Mind the gap! Conflict and cohesion in primary care delivery models

We need to learn from historic changes in accident and emergency (A&E) and urgent care services and identify the conflicts in provision of planned and unplanned care. We have choices as to whom, and how, primary care services are provided in the future. But we will get this wrong if we fail to recognise that the interface between planned and unplanned care needs to be carefully managed. If managed well, we might encounter the opportunity to develop high quality, coordinated and integrated care.

I have watched myself and others struggle with the conflict between planned and reactive care, and thought it time to 'name the devil' in order to understand it and think about the choices ahead. Personally, I enjoy being able to deliver both planned and unplanned care to a practice population and would not want to lose either.