TY - JOUR
AU - L. Kovacevic
AU - L. Forbes
AU - H. Ashrafian
AU - E. Mayer
AU - E. Mossialos
AU - D. Lugo-Palacios
A1 - 
AB - Recent years have seen an emergence of collaborative primary care models in the English National Health Service and other international health systems. Primary Care Networks (PCNs) were introduced in England in July 2019, marking the first time collaboration between general practices was incentivised through a nationwide policy. While participation was not mandatory, nearly all general practices joined a PCN, largely due to strong financial incentives. Our study aim was to estimate the impact of PCNs on emergency hospitalisations using an interrupted time series design. Quarterly data between October 2016 and March 2023 from the North West London Whole Systems Integrated Care dataset was used to construct two primary outcomes: all-cause and ambulatory care sensitive conditions (ACSC) emergency hospitalisations, as well as Accident and Emergency attendances, considered as a secondary outcome. Furthermore, we analysed whether the impact of PCNs varied based on practice characteristics. A reduction in all-cause and ACSC hospitalisations was observed following the PCNs' introduction, until the start of the COVID-19 pandemic. The analysis also revealed a smaller reduction in ACSC hospitalisations among practices with more deprived patient populations and larger populations of patients with long-term conditions. While PCNs' implementation appears to have led to a reduction in emergency hospitalisations in North West London, this effect was only observed in the very short term as it stopped with the COVID-19 pandemic. Future studies should examine the effect across England and evaluate their continued impact.
AD - NIHR North West London Patient Safety Research Collaboration, Imperial College London, Queen Elizabeth Queen Mother Wing, St Mary's Hospital, South Wharf Road, London W2 1NY, United Kingdom; Institute of Global Health Innovation, Imperial College London, Queen Elizabeth Queen Mother Wing, St Mary's Hospital, South Wharf Road, London W2 1NY, United Kingdom. Electronic address: l.kovacevic19@imperial.ac.uk.; Centre for Health Services Studies, University of Kent, Canterbury, Kent CT2 7NZ, United Kingdom.; Institute of Global Health Innovation, Imperial College London, Queen Elizabeth Queen Mother Wing, St Mary's Hospital, South Wharf Road, London W2 1NY, United Kingdom.; NIHR North West London Patient Safety Research Collaboration, Imperial College London, Queen Elizabeth Queen Mother Wing, St Mary's Hospital, South Wharf Road, London W2 1NY, United Kingdom; Institute of Global Health Innovation, Imperial College London, Queen Elizabeth Queen Mother Wing, St Mary's Hospital, South Wharf Road, London W2 1NY, United Kingdom; Imperial Clinical Analytics, Research and Evaluation (iCARE) Secure Data Environment, London SW7 2AZ, United Kingdom.; NIHR North West London Patient Safety Research Collaboration, Imperial College London, Queen Elizabeth Queen Mother Wing, St Mary's Hospital, South Wharf Road, London W2 1NY, United Kingdom; Department of Health Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom.; Institute of Global Health Innovation, Imperial College London, Queen Elizabeth Queen Mother Wing, St Mary's Hospital, South Wharf Road, London W2 1NY, United Kingdom; Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom.
AN - 41406703
BT - Health Policy
C5 - General Literature
DA - Dec 5
DO - 10.1016/j.healthpol.2025.105524
DP - NLM
ET - 20251205
JF - Health Policy
LA - eng
N2 - Recent years have seen an emergence of collaborative primary care models in the English National Health Service and other international health systems. Primary Care Networks (PCNs) were introduced in England in July 2019, marking the first time collaboration between general practices was incentivised through a nationwide policy. While participation was not mandatory, nearly all general practices joined a PCN, largely due to strong financial incentives. Our study aim was to estimate the impact of PCNs on emergency hospitalisations using an interrupted time series design. Quarterly data between October 2016 and March 2023 from the North West London Whole Systems Integrated Care dataset was used to construct two primary outcomes: all-cause and ambulatory care sensitive conditions (ACSC) emergency hospitalisations, as well as Accident and Emergency attendances, considered as a secondary outcome. Furthermore, we analysed whether the impact of PCNs varied based on practice characteristics. A reduction in all-cause and ACSC hospitalisations was observed following the PCNs' introduction, until the start of the COVID-19 pandemic. The analysis also revealed a smaller reduction in ACSC hospitalisations among practices with more deprived patient populations and larger populations of patients with long-term conditions. While PCNs' implementation appears to have led to a reduction in emergency hospitalisations in North West London, this effect was only observed in the very short term as it stopped with the COVID-19 pandemic. Future studies should examine the effect across England and evaluate their continued impact.
PY - 2025
SN - 0168-8510
SP - 105524
ST - The impact of primary care networks on emergency hospitalisations in the English NHS: An interrupted time series analysis
T1 - The impact of primary care networks on emergency hospitalisations in the English NHS: An interrupted time series analysis
T2 - Health Policy
TI - The impact of primary care networks on emergency hospitalisations in the English NHS: An interrupted time series analysis
U1 - General Literature
U3 - 10.1016/j.healthpol.2025.105524
VL - 165
VO - 0168-8510
Y1 - 2025
ER -