Developing middle-ground research to support primary care transformation

Healthcare systems across the world are facing common challenges relating to changing demographics, and in particular ageing populations. In the UK multimorbidity is a key common denominator in frailty in older people, and health inequalities in younger age groups. There is substantial divergence in how the four nations of the UK are responding to this challenge. In this editorial we describe the Scottish approach to primary care transformation and how better evidence to support transformation can be generated in countries undergoing healthcare reforms.