Levers for change in primary care: a review of the literature

This brief literature review was commissioned by NHS England to inform the Fuller Stocktake.

This is not a review of the effectiveness of particular innovations or service changes, rather it considers the available literature on the processes and levers used in programmes of change, improvement, innovation and transformation in primary care, with a particular focus on general practice.

Drawing from literature from the English health system and international systems, we review key levers of change and suggest the main lessons learned through the evidence.