Economic evaluation of shifts in services from secondary to primary care

This chapter outlines some of the problems encountered when shifting services across the secondary/primary care interface from an economic perspective, and highlights some of the barriers to progress in this area. The continuing emphasis on a primary care led NHS is likely to encourage a shift of services from secondary to primary care. Economic analysis offers a framework to compare the costs and benefits of different interventions to assist decision makers in effective allocation of limited resources. From the broader NHS perspective, shifts between secondary and primary care aim to maximise the health of the population from a fixed healthcare budget. Current policy making remains firmly in line with the development of a primary care led NHS underpinned by evidence of effectiveness and cost effectiveness. It is important to recognise that shifts in the balance of care are part of an overall process of integration that occurs at a number of levels.