PHSSR Policy Roadmaps for Acting Early on NCDs Synthesis Report 2025

54 Acting early on NCDs The Partnership for Health System Sustainability and Resilience■ Develop structured coordination protocols Clear frameworks should specify responsibilities between primary and specialist care, including criteria for specialist referral, coordination arrangements, and back-referral to primary care once stable. These protocols should address common scenarios such as patients requiring multiple specialist opinions, ensuring coordination rather than fragmentation. ■ Address geographic disparities in specialist access Solutions must recognise that rural populations face compound disadvantages at every stage. This requires hub-and-spoke models linking rural primary care to urban specialists, telemedicine for consultations that do not require physical examination, and mobile specialist services for underserved areas. Transport support and accommodation assistance may be necessary for those requiring in-person specialist care. ■ Build monitoring systems that track complete specialist pathways Health systems need to measure not just individual waiting times but total time from initial referral to specialist assessment and onwards to treatment, disaggregated by condition, geography, and socioeconomic status. Regular public reporting of pathway performance can drive improvement through transparency whilst identifying where targeted interventions are most needed.