Primary Care Development in China
Within the theme of Global Health, there is a well-established team working on Primary Care Development in China.
Led by Professor KK Cheng , Director of the Institute of Applied Health Research (IAHR) and in close collaboration with colleagues from the NHS and Health Education England, this team has over ten years’ experience working at various levels with colleagues in China in their redevelopment of primary healthcare and general practice. One of our key objectives is to develop cohorts of future leaders and relevant infrastructure in health policy, health service management, clinical care delivery, education and research that are essential for a thriving primary care system.
The University of Birmingham (UoB) has a long record and very extensive links in China. KK Cheng is the Founding Head of General Practice at Peking University Health Science Center (or PUHSC, the premier medical school in China). In April 2014, a Memorandum of Understanding was signed between the UoB, Health Education England, PUHSC and the National Steering Committee for Medical Professional Degree Education of China. This has provided a strong platform for developing further links in postgraduate training in the areas of General Practice. In addition to academic links in China, we have been collaborating closely with the National Health Commission (NHC) and health commissions in major provinces and cities. Through our wide range of work that cuts across a number of relevant sectors (see below), we have also established an extensive network at national and local levels.
Influencing policy and implementation
Our regular and in depth interactions with the NHC (especially the Primary Care Directorate and the Science and Education Directorate) have allowed us to provide input to national policies relevant to primary care. The three most significant were enshrined in: Guidance on the Establishment of a General Practitioner system (2011); Guidance on Setting Up Hierarchical Medical System (2015); and Reforming and Improving General Practitioner Training and Incentive Mechanisms (2018). During the drafting of these key documents, we had extensive dialogues with relevant officials at the Ministry/Commission. Our contacts with colleagues at the provincial and municipal levels have also contributed to the local implementation of these policies.
Training and capacity building
Providing opportunities for the sharing of British experiences in developing primary care with health officials in the NHC and provincial and municipal health commissions:
- We have organised various training programmes and incoming visits for more than 100 senior managers from the NHC, 400 senior health service managers from provinces and cities including Beijing, Shanghai, Guangzhou, Shenzhen and Qingdao. In 2019, four delegations from the NHC, Chongqing, Guangzhou and Chengdu will receive training in Birmingham, under the auspice of a programme approved by the relevant administrative agency of the State Council of China.
Training front line clinical GPs and GP trainers based on the British model:
- We have held a number of courses and training for GPs since 2011, which catered for more than 5,000 GPs and 1,000 GP trainers in China. We have also organised 12 Training the Trainers programmes in Birmingham attended by over 200 GP trainers from more than 40 Chinese medical schools.
- Six China-UK GP collaboration-training centres have been established, with four ranking in the top 100 community health centres in China,
Inspiring top medical students and GP vocational trainees by exposing them to first class primary care service in the UK
- Recognising the importance of early exposure to high quality general practice among medical students and GP trainees, IAHR has hosted a number of these individuals from Peking University Health Science Centre since 2014.
Developing academic capacity in key academic departments of General Practice in China
- KK Cheng founded the Department of General Practice at Peking University Health Science Center in 2011, which has become one of the strongest in the country. Professor Chunhua Chi, one of the first faculty members, succeeded KK Cheng as Head of Department and is President Elect of Chinese Society of General Practice. In 2017 the UoB signed an agreement with Sun-Yat Sen University to establish a Primary Care training centre at its First Affiliated Hospital, in a ceremony that was witnessed by current Vice Premier Hu Chunhua. Our successes have attracted attention from other key medical schools and teaching hospitals, which have expressed strong interests in collaborating with us in developing further the academic discipline.
- KK Cheng is Principal Investigator of two large population cohorts in Guangzhou and has been involved in a wide range of collaborative research activities in public health and primary care. Lately, with the support of two NIHR Global Health programmes in COPD (Breathe Well) and atrial fibrillation (Global AF Reach) (£2m funding each), we have consolidated our community based research in these areas. KK Cheng also helped to establish the Chinese Alliance for Respiratory Diseases in Primary Care, an organisation led by Professors Chen Wang and Chunhua Chi.
- We also provide training to public health and health service researchers with interest in primary care and have hosted a large number of visiting fellows from China who worked on community based research. KK Cheng has also supervised a number of Chinese PhD students working in this area.
Credential in delivering large scale projects
We are one of the largest applied health research institutes in the UK, with a comprehensive range of world leading expertise that enables us to conduct high quality research and education nationally and globally. Our current total annual research award is approximately £17m and we ranked 6th in the country among 32 British universities in the last Research Excellence Framework (2014) in terms of research income per FTE. In the global health arena, our staff lead or are key contributors to research awards in excess £25m. We are one of the most successful universities in several main funding schemes of the National Institute for Health Research.
British General Practice already enjoys an unsurpassed reputation in China. We are confident that our continuing efforts to develop people and infrastructure in primary care in collaboration with our partners in both public and private sectors will help to further strengthen the position of British general practice and academia in China at this critical phase of their primary care development. Capitalising on this historic opportunity would help us to contribute to the development of a sustainable health service in China.