Health systems across the WHO European Region are striving to meet an unprecedented surge in health and care needs caused by the COVID-19 pandemic. Primary care is leading efforts to balance the response to COVID-19 while ensuring the continuity of essential health services. This situation, along with funding and staffing constraints, has put primary care in Spain under strain, pushing primary care teams to work differently to cope with the increased workload. Expanding the role of, and shifting and distributing tasks among, particular primary care professionals and recruiting new professional profiles have made teams work more efficiently amid extremely demanding circumstances.

The COVID-19 pandemic has exposed structural deficits in the Spanish health-care system. Newly enacted policy instruments have enabled the response of primary care — the first point of contact for more than 80% of COVID-19 patients — to evolve from an emergency-driven reaction in the first wave to a more proactive approach in successive waves. Primary care teams focused on providing face-to-face consultations only for urgent-care cases, addressing the needs of patients with all other health conditions through virtual-care delivery. Later in the pandemic, responsibility for providing clinical support to care homes and delivering the massive testing, contact-tracing and vaccination programmes fell to primary care.