Primary care (PC) is widely recognized as the foundation of effective and equitable health systems. In Quebec, access to a regular source of PC remains a major challenge.. In this context, the Quebec government initiated the development of its first provincial PC policy and mandated an independent expert committee to formulate evidence-informed recommendations.The objective is to synthesize the committee’s work and outlines a pragmatic roadmap to strengthen PC in Quebec.The mandate was conducted over four months using three sequential components integrating scientific and experiential knowledge: 1) a targeted review of literature and policy syntheses and a jurisdictional analysis of six countries (United Kingdom, Sweden, Netherlands, Norway, France, Canada) and three provinces (Ontario, Alberta, Quebec); 2) 59 semi-structured consultations with more than 210 participants across Quebec and 3) an in-person forum with 135 participants to enrich preliminary recommendations. The final recommendations were developed during a two-day meeting, aligned with Quebec system values and the quintuple aim.Evidence synthesis emphasized that no single “best” PC model exists; performance depends on coherent system configurations adapted to context. Nevertheless, international consensus converges on several core features: a clear policy vision, financing aligned with health objectives, governance structures linked to communities, formal attachment to reinforce continuity and accountability, interprofessional teams, and strong coordination across services. Findings from the consultations revealed a fragmented, hospital-centered system characterized by inequitable access and insufficient continuity, while existing performance indicators were perceived as volume-focused and insufficiently oriented to quality and value. The committee proposed six recommendations: (1) a comprehensive PC workforce development strategy; (2) universal patient registration within interprofessional teams; (3) strengthened local governance; (4) sustained investment in research and data infrastructure; (5) dedicated and protected public funding for PC; and (6) population-level performance measurement focused on outcomes important to patients.The Quebec’s first government PC policy can serve as a strategic lever to address the PC crisis if reforms are implemented as a coherent package rather than selectively.Achieving the proposed vision requires a concrete, phased action plan, and long-term investments in teams, governance, financing, and data infrastructure.

Globally, over 7 billion people are at risk for not receiving adequate health care. As a country becomes more developed, the causes of morbidity and mortality change. This is called epidemiologic transition. To help countries in epidemiologic transition, the World Health Organization (WHO) has created early diagnosis and management protocols, called “Package of Essential NCD Interventions” (PEN). PENs are designed to help this transition from communicable diseases to non-communicable diseases (NCD)s, and to be less labor-intensive and more affordable than developed world standards.The objective is to discuss PEN implementations in Eastern Europe, their outcomes, and implications for further healthcare improvement.European countries were stratified according to an adapted five-stage model of epidemiological transition aligned with WHO priorities. Published data were reviewed to identify sites across Europe where PEN protocols were implemented. A literature search was done to look for outcomes data from these programs.At least 5 countries have implemented PENs, Kyrgyzstan, Moldova, Tajikistan, Ukraine, and Uzbekistan. Published results are available from Moldova, Tajikistan, and Ukraine. Sample results: Moldova showed cost-effectiveness, Tajikistan improved hypertension (HTN) control, and statin prescribing, and Ukraine showed improved HTN control and decreased reliance on donor funding. Other findings will be presented.Most countries are facing high morbidity and mortality from NCDs.  PENs are proving to be effective in improving health in a cost-effective manner in Eastern Europe. Similar findings are seen in countries such as Costa Rica, Thailand, and Viet Nam, with dramatic improvements in their management of NCDs and improvement of life expectancy with PEN implementation. We believe similar outcomes can be achieved with the implementation of PENs both locally and throughout entire countries.The countries who have implemented PENs have uniformly had positive results both in improving health care and/or in creating cost savings. This shows that more widespread implementation of PENs may be useful to improving health care in Eastern Europe and throughout the world. Since health dollars are limited, wise use of these funds is warranted. PENs are one cost-effective method for health improvements in developing countries.

Healthcare significantly contributes to climate change, which poses a major threat to public health. Previous initiatives have introduced tools and guidelines to reduce the environmental footprint of general practice. Building on this foundation, a national implementation project was launched to prioritize sustainable goals in primary care. Which mitigation measures have the greatest impact on climate change?The project, funded by the Dutch Ministry of Health, involves several stakeholders. Two sub-projects were prioritized:  (1) A scientific impact analysis of GP care, including a literature review of life cycle assessments and expert consultation to identify ten high-potential mitigation actions.  (2) Development of a national roadmap for sustainable GP care, integrating existing initiatives and aligning with the Green Deal Sustainable Healthcare 3.0.The impact analysis revealed environmental hotspots in prescribing, diagnostics, and practice management. Ten mitigation actions were evaluated for feasibility and potential climate impact. The roadmap outlines a phased transition strategy for Primary care practices and professional organizations.Within the Sustainable Development Goals, gains can be achieved in primary care. For some Green Deal objectives, such as health promotion, the environmental impact is difficult to quantify, but it also is important to consider these in the analyses.Sustainable GP care is achievable through targeted actions and coordinated implementation. These first results provide a foundation for scaling up and embedding sustainability in clinical practice. Primary care can play a leading role in planetary health.

XXXX  is currently undergoing major primary care reform including shifts in funding and organisational structure general practice.  This presentation will outline recent policy changes and their impact on the availability and financial viability of high-quality general practice servicesTo outline changing nature of general practice consultations To outline recent policy changes and the impacts on the delivery of high-quality primary care.Quantitative data analysis of health utilisation statistics, and results from a survey of 2416 general practitioners (GPs) commissioned by the national GP college/assocationPsychological/mental health conditions rank highest of commonly treated conditions, followed by women's health and endocrine conditions.  Average consuttation length has increased to 20 minutes, and is nearly 22 minutes for female GPs, 57% of GPs work in multidisciplinary teams, with 2/3 of GPs wanting to provide more multidiscipllinary teams but report time and inadequate remuneration as barriers.   More than 80% of GPs report providing care which was preveiously referred to other medical specialists.  Since 2014 the percentage of Health funding allocated to comprehensive primary care is decreasing, reflecting both static general practice investment and increasing costs of hospital care.General practice care is becoming more complex and GPs are managing more care in the community.  Current funding models provide greatest reward for short consultations.  There is an increasing need for funding to support more preventative care and multidisciplinary teams based care.These results indicate growing complexity in general practice consultations reflecting population ageing and increasing multimorbidity.  Current financial incentives are greatest for short and simple consultations.  Incentive redesign is needed to better support patients requiring complex care, and the primary care workforce delivering this care.

Thailand's primary healthcare (PHC) system, crucial for universal coverage, faces intense pressures: resource scarcity, aging populations, rising non-communicable diseases, and workforce burnout. The 2019 Primary Health System Act aimed to reshape governance. This presentation explores the dynamic interplay between national policies and local realities.Our mixed-methods study primarily employed a qualitative case study. We analyzed the 2019 Act and related policies, alongside semi-structured interviews with policymakers, health administrators, and community representatives across national, subnational, and local levels, yielding granular implementation insights.Lessons highlight the integration of innovative solutions, such as enhanced supportive supervision and self-care promotion, to build workforce resilience. Adaptable governance that addresses transport infrastructure and professional development is vital for tangible, cost-effective interventions and equitable access. These findings offer valuable insights for strengthening global PHCThailand's challenges—resource scarcity, workforce burnout, and demographic shifts—mirror global concerns about the sustainability and equity of the health system. This necessitates comprehensive policy re-evaluation. The discussion connects findings to broader international efforts, emphasizing integrated, preventative care models and robust governance for sustainable outcomes.Urgent, comprehensive reforms are paramount for Thailand's PHC. Success hinges on the 2019 Act bridging national mandates with local realities. This strategic shift towards integrated, preventative care, supported by resilient infrastructure and a motivated workforce, is crucial for equitable and sustainable health for all citizens.

Primary health care (PHC) systems within the European Union (EU) vary considerably in governance, financing, workforce structure, accessibility, and digital/infrastructural resources. Understanding these differences is essential for strengthening PHC performance and guiding effective policy development. Finland, Slovakia, Estonia, Lithuania, and Latvia represent diverse PHC approaches shaped by diverse historical, economic, and organisational contexts.To analyse PHC models across Finland, Slovakia, Estonia, Lithuania, and Latvia, assessing how differences in governance, financing, workforce organisation, accessibility, and system resources correspond to variations in health outcomes.A comparative cross-sectional analysis was conducted using OECD Health Statistics 2023, WHO European Health Information Gateway, and national health system reports from 2015–2024. Indicators included general practitioner (GP) density, workforce metrics, service accessibility, digital/infrastructure availability, chronic disease management, and avoidable hospitalisations. Qualitative analysis examined PHC organisation, gatekeeping, digital integration, and community-based care. Findings synthesised quantitative trends with policy contexts.Finland and Estonia demonstrate strong gatekeeping, clearer PHC entry points, and a predominance of group or integrated practices. Lithuania combines capitation-based financing with growing community care integration, while Latvia and Slovakia use mixed financing and feature more solo practices. Higher GP density in Finland, Estonia, and Lithuania is associated with better access and continuity of care. Estonia has the most advanced digital PHC infrastructure, followed by Finland and Lithuania. Avoidable hospitalisations are higher in Latvia and Slovakia.Despite shared EU policy frameworks, substantial differences remain in PHC organisation and performance. PHC models with strong gatekeeping, stable financing structures, group practices, and integrated community services achieve greater efficiency and improved outcomes. Solo practice dominance, limited integration, and underdeveloped digital systems in Latvia and Slovakia contribute to higher avoidable hospitalisations. Variations in financing and workforce shortages affect accessibility and continuity of care.PHC systems that combine strong gatekeeping, group or integrated practices, and reliable digital and community-based services achieve better accessibility, continuity, and chronic disease outcomes. Strengthening these features—particularly in countries relying on solo practices or mixed financing—can enhance efficiency and reduce avoidable hospitalisations. Further research should focus on longitudinal evaluation of PHC reforms and opportunities for cross-country learning.