Co-location of services: an umbrella review of how primary care estates can be used better to support disadvantaged groups
Br J Gen Pract. 2025 May 22;75(suppl 1):bjgp25X742125. doi: 10.3399/bjgp25X742125. Print 2025 May.
ABSTRACT
BACKGROUND: There are thousands of primary care estates and premises across the country. They present an ideal opportunity to both support communities, especially in disadvantaged areas, and improve integrated care.
AIM: We explored the impact of co-located community and health services in primary care to support disadvantaged groups.
METHOD: We undertook an umbrella review using a systematic search in Ovid Medline and Ovid Embase with supplementary snowball and grey literature searches. Systematic reviews of co-located services supporting disadvantaged groups in primary care were included. Screening and data extraction was conducted by two reviewers. Quality was assessed using the AMSTAR2 and data analysed narratively. Outcomes were synthesised according to five domains: access and engagement, quality of care, efficiency, improved health and improved social factors.
RESULTS: The database search identified 2626 studies, supplemented by snowball and grey literatures searches, resulting in thirteen included studies. Three models of care were identified; six included reviews focus on legal or welfare advice services and seven focus on speciality healthcare. We found evidence that co-located services can improve access to care, engagement in treatment and quality of care for disadvantaged groups. Improvements to social determinants of health and mental health and wellbeing outcomes were reported. Efficiency outcomes, including healthcare utilisation were varied.
CONCLUSION: Co-located services in primary care have the potential to improve identification of people most in need and improve their access to care and social support. Policy makers and practitioners should maximise the use of primary care estates to support disadvantaged groups and communities.
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