EFPC Newsflash 19-2019
The aftermath of the #EFPC2019 Nanterre conference: results, agreements and opinions!

#EFPC2019 Nanterre

Message from Nanterre; 1 October 2019
Dear colleague,
We have been together with other members and friends of EFPC at our recent conference in Nanterre. We wish you could have been there in Nanterre because....
Best wishes, #EFPC2019 Nanterre conference delegates
Reflection on the Nanterre conference by Peter Groenewegen
“The inverse patient records law”
The Nanterre conference was a big success. Thanks to high quality presentations and a venue that supported contact and debate. A highlight for me was the key note presentation by professor Sara Willems about equity in primary care. She brought together a number of important insights on equity in health and in health care. On equity in health, the evidence suggests that the most important determinant of health is structural circumstances, such as social and economic status of people and the environment they live and work in. This accounts for 45% of differences in health outcomes. Next is behaviour and life style, which according to review studies accounts for some 40% of differences in health outcomes. And finally health care: this seems to account for only approximately 15%. For primary care this illustrates how important it is to know about these social determinants of health and to try to influence people’s life style and wherever possible to support them in improving their structural position.
Access to good quality care and in particular primary care is important. John Tudor Hart, a GP who worked in the mining areas of Wales, formulated his famous ‘inverse care law’: the more health problems there are in a community, the less good quality care is available. Combining this with the relative importance of determinants of health, it struck me that there is also something that we may call the ‘inverse patient records law’. Most of what GPs note in their patient records relates to diagnostic and therapeutic interventions – which in terms of determinants of health are least important. As far as I can see, GPs record some information in their patient records about life style and behaviour. In the Dutch situation, this is largely restricted to patients who participate in disease management programmes. I think we can say that GPs do not have a good overview of the life style and health behaviours of their patient population as a whole. And still, as we saw, this is the second important determinant of differences in health outcomes. Finally, the structural circumstances, such as education, health literacy, income, work circumstances. These are not routinely in the patient records at all.
Of course it is not easy to change this situation. Recording information about health behaviour and structural circumstances takes time of health care providers who are already burdened with administrative tasks; health behaviours change and data must be accurate to act upon them; recording this kind of information may be in conflict with data protection and privacy regulation. However, it may be worthwhile to look for practical solutions. On the technical side there may be possibilities of data linkage (with informed consent of patients). On the patients’ side there may be willingness to provide life style and structural information and update it regularly if patients have direct access to a personal digital health environment, containing also their electronical medical record. However, we still have to be aware of John Tudor Hart’s wise observation: it will be easy to get this life style and structural information of the patients whose information we need least. 
Conference evaluation
We got approximately 60 responses of which 75% answered with agree or fully agreement to the most important general questions:
•       There was sufficient room to exchange new ideas, insights, solutions and interesting experiences from different countries between primary care professionals, researchers, policymakers and health service managers
•       Based on my Nanterre experience, I will attend the next conference in Ljubljana 2020
We might have to improve for the catering and dinner based on several individual comments which we will definitely try to achieve in Ljubljana next year.
Our heroine escaped from an asylum. Hastily seeking for a place to hide, she finds herself in the middle of a theatre stage. She powerfully captures the stage and scenery with her presence. The EFPC audience experienced a dynamic, unorthodox performance that goes beyond the ordinary. The subsistence struggle of the woman with her demons, herself and the stage reflected all the existential efforts in life. The audience experienced the weirdness of sharing the same environment with this woman, trail the borders of insanity and having fun like a child.
Thanks to Aysegul Cengiz Akman for this impressive performance! Hope to see you back in one of our future EFPC conferences!
Deep End paper
Our Scottish colleagues of the Deep End movement led a workshop on highlighting the exceptional potential of general practice to support health equity – what is the role of academic/service partnership?
A paper written by Graham Watt explains the basics on how to develop a Deep End project.
Soon an EFPC lunch webinar will be organised to provide further explanation and the possibility to ask questions to the experts behind the Deep End project.
University of Glasgow, Institute of Health and Wellbeing's newsletter
Based on their presence in Nanterre a blogpage was published within the Institute of Health and Wellbeing's newsletter
EFPC 2019 General Assembly
Please find the minutes made by Alessandro Mereu at the EFPC webpage reporting on the 2019 General Assembly
Vaccination statement
At the 2019 Nanterre EFPC General Assembly the members of the EFPC agreed on a statement regarding vaccination and Primary Care.
New EFPC Advisory Board members
We say once more welcome to our new Advisory Board members:
  • Lorena Dini
  • Elena Petelos
  • Peter Pype
  • Tugba Caliskan
  • Maria vd Muisenbergh
  • Anke van Dam
  • Liga Kozlovka
  • Sarah Burgmann
  • Trude Backer Mortensen
We look forward to have their support in bringing our network further in our objective to improve the health of the population by promoting strong Primary Care.
PIE update
A very valuable contribution by new EFPC individual member Yann Lefeuvre on “shared learning” in the Interprofessional Learning theme
Please include your comments and connected PIE’s so the discussion will come further and a knowledge base will be developed.
Farewell Diana
At the Nanterre conference Diana Castro Sandoval announced her farewell as coordinator of the Forum. She has found a new and challenging job after having three years served in the EFPC secretariat. We wish her good luck and thank her for all her commitment!
For this reason we are going to look for a new candidate to strengthen the EFPC secretariat, being a future colleague of Diederik Aarendonk and Irene Cubells. More details will follow soon!
Recent new EFPC members
  • Yann Lefeuvre – UK
  • Aids Foundation East West (AFEW) – NL
  • Simon de Lusignan – UK
  • Österreichisches Forum Primärversorgung im Gesundheitswesen (OEFOP) – AT
  • Thierry Blanchon – FR
  • Division of Community Nursing, Cyprus Nurses Association – CY
  • Cyprus University of Technology – CY
  • Christophe Heintze - GE
  • Salman Rawaf – UK
  • Ecole des Hautes Etudes en Sante Publique (EHESP) – FR
  • University of Angers, Department of general practice - FR
  • Terri Rotchell – UK
  • Alexandra Tsipou - GR
  • Thibault Detremerie - BE
  • Esther Mugweni – UK


Interprofessional Education in Primary Care by the You&EFPC group together with the Young Community Pharmacists.
Tuesday 12 November, 2019 @ 12.30 PM (Dutch time)
Registration: send a message to the EFPC secretariat!


New on Primary Health Care Research & Development (PHCR&D)
Palliative care in primary care: European Forum for Primary Care position paper
Rotar Pavlič, D., Aarendonk, D., Wens, J., Rodrigues Simões, J., Lynch, M., & Murray, S. (2019).  Primary Health Care Research & Development, 20, E133. doi:10.1017/S1463423619000641
The aim of this position paper is to assist primary health care (PHC) providers, policymakers, and researchers by discussing the current context in which palliative health care functions within PHC in Europe. The position paper gives examples for improvements to palliative care models from studies and international discussions at European Forum for Primary Care (EFPC) workshops and conferences.
*Primary Health Care Research & Development is the EFPC official Journal
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