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Integrating a nationally scaled workforce of community health workers in primary care: a modelling study.

Authors
  • Hayhoe, Benedict1
  • Cowling, Thomas E1, 2
  • Pillutla, Virimchi3
  • Garg, Priya4
  • Majeed, Azeem1
  • Harris, Matthew1, 5
  • 1 1 Department of Primary Care and Public Health, School of Public Health, Imperial College London, London W6 8RP, UK.
  • 2 2 Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK.
  • 3 3 Department of Medicine, School of Clinical Sciences, Monash University, VIC 3168 Australia. , (Australia)
  • 4 4 School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1010, New Zealand. , (New Zealand)
  • 5 5 Centre for Health Policy, Institute of Global Health Innovation, St Marys Hospital, London W2 1NY, UK.
Type
Published Article
Journal
Journal of the Royal Society of Medicine
Publisher
SAGE Publications
Publication Date
Dec 01, 2018
Volume
111
Issue
12
Pages
453–461
Identifiers
DOI: 10.1177/0141076818803443
PMID: 30286301
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To model cost and benefit of a national community health worker workforce. Modelling exercise based on all general practices in England. United Kingdom National Health Service Primary Care. Not applicable. Publicly available data on general practice demographics, population density, household size, salary scales and screening and immunisation uptake. We estimated numbers of community health workers needed, anticipated workload and likely benefits to patients. Conservative modelling suggests that 110,585 community health workers would be needed to cover the general practice registered population in England, costing £2.22bn annually. Assuming community health workerss could engage with and successfully refer 20% of eligible unscreened or unimmunised individuals, an additional 753,592 cervical cancer screenings, 365,166 breast cancer screenings and 482,924 bowel cancer screenings could be expected within respective review periods. A total of 16,398 additional children annually could receive their MMR1 at 12 months and 24,716 their MMR2 at five years of age. Community health workerss would also provide home-based health promotion and lifestyle support to patients with chronic disease. A scaled community health worker workforce integrated into primary care may be a valuable policy alternative. Pilot studies are required to establish feasibility and impact in NHS primary care.

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