Who’s who in General Practice?

National Institute for Health and Care Research | https://doi.org/10.3310/nihrevidence_61223

This NIHR Evidence Collection brings together research for general practices and Primary Care Networks to help them maximise benefit from new roles and the growing diversity in their staff, and could be used by practices to help patients and the public understand the changes they are experiencing in primary care.

Full detail: Who’s who in General Practice? Research can help practices introduce new roles

Continuity of care: Delayed diagnosis in GP practices

via Health Services Safety Investigations Body

Patients who visit their GP practice with an ongoing health problem may see several different GPs about the same symptoms. To make sure they receive safe and efficient care, there needs to be a system in place to ensure continuity of care. In the context of this report, continuity of care is where a patient has an ongoing relationship with a specific doctor, or when information is managed in a way that allows any doctor to care for a patient.

While some GP practices in England operate a formalised system of continuity of care, many do not. This investigation explored the safety risk associated with the lack of a system of continuity of care within GP practices.

This investigation’s findings, safety recommendations and safety observations aim to prevent the delayed diagnosis of serious health conditions caused by a lack of continuity of care and to improve care for patients across the NHS.

Full report: Continuity of care: delayed diagnosis in GP practices

Supporting family carers in general practice

Cronin, M. et al. | Supporting family carers in general practice: a scoping review of clinical guidelines and recommendations | BMC Primary. Care 24, 234 (2023) | https://doi.org/10.1186/s12875-023-02188-1

Increasing numbers of family carers are providing informal care in community settings. This creates a number of challenges because family carers are at risk of poor physical and psychological health outcomes, with consequences both for themselves and those for whom they provide care. General Practitioners (GPs), who play a central role in community-based care, are ideally positioned to identify, assess, and signpost carers to supports. However, there is a significant gap in the literature in respect of appropriate guidance and resources to support them in this role.

This scoping review was undertaken to examine clinical guidelines and recommendations for GPs to support them in their role with family carers. It addresses a significant gap in the literature by providing an important synthesis of current available evidence on clinical guidelines for GPs in supporting family carers, including strategies for identification, options for assessment and potential referral/signposting routes.

Full paper: Supporting family carers in general practice: a scoping review of clinical guidelines and recommendations

Medical students’ perceptions of General Practice

Banner, K. et al. | ‘They say’: medical students’ perceptions of General Practice, experiences informing these perceptions, and their impact on career intention—a qualitative study among medical students in England | BMJ Open | 2023; 13: e073429. | doi: 10.1136/bmjopen-2023-073429

The number of UK graduates choosing General Practice training remains significantly lower than the current numbers required to meet the demands of the service. This work aims to explore medical students’ perceptions of General Practice, experiences which lead to the development of these perceptions, and the ultimate impact of these on career intention.

This mixed-methods, qualitative study concludes that future strategies to recruit graduates to General Practice need to consider factors at an undergraduate level. Positive placement experiences should be maximised, while avoiding overtly ‘pushing’ GP onto students.

Full paper: ‘They say’: medical students’ perceptions of General Practice, experiences informing these perceptions, and their impact on career intention—a qualitative study among medical students in England

Strengthening primary and community care services

Healthwatch

Staff in primary and community care settings are facing immense challenges, with both clinical and administrative workforce shortages combining with a rise in demand for increasingly complex care. This briefing shows how people’s experiences can be used to support the development of a long-term vision to strengthen primary and community care services.

The briefing analyses the experiences people shared with Healthwatch and identified what is working well and which areas patients want to see improved. Recommendations are made to help inform a future vision for primary care and drive efficiencies across the whole system.

Full briefing: Strengthening primary and community care services – the foundation for most care and treatment

New general practice team campaign launched

NHS England has launched a new campaign to highlight the different health professionals in general practice teams who are helping patients get the right care, more easily, first time. The campaign, which will also highlight the important role of general practice reception teams, is a key commitment in the recovery access plan and will run until March 2024. A toolkit and a range of assets, including social media visuals, are available to download to support the general practice team campaign.

Further detail: Campaign toolkit to support GP Access Team campaign

In this film, three children go behind the scenes at a general practice to meet a range of health professionals working in general practice:

Supporting general practice at scale: fit for 2024/25 and beyond

NHS Confederation

Tangible actions to address some of the immediate pressures facing general practice and primary care networks across the country. The overarching focus of these recommendations is to:

• Increase trust and flexibility through the contracts so primary care can deliver for local people based on local needs, with a key focus on prevention and addressing health inequalities.
• Support the basic infrastructure with dedicated funding and funding uplifts that mirror the rest of the system.
• Make primary care a more attractive place to work.
• Where possible, use contractual and non-contractual levers to make it easier for primary care to work with the rest of the system within a local community.

Read the Report – Supporting general practice at scale: fit for 2024/25 and beyond

Empowered, connected and respected: a vision for general practice at scale and primary care networks

This paper explores what is needed to develop a robust, resilient and thriving future for primary care | NHS Confederation

This paper sets out a vision for at-scale general practice in the context of the three core principles of the Fuller stocktake: personalised care for those who need it most delivered through integrated neighbourhood teams, a joined-up approach to prevention and streamlined access.

At-scale primary care is a critical system partner with the potential to deliver significant progress towards the ambitions of integrated care systems, and it must be empowered to lead and innovate to meet that potential.

To deliver the right care in the right place, primary care must have the flexibility and support to develop models of delivery which suit the needs of their population. Embracing new models and economies of scale shaped by primary care providers has the potential to build on the success of existing at-scale providers who have demonstrated that they can provide more efficient and effective care as part of an integrated system.

Full paper: Empowered, connected and respected: a vision for general practice at scale and primary care networks

A positive vision for equitable primary care

The findings of two academic projects – EQUALISE and FAIRSTEPS – have been brought together to produce a toolkit for addressing unequal access to primary care | via Queen Mary University of London

Addressing inequalities in primary care is crucial for achieving high-quality healthcare for all. Primary care serves as the foundation of the healthcare system, being the first point of contact for most people seeking help. But unequal access to these services can perpetuate health inequalities. By addressing issues of access, we can ensure that everyone, regardless of their socioeconomic status, race, gender, or geographic location, has an equal chance of comprehensive and timely care.

Two academic groups have independently looked at what works to address inequalities in and through primary care. EQUALISE and FAIRSTEPS have produced a solution-focused toolkit that brings together the findings of the two studies to describe what equitable primary care looks like, and provide practical steps to help local decision makers address inequalities in health and healthcare.

Full detail: Building Equitable Primary Care – a toolkit for practitioners and decision makers

Dr John Ford of Queen Mary’s Clinical Effectiveness Group gives an insight into the development and recommendations of the toolkit.

Multidisciplinary teams in general practice: What this means for people experiencing health inequalities and frequent users of primary care services

Via National Voices

The model of general practice is changing and, at the core of this, general practice is moving away from a model of ‘seeing a GP’ to a model that is ‘consulting with the multi-disciplinary team’. This project set out to understand awareness and experience of multidisciplinary teams across two groups: frequent users of primary care services and those who experience health inequalities.  

The project found that: 

• There was a low level of awareness of multidisciplinary teams, including amongst people who frequently use primary care.  
• In the current context of pressures in primary care, people often felt that multidisciplinary teams were a cost reduction measure, rather than an initiative designed to improve their care. This was the case, even though most people reported positive experiences with individual members of the multidisciplinary team. 
• For some groups, particularly those who have experienced inequalities and barriers to primary care, the shift to multidisciplinary teams can be experienced as a further barrier to participation in health and care.  
• The major themes that emerged were the importance of embedding practice within multidisciplinary teams which build trust, valuing the time and energy of patients and setting clear and reasonable expectations of what primary care users can expect. 

The report presents these insights and makes recommendations on how to improve experiences of multidisciplinary teams within general practice amongst populations who experience health inequalities and frequent users of primary care services. In particular, the report highlights how primary care teams can build trust and assure people that general practice has oversight of their care.

Full report: A shift to multidisciplinary teams in general practice: What this means for people experiencing health inequalities and frequent users of primary care services