The interface between primary health care and population health: challenges and opportunities for prevention

Primary health care has the potential to contribute to population health at the individual and population levels. The '5As' (ask, assess, advise/agree, assist and arrange) provide a framework to realise this potential, especially for disadvantaged and vulnerable populations, not only by better organising multidisciplinary preventive interventions within primary health care, but also by linking these interventions with more intensive community and population programs and services, especially for patients with low health literacy. This requires changes to information systems to prompt and record preventive care, work with practices to engage a range of disciplines, including practice nurses, and development of effective linkages with other services in the local community. This has important implications for the newly established Primary Health Networks in supporting improvement within primary care, and creating linkages and partnerships with a range of organisations involved in delivering preventive interventions in the community. However, prevention in primary health care needs to be underpinned by funding systems that support multidisciplinary and preventive care for a population, rather than simply reactive, episode-based care.