Community homes and family doctors, the hubs open 24 hours a day

All doctors joining the national health system starting in 2025 will have a dual obligation: to practice to care for their patients, and to work on an hourly basis, assigned by the relevant health authority, in community centers connected to hospitals and clinics. The old concept of on-call doctors will also be abolished, with a 24-hour community care system.

The goal is to relieve hospitals of white codes, which can be easily managed by equipped facilities in the area. Care will be provided continuously, night and weekends, and during the day and weekdays.

Health Minister Orazio Schillaci has always supported this approach, and the reform has taken another step forward. The guidelines that dictate the rules for the operation of community centers, the structures that will reform community medicine, were approved by the Conference of the Regions on September 9th. It will now be up to the Regions to make this actually operational, especially given the difficulties in recruiting new doctors for this role among the growing ranks of young people.

Essentially, there will be two reference points: hubs and spokes. In Community Homes, the "hub and spoke" model identifies a hub facility as the reference center for more complex healthcare services and for continuity of care, with a 24/7 medical presence. Spoke facilities, on the other hand, are smaller, more widespread primary care centers, offering basic services and serving as a point of contact between the citizen and the healthcare system, connecting to the hubs for more complex cases.

Doctors will be present 24/7 in the hubs, and 12/6 in the spokes. Hourly activities include outpatient visits for non-deferrable needs, team management of chronic conditions and frailty, public health and health promotion interventions, initial diagnostic screenings, and assistance to tourists, out-of-town students, and non-resident citizens.

The facilities will be equipped with ECGs, ultrasound scanners, rapid examination equipment, access to clinical databases, and devices for teleconsultation and telemedicine.

A key role is also assigned to the care of chronically ill and frail patients, in collaboration with nurses and specialists. A commitment to prevention and health education activities is also planned: vaccination campaigns, promotion of healthy lifestyles, and interventions for at-risk groups, including through population stratification by needs and proactive medicine.