Primary Health Care

Address: Primary Health Care (Head Office), 7, Harper Lane, Floriana, Malta, FRN 1940

Telephone number for client support or to be transferred to speak to a doctor (24/7): 21231231 or 21222444

Email: customercare.phc@gov.mt​

Facebook: Primary Health Care Malta

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The main aims of Primary Health Care (PHC) are to:

• Provide the public with holistic quality care, based on a multidisciplinary approach.
• Provide PHC services for a healthier society through health education, timely prevention and treatment, thus achieving better health for all. 

One of the key objectives that contribute to the aims of the department is planning services around people’s needs and expectations. This includes identifying behavioural patterns or complaints that constitute or indicate a risk to a person’s health.  PHC teams are the first point of contact for people, bringing health care as close as possible to where people live and work.

PHC services are delivered to the public through ten health centres, and a considerable number of community clinics (bereġ) around Malta and Gozo.

Centres around Malta and Gozo

Victoria Health Centre is open from Monday to Sunday (07:00am to 08:00pm). Services offered are Treatment Room services by the nurses and a General Practitioner (GP) service that are both operational till 08:00pm.

Immunisation services are offered at the Xewkija Community Clinic (Monday to Friday 07:00am to 03:00pm.As regard to Saturday and Sunday, clients need to contact client support centre on 21231231 for the opening hours).

Centres: Table

Primary Healthcare: Flowchart

Scenario 1 – Home Visits

Healthcare Centre: Flowchart

Scenario 2 – Healthcare centre

The General Practitioner (GP) Service

Primary HealthCare offers access to GP services through three pathways namely telemedicine, the walk-in service, and the appointment service. Patient encounters are inputted in the electronic patient records (EPR) offering continuity of care across all entity premises.

Telemedicine

Telemedicine is available from Monday to Sunday including Public Holidays, 24 hours daily. Through tele – and video consultations, GPs at telemedicine offer medical advice to patients in the community, those living in institutions and vet requests for home visits through liaison with Health Centre doctors. 

General Practitioner (GP) Service

The General Practitioner (GP) Service offered from all Health Centres includes primary prevention, the provision of minor medical and surgical interventions as well as medical support in emergency situations. GPs also perform home visits which have been vetted from telemedicine, in cases of medical emergencies, or in patients who are bedbound, frail, or impaired. Referral for further specialist care is done based on the individual case. If the patient has grievous injuries, the GP informs the patient of any limits to confidentiality imposed by mandatory reporting requirements.  In the cases of fracture of major bones, dislocation of a joint, disfigurement of the head or face or any injury which endangers life (and are therefore legally classified as grievous injuries), the doctor is obliged to notify the police irrespective of the patient’s consent, as obliged by Maltese law (Chapter 9 of the Laws of Malta). The doctor is to proceed with the required medical documentation and is legally obliged to report the abuse to the domestic violence unit of Appoġġ.

The GP Appointment Clinic

The General Practitioner (GP) Appointment Service is provided through Community Clinics and Health Centres. Appointment clinics offer longer consultation times for cases that might offer more complexity and would thus need enhanced care and follow-ups.

Outreach Services

Acute Treatment Area and Venepuncture (Bloodletting) Service

The scope of the Acute Treatment Area in a health centre is to provide high quality immediate medical care to acutely sick or injured patients. Whenever patients present themselves with suspected or alleged domestic violence, especially where there is visible physical trauma, these are usually examined by the General Practitioner (GP) and treated for the minor injuries in this area by the nurses.

As is the case with the GP service, in cases presented at the treatment room with physical injuries or trauma resulting from suspected or alleged domestic violence, the perpetrator often accompanies the patient and may refuse to leave the patient alone and may insist on answering questions for the patient. Attempts should be made to speak to the alleged victim in private. Health professionals are legally obliged to report all cases of domestic abuse.

Medical Digital Imaging (X-Ray) Service

All Health Centre X-ray Units possess the capability to image the musculoskeletal system effectively. Nonetheless, it’s crucial to recognize that in cases of domestic violence, the head and face emerge as the frequently affected areas. For injuries sustained in these regions, planar X-rays is not indicated, while CT scan is the preferred diagnostic modality.

Wound Clinic

This appointment-based service caters for the management of wounds of different aetiologies requiring follow-up care. Urgent cases arising from traumatic injuries are managed in the treatment room.

Nurses have an important role to play in the Primary Health Care (PHC) setting. Nursing care offered at this clinic may also involve aiding individuals including children, who have experienced abuse or violence within a domestic context. 

Clients who have sustained traumatic wounds also come to this clinic for dressing changes or suture removal, based on the wound type. Additionally, some patients are referred from Mater Dei Hospital (MDH) after their initial treatment there.

While running this clinic, nurses might encounter individuals who reveal that their wounds are a result of domestic violence (DV). Additionally, nurses might take the initiative to question patients if they suspect indications of DV, particularly when dealing with recurring wounds such as bruises or burns.

Social Worker Services in Healthcare Settings

The Social Worker Services are offered from Tarxien community Clinic and Birkirkara Health Centre. The working schedule is between 07:00am and 15.30pm on Monday and Wednesday at Tarxien Community Clinic while on Tuesday, Thursday and Friday, at Birkirkara Health Centre.

A ticket of referral from General Practitioners (GPs), Allied Health Practitioners, Nursing or Pharmacy professionals working within Primary Health Care is required for this service.  Referral to this clinic is through the normal ticket of referral form, which should be filled in with all the pertinent clinical details. 

The role of a social worker is to intervene with persons who are experiencing any form of social difficulty, including relationship problems, poverty, and substance misuse/abuse amongst others. The social worker can carry out risk/needs assessment, provide emotional support to the client and be a liaison/referral person to other professionals and services.

Some of the possible scenarios that a GP/health professional may come across at the health centre and would be required to refer to the social worker include:

• Patients with injuries secondary to domestic violence
  • Patients being closely monitored and dominated by their respective partner/employer
  • Children with non-accidental injuries
  • Mental health patients needing support and monitoring
  • Substance/alcohol misuse
  • Gambling problems
  • Sexual abuse

The above scenarios are identified through the medical history and behaviours associated with domestic violence and abuse.

Well Baby Clinics

Doctors work in Well Baby Clinics in all health centres on a daily basis according to a fixed schedule. Mothers who deliver their babies at Mater Dei Hospital are invited to bring their baby to the Well Baby Clinic by appointment. Mothers who deliver their babies in private hospital and clinics or at home are requested to make the appointment themselves by calling 21231231 or send an email to wellbabyclinic@gov.mt.

These clinics serve the purpose of clinical examinations and developmental assessments for babies between the ages of 8 weeks and 18 months. Three routine visits are offered, the first being at 8 to 12 weeks of age and then at 8 months and 18 months of age respectively. 

This service offers an opportunity for health care professionals to identify women and babies being abused or babies who may be suffering from abuse. Health care professionals can also identify children and families at risk and in need of more support, whilst improving maternal mental health if needed.

Well Women Clinics

The women’s health clinic encompasses obstetrics and gynaecology clinics.  Community gynaecology is an ever-evolving specialty, which is gathering momentum and is gaining an increasingly essential role.

The Well Women Clinic encompasses the following clinics:

• A Gynaecological Clinic
• Antenatal and Postnatal Clinic
• Screening

Primary Health Care (PHC) offers a gynaecological check-up service including smear tests and any necessary investigations in Health Centres through a ticket of referral from either a health centre or private General Practitioner (GP).  There is also antenatal and postnatal care.

The Gynaecology clinics also offer an opportunity to identify any women suspected to be suffering domestic violence or abuse. Certain gynaecological complaints, signs, and symptoms may prompt enquiry of whether there is the possibility of sexual abuse. There may also be cases of pregnant patients where it is noted that there is severe lack of prenatal care. Other findings may include problem pregnancies which might indicate the possibility of sexual abuse by partner.  These cases require the professional assessment of the gynaecologist.

Where there is clear suspicion of sexual assault, the patient is referred to the A&E Department by the health centre GP as immediate further examinations and investigations are required.

Midwifery Services The midwifery services include the Maternal Health Clinic Screening and Advice, as well as the Parent and Baby Primary Health Support Clinic.

The Well Woman Clinics are run at the following Health centres as per below schedule:

	Monday		Tuesday	Wednesday	Thursday	Friday		Saturday
Clinic	Mosta HC	Gzira HC	Kirkop HC	Poala HC	Gżira HC	B’Kara HC	Qormi HC	Cospicua HC	Poala HC	Mosta HC
Recurrence	Weekly	Weekly	Weekly	Weekly	Weekly	Alternate weeks		Alternate weeks	Every 4 weeks
Time	07:00 – 14:45	07:00 – 14:45	07:00 – 14:45	07:00 – 14:45	07:00 – 14:45	07:00 – 14:45	07:00 – 14:45	07:00 – 12:00
Extension	718	667	217/218	322/323	632	452/453	830/831	562/564	322/323	718

Dietitian, Podiatry and Physiotherapy Clinics

All these clinics are led by allied health professionals who run their own clinics. They see clients on a one-to-one basis, all those aged 18 years and over (16+ years for physiotherapy; under 18 years, children to be accompanied by an adult for dietitian). Thus, they are all able to build a relationship of trust with their clients and recognize signs and symptoms of domestic abuse.

Immunisation, Speech and Language Pathology Clinics

The Immunisation, Speech and Language Pathology Clinics are led by nurses and allied health practitioners. They are also in the unique position of seeing children in their clinics and not only persons who are aged 18 years and over. Thus, they can identify cases of domestic and child abuse in an environment that is accessible and personalised.

Migrant Health Liaison Office

The office is a point of reference for migrants seeking health care services and liaises with other health and social care entities accordingly.  The service of cultural mediators within Primary Health Care (PHC) is provided for migrants in Arabic, Tigrinya and Amharic languages.  Health education sessions related to female genital mutilation (FGM), human trafficking and gender-based violence (GBV) are delivered to migrant population groups. The office also assists and supports migrant women and girls who are at risk of FGM. Health and social care professionals in Malta and Gozo are being trained on FGM and human trafficking.