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Digital first primary care in NHS England: evaluating alignment with patient-centered care and implications for
Kunyue Xing1,2, Jialian Wen3, Dongming Xing4,5
1School of Public Health, Peking University, Beijing, China.
Frontiers in Digital Health
|June 10, 2026
Summary
Digital First Primary Care (DFPC) improves access but benefits are uneven. DFPC aligns with patient-centered care (PCC) in flexible hybrid models that ensure choice and equity.
Area of Science:
- Health Services Research
- Digital Health
- Primary Care Policy
Background:
- NHS England introduced the Digital First Primary Care (DFPC) model to improve healthcare accessibility and efficiency using digital tools.
- The DFPC model incorporates telemedicine, digital triage, and virtual consultations to reshape primary care delivery.
- Evaluating DFPC requires distinguishing between emergency COVID-19 responses and planned, post-pandemic implementations.
Purpose of the Study:
- To examine the Digital First Primary Care (DFPC) model through the lens of patient-centered care (PCC) domains.
- To synthesize UK-focused literature on the empirical, policy, and implementation aspects of DFPC.
- To identify conditions under which DFPC aligns with patient-centered care principles.
Main Methods:
- A structured narrative review of UK-focused empirical, policy, and implementation literature.
- Analysis of DFPC's impact on PCC domains: access, autonomy, shared decision-making, continuity, relational quality, and equity.
- Distinction between evidence from the COVID-19 emergency period and routine post-pandemic implementation.
Main Results:
- DFPC offers improved convenience, flexibility, and timeliness for some patients, but these benefits are not universally distributed.
- Patient capability, system design, and workflow integration significantly influence the effectiveness of DFPC.
- Evidence from the COVID-19 pandemic differs from routine DFPC due to varying goals, constraints, and patient expectations.
Conclusions:
- DFPC aligns with PCC principles only when implemented as a flexible hybrid model.
- Key components for alignment include preserving modality choice, ensuring continuity of care, and providing safe escalation pathways.
- Mitigating digital exclusion and prioritizing patient-reported outcomes (experience, continuity, safety, equity) are crucial for future DFPC research and implementation.
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