Integrating a nationally scaled workforce of community health workers in primary care: a modelling study
File(s)CHWs paper-JRSM-10th Aug-final.docx (134.6 KB)
Accepted version
Author(s)
Type
Journal Article
Abstract
Objective
To model cost and benefit of a national community health worker workforce.
Design
Modelling exercise based on all general practices in England.
Setting
United Kingdom National Health Service Primary Care.
Participants
Not applicable.
Data sources
Publicly available data on general practice demographics, population density, household size, salary scales and screening and immunisation uptake.
Main outcome measures
We estimated numbers of community health workers needed, anticipated workload and likely benefits to patients.
Results
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.
Conclusion
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.
To model cost and benefit of a national community health worker workforce.
Design
Modelling exercise based on all general practices in England.
Setting
United Kingdom National Health Service Primary Care.
Participants
Not applicable.
Data sources
Publicly available data on general practice demographics, population density, household size, salary scales and screening and immunisation uptake.
Main outcome measures
We estimated numbers of community health workers needed, anticipated workload and likely benefits to patients.
Results
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.
Conclusion
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.
Date Issued
2018-12-01
Date Acceptance
2018-09-07
Citation
Journal of the Royal Society of Medicine, 2018, 111 (12), pp.453-461
ISSN
1758-1095
Publisher
SAGE Publications
Start Page
453
End Page
461
Journal / Book Title
Journal of the Royal Society of Medicine
Volume
111
Issue
12
Copyright Statement
© The Royal Society of Medicine 2018
Subjects
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
Clinical
family medicine
general practice/family medicine
health policy
non-clinical
public health
BRAZIL
INTERVENTIONS
OUTCOMES
1117 Public Health And Health Services
Publication Status
Published
Date Publish Online
2018-10-04