Community Health Centres as a model of care: contextualizing for Europe - a Delphi study

This study aimed to develop a European definition of Community Health Centres (CHCs) as a model of primary care, assess the acceptability and feasibility of this model among experts, and propose a common framework to guide CHC implementation across European countries.

CHCs have existed in Europe for more than five decades and are increasingly recognized as effective models for delivering comprehensive, equitable and integrated primary care. Despite their established global presence, there remains a need to contextualize and define CHCs within Europe's diverse healthcare systems.

Building on the International Federation of Community Health Centres (IFCHC) definition, a refined version comprising 35 key statements was developed through expert consultations. A two-round Delphi study was conducted with 31 experts from 16 countries, using five-point Likert-scale questionnaires to evaluate the acceptability and feasibility of each statement.

All 35 statements were rated as acceptable and feasible (average value >3 on the five-point Likert scale). The most highly rated elements included respect for human rights, accessibility irrespective of socioeconomic status, interprofessional collaboration, and integrated, people-centred care. Although feasibility ratings were slightly lower than acceptability ratings, they improved in the second round, indicating increased consensus. Statements concerning governance, community participation, and responsibility for specific population subgroups received lower feasibility ratings. Overall, the findings demonstrate broad expert consensus on the relevance and adaptability of the CHC model within Europe. While some implementation challenges persist, particularly regarding governance, interprofessional collaboration, and intersectoral coordination, the proposed definition offers a robust foundation for strengthening primary care across diverse European contexts.