2020
N2 - The World Health Organisation Alma-Ata Declaration on Primary Healthcare, and the more recent Astana Declaration from the Global Conference on Primary Healthcare, emphasise the involvement of individuals and communities in health decision-making about their individual health care, service delivery and policy development. Increasingly, health funding agencies and academic publishers like the BMJ require Public and Patient Involvement in health research. These imperatives cover health decision-making about different issues in different settings. In this position paper, I argue that individual and community involvement in health decision-making are core to, and useful for, the discipline of general practice but may not be equally familiar or routinised practices in European primary care settings. I use the social science concept of participatory spaces, to describe three overlapping forms of involvement–shared decision-making (SDM) in clinical care, community participation to develop services and Public and Patient Involvement in research. I refer to evidence of implementation challenges for these forms of involvement and provide insights about how to routinise them with reference to the need for these practices to make more sense to general practitioners, for general practitioners to have more time and resources to incorporate them into their daily work and for more research to understand the power dynamics involved. We need leadership in our discipline, and partnership working with policymakers, patient and community organisations, to progress these issues and enable us to optimise benefits for general practitioners, patients and the broader practice population.
AB - The World Health Organisation Alma-Ata Declaration on Primary Healthcare, and the more recent Astana Declaration from the Global Conference on Primary Healthcare, emphasise the involvement of individuals and communities in health decision-making about their individual health care, service delivery and policy development. Increasingly, health funding agencies and academic publishers like the BMJ require Public and Patient Involvement in health research. These imperatives cover health decision-making about different issues in different settings. In this position paper, I argue that individual and community involvement in health decision-making are core to, and useful for, the discipline of general practice but may not be equally familiar or routinised practices in European primary care settings. I use the social science concept of participatory spaces, to describe three overlapping forms of involvement–shared decision-making (SDM) in clinical care, community participation to develop services and Public and Patient Involvement in research. I refer to evidence of implementation challenges for these forms of involvement and provide insights about how to routinise them with reference to the need for these practices to make more sense to general practitioners, for general practitioners to have more time and resources to incorporate them into their daily work and for more research to understand the power dynamics involved. We need leadership in our discipline, and partnership working with policymakers, patient and community organisations, to progress these issues and enable us to optimise benefits for general practitioners, patients and the broader practice population.
KW - community participation
KW - General practice
KW - patient-centred care
KW - primary care
KW - public and patient Involvement in research
KW - shared decision-making
UR - http://www.scopus.com/inward/record.url?scp=85097746304&partnerID=8YFLogxK
U2 - 10.1080/13814788.2020.1861245
DO - 10.1080/13814788.2020.1861245
M3 - Article
C2 - 33337921
AN - SCOPUS:85097746304
SN - 1381-4788
VL - 26
SP - 196
EP - 201
JO - European Journal of General Practice
JF - European Journal of General Practice
IS - 1
ER -