Family doctors in community homes: here are the 24-hour services for emergencies and chronically ill patients.

Dependent on the national health service or free agents, what are they today? The fate of family doctors, embroiled for years in the national political debate and healthcare landscape with varying fortunes and fan bases, remains uncertain and will certainly not see the light of day before the next regional elections. This is a highly controversial issue, capable of shifting many votes, given the large pool of patients and beyond that each GP, as they are called, brings with them, along with the undisputed consensus they generally enjoy among their patients.

What is certain, however, is that the new family doctors who will assume the single role starting in 2025 will work in community centers, which are the cornerstone of the reorganization of local care envisioned in the National Recovery and Resilience Plan (NRRP). This has been discussed for years, and now a new regional document—designed to standardize the criteria nationwide—provides for "mixed-mode" practice: both in practices and community centers, with schedules dictated by the relevant health authority, scaled based on the number of patients in the clinic. In any case, their work will be provided with a view to 24-hour or 12-hour continuity of care, which should guarantee citizens complete coverage of their health needs, including minor diagnostics, from ultrasounds to ECGs. This will also be achieved through telemedicine, fully integrated with other healthcare providers, from nurses to psychologists to specialists.

Indeed, Health Minister Orazio Schillaci himself has said it repeatedly. He reiterated it in his latest TV appearance: "We cannot even consider launching community medicine without the support and assistance of general practitioners. They will certainly have to spend part of their time in community centers." The trade-off is making the profession, among those most affected by the "desertification" of public healthcare, significantly more attractive. Therefore, family doctors will also be able to specialize, complete with scholarships finally aligned with those of young hospital doctors.

But what will be the role and responsibilities of GPs in community homes? Giving substance to what has so far remained on paper following the indications outlined in Ministerial Decree 77 of 2022, which rewrote community care according to the National Recovery and Resilience Plan (PNRR) three years ago, is the document approved by the Conference of the Regions with the guidelines on the hours of work that primary care physicians with the "single role" will be required to provide in hub and spoke community homes. These are, admittedly, still far from being fully implemented and operational. However, they are one of the hubs of the broader network of healthcare, social health, and social assistance services, and at the same time, once fully operational, they will become "places of life" for the local community. Easily identifiable health centers, in connection with the territorial functional aggregations (Aft) of family doctors, with acute hospitals, polyclinics and counseling centers, community hospitals, territorial operations centers for the sorting of interventions and operators, the operations center of the single number 116117, the Continuity of Care Unit, the service pharmacies, the Single Access Points and the social services of the third sector.

But above all, according to the Regional Guidelines, the Complex Primary Care Units (UCCP) envisaged by the latest collective agreements of the National Health Service (NHS) must "find physical accommodation primarily in community hub homes, while doctors from the simpler AFTs will connect with the relevant UCCPs, acting as sentinels and also in conjunction with other services and hospitals to manage chronic conditions as well as youth problems.