In Spain, primary health care (‎PHC)‎ has played an important role in achieving good health outcomes among the population. Since the turn of the 21st century, PHC has shown signs of fragility. In the aftermath of the coronavirus disease (‎COVID-19)‎ pandemic, the PHC system in Spain is at a crossroads, also driven by changes in demography, population health-care needs and expectations and innovation.

This case study has two overarching aims. First, to inform and support the dialogue among actors in Spain’s health-care system about how to move forward and strengthen PHC; and second, to provide a snapshot of the PHC model of care in Spain to an international audience. To achieve these aims, this case study focuses on providing a comprehensive analysis of the current state of the PHC system, how it is performing and how the providers and decision-makers perceive the key challenges and opportunities.

The case study concludes with a set of recommendations to enhance the development and sustainability of PHC in the broader health-care system in Spain.