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As the health and care system in England evolves, facing challenges and opportunities on its way, the need for transformation becomes increasingly evident (Murray 2019b). Particularly clear is the need for a more joined-up health and care approach with focus at its heart on population health (Buck et al 2018). Numerous examples of innovative practice exist, but challenges are faced when spreading this practice more widely (Dougall et al 2018).

In this report we look at factors that contributed to the spread of the ‘primary care home’, a type of primary care network, from concept to more than 200 sites in a few years. We draw on a series of interviews with staff from the National Association of Primary Care (NAPC, who curated the primary care home concept for use in England in 2015), NHS England (who supported the work) and local sites (who delivered changes on the ground).

The report identifies factors that enabled the spread of primary care homes, as well as the factors that made the spread harder. It provides insights for the NAPC and others that can inform their health and care transformation efforts.