Robert Oliver Barker, Rachel Stocker, Siân Russell, Barbara Hanratty
{"title":"Future-proofing the primary care workforce: A qualitative study of home visits by emergency care practitioners in the UK.","authors":"Robert Oliver Barker, Rachel Stocker, Siân Russell, Barbara Hanratty","doi":"10.1080/13814788.2021.1909565","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Broadening the skill-mix in general practice is advocated to build resilience into the primary care workforce. However, there is little understanding of how extended-scope practitioners from different disciplines, such as paramedicine and nursing, embed into roles traditionally ascribed to general practitioners (GPs).</p><p><strong>Objectives: </strong>This study sought to explore patients' and professionals' experiences of a primary care home visiting service delivered by emergency care practitioners (ECPs), in place of GPs; to determine positive impacts/unintended consequences and establish whether interdisciplinary working was achieved.</p><p><strong>Methods: </strong>Three practices in England piloted an ECP (extended-scope practitioners with a paramedic or nursing background) home visiting service (November 2018-March 2019). Following the pilot, focus groups were conducted with each of the three primary healthcare teams (14 participants, including eight GPs), and one with ECPs (five participants) and nine individual patient interviews. Data were analysed using a modified framework approach.</p><p><strong>Results: </strong>The impact of ECP home visiting on GP workload and patient care was perceived as positive by patients, GPs and ECPs. Initial preconceptions of GPs and patients about the ECP role and expertise, and reservations about the appropriacy of ECPs for home visiting, were perceived to have been overcome by the expertise and interpersonal skills of ECPs. Fostering a culture of collaboration between ECPs and GPs was instrumental to remodelling professional boundaries at the practice level.</p><p><strong>Conclusion: </strong>Broadening the skill-mix to incorporate extended-scope practitioners such as ECPs, to deliver primary care home visiting, presents an opportunity to increase resilience in the general practice workforce.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"27 1","pages":"68-76"},"PeriodicalIF":2.3000,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13814788.2021.1909565","citationCount":"4","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of General Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/13814788.2021.1909565","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 4
Abstract
Background: Broadening the skill-mix in general practice is advocated to build resilience into the primary care workforce. However, there is little understanding of how extended-scope practitioners from different disciplines, such as paramedicine and nursing, embed into roles traditionally ascribed to general practitioners (GPs).
Objectives: This study sought to explore patients' and professionals' experiences of a primary care home visiting service delivered by emergency care practitioners (ECPs), in place of GPs; to determine positive impacts/unintended consequences and establish whether interdisciplinary working was achieved.
Methods: Three practices in England piloted an ECP (extended-scope practitioners with a paramedic or nursing background) home visiting service (November 2018-March 2019). Following the pilot, focus groups were conducted with each of the three primary healthcare teams (14 participants, including eight GPs), and one with ECPs (five participants) and nine individual patient interviews. Data were analysed using a modified framework approach.
Results: The impact of ECP home visiting on GP workload and patient care was perceived as positive by patients, GPs and ECPs. Initial preconceptions of GPs and patients about the ECP role and expertise, and reservations about the appropriacy of ECPs for home visiting, were perceived to have been overcome by the expertise and interpersonal skills of ECPs. Fostering a culture of collaboration between ECPs and GPs was instrumental to remodelling professional boundaries at the practice level.
Conclusion: Broadening the skill-mix to incorporate extended-scope practitioners such as ECPs, to deliver primary care home visiting, presents an opportunity to increase resilience in the general practice workforce.
期刊介绍:
The EJGP aims to:
foster scientific research in primary care medicine (family medicine, general practice) in Europe
stimulate education and debate, relevant for the development of primary care medicine in Europe.
Scope
The EJGP publishes original research papers, review articles and clinical case reports on all aspects of primary care medicine (family medicine, general practice), providing new knowledge on medical decision-making, healthcare delivery, medical education, and research methodology.
Areas covered include primary care epidemiology, prevention, diagnosis, pharmacotherapy, non-drug interventions, multi- and comorbidity, palliative care, shared decision making, inter-professional collaboration, quality and safety, training and teaching, and quantitative and qualitative research methods.