Eddie Donaghy, Kieran D Sweeney, Lauren Ng, Holly Haines, Alexandra Thompson, David Henderson, Harry Hx Wang, Andrew Thompson, Bruce Guthrie, Stewart W Mercer
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引用次数: 0
Abstract
Background: The 2018 Scottish GP contract established GP Clusters and multidisciplinary team (MDT) expansion. Qualitative studies have suggested suboptimal progress with these initiatives.
Aim: To quantify progress since the introduction of the new contract.
Design & setting: A cross-sectional postal survey of all qualified GPs was undertaken in Scotland in 2023.
Method: GPs working lives, career intentions, and views on the new contract were compared with a similar survey conducted in 2018.
Results: In total, 1385/4529 (31%) GPs responded to the 2023 survey compared with 2465/4371 (56%) in 2018. Job satisfaction and negative job attributes were similar in both surveys. Both positive job attributes (P = 0.011) and job pressures (P = 0.004) increased but the changes were small (effect sizes <0.2). Significantly more GPs were planning to reduce hours (P<0.001) and leave direct patient care (P = 0.008) in 2023 than in 2018. Quality leads' views on Cluster working were unchanged, with 70-80% reporting insufficient support. Cluster knowledge and engagement was unchanged but there were small increases in knowledge of quality improvement. More than half of the GPs reported that access to MDT staff was insufficient to reduce their workload in all staff categories except vaccinations. Significantly more practices were trying to recruit GPs (P<0.01), and GPs reported worsening NHS services, higher workload, and lower practice sustainability in 2023 (P<0.001). Only 5% of GPs in the 2023 survey thought that the new contract had improved the care of patients with complex needs.
Conclusions: GPs report few improvements in working life 5 years after the new contract was introduced, and are responding by planning to reduce their hours or leave direct patient care.
期刊介绍：
The British Journal of General Practice is an international journal publishing research, editorials, debate and analysis, and clinical guidance for family practitioners and primary care researchers worldwide.
BJGP began in 1953 as the ‘College of General Practitioners’ Research Newsletter’, with the ‘Journal of the College of General Practitioners’ first appearing in 1960. Following the change in status of the College, the ‘Journal of the Royal College of General Practitioners’ was launched in 1967. Three editors later, in 1990, the title was changed to the ‘British Journal of General Practice’. The journal is commonly referred to as the ''BJGP'', and is an editorially-independent publication of the Royal College of General Practitioners.
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