Since the 1970s there has been a growing policy and practice interest in the public health role of primary care but little is known about the effectiveness of delivery of health improvement and disease prevention within primary care settings. In order to understand how such services are delivered in UK general practice and to identify what evidence there is of effectiveness we undertook a review that examined who delivers interventions, where they are located, what approaches are developed in practices and how individual practices and the primary healthcare team organise such public health activities. Generally, little attention has been paid to examining the impact of the organisational context on the way public health services are delivered or how this affects the effectiveness of health promoting interventions in general practice. While health promotion is seen as an integral part of primary care practice, the main focus of research has been on individual, secondary prevention approaches despite general practices engaging in both primary and secondary prevention activities. Consequently there is insufficient good quality evidence to support many of the preventive interventions undertaken in primary care and more attention needs to be paid to the role of primary care organisations in promoting public health.

Professor Willem J.J. (Pim) Assendelft is professor in general practice and head of the department of Primary and Community Care of the Radboud University Medical Center, which involves both general practice and public health. His research focuses on prevention (connection between public health and primary care) and on organization of care and outcomes research.
He was member of the committee Prevention of the Netherlands Organization for Health Research and Development (ZonMw) and of the Taskforce Prevention of the recently running National Science Agenda.
His aim is to bridge the gap between research and practice. In Nijmegen he is board member of the Radboudumc research theme "Healthcare Improvement Science". He is member of the steering group of "Nijmegen Green, Healthy and in Movement", a 10 year collaboration between the municipal health service, municipality and the university medical center. He has an important role in the recently established national course of Prevention of the vocational GP training.

The Netherlands are characterized by a strong primary healthcare system. All persons are registered at a general practice. This provides opportunities for a role of the general practitioners (GPs) in health promotion and community care in a broader sense. GPs see all persons in the community and are a trusted person concerning health matters. In addition, health complaints are a good starting point for lifestyle change. Despite this opportunities, primary care is hesitant in taking a large role in health prevention. Main barriers are role definition by primary care workers, lack of specific training in prevention and lacking reimbursement. A national initiative for a prevention consultation at the GP’s office has pitifully failed.
Fortunately, the last decade some promising developments have taken place. In the GP vocational training "prevention" has been selected as one of the 8 core themes of the training. A national obligatory course, specially developed for this purpose, has started in 2018. The national Health Insurance Board has decided that several sorts of indicated prevention, like smoking cessation support, alcohol counselling and depression prevention, is now reimbursed. Most likely, next year a costly intensive integrated lifestyle intervention for obesity is also being reimbursed.
In the background some hopeful developments are taking place. The national organizations of both medical specialists and GPs have given prevention a prominent place in their recent vision documents. On a local level, due to national legislation, all municipalities are giving shape to a community-based interaction between the welfare and medical domain. Social welfare teams that are formed by the municipality are supposed to work closely together with primary care. On a regional level municipal health services are collaborating with public and primary care departments at universities in so-called academic collaborative centers. On the national level organizations of healthcare providers, health insurance companies, hospitals and the government are now working towards a collective "Prevention deal".
Bridging the gap between public health and primary care is a process of taking small steps and being patient. I would like to share my personal experiences with you, and hope to inspire you to proceed working on collaboration between sectors.