Skill-mix innovation, effectiveness and implementation : improving primary and chronic care

"Access to and the quality of health services are closely linked to the density and skill-mix of a country's health workforce (OECD, 2016; World Health Organization, 2006, 2016). High rates of chronic conditions and multimorbidity, new treatment options, and technological advances and economic pressure have led to fundamental changes to health systems and have impacted on the daily work of health professionals. Many countries worldwide are experiencing a shortage of primary care providers, particularly in rural or socially deprived urban areas (OECD, 2016; World Health Organization, 2013). Primary care systems face the challenge of ensuring a sustainable workforce to allow timely access to services, high-quality care and person-centred services (Kringos et al., 2015a, 2015b). Against this backdrop, the skills and composition of the workforce have changed in many countries and settings to meet the increasing and diversifying demands of patients (Dubois & Singh, 2009; Freund et al., 2015). At the same time, health promotion and prevention are gaining increasing attention among primary care providers to ensure that all people can live in good health. Moreover, the global coronavirus disease 2019 (COVID-19) pandemic has brought to the forefront the necessity of having a well-qualified health workforce that has surge capacity, competencies and flexibility to react to shortterm crises (WHO Regional Office for Europe, 2020)."