Determinants of primary care workforce variation in England

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711389
Author(s):  
Jon Gibson ◽  
Sharon Spooner ◽  
Matt Sutton
Keyword(s):  
General Practice ◽  
Significant Proportion ◽  
List Size ◽  
Employment Decisions ◽  
Patient Demographics ◽  
Practice Characteristics ◽  
Primary Care Workforce ◽  
Total List ◽  
Varied Range ◽  
The Government

BackgroundThe General Practice Forward View (GPFV) outlined how the government plans to attain a strengthened model of general practice. A key component of this proposal is an expansion of the workforce by employing a varied range of practitioners, in other words ‘skill mix’. A significant proportion of this investment focuses on increasing the number of ‘new’ roles such as clinical pharmacists, physiotherapists, physician associates, and paramedics.AimThe aim of this study is to examine what practice characteristics are associated with the current employment of these ‘new’ roles.MethodThe study uses practice level workforce data (2015–2019), publicly available from NHS Digital. The authors model FTE of specific workforce groups (for example, advanced nurse) as a function of deprivation, practice rurality, patient demographics (total list size and percentage of patients aged >65 years) and FTEs from other staff groups.ResultsAlthough analysis is ongoing, initial estimation suggests that the employment of ‘new’ roles has occurred in larger practices (in terms of list size), in practices with a higher proportion of patients living in deprived areas and practices with a larger proportion of patients aged >65 years. FTE for advanced nurses is negatively associated with GP FTE.ConclusionA negative correlation between advanced nurse FTE and GP FTE is potentially suggestive of substitution between roles, deliberate or otherwise. For example, practices may employ ‘new’ roles if they are unable to recruit GPs or they may recruit staff to free up GP time. Further work is needed to confirm these findings and to explore the reasons behind practice employment decisions.

Motivating factors behind skill mix change: results from a practice managers’ survey in England

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711401
Author(s):  
Jon Gibson ◽  
Sharon Spooner ◽  
Matt Sutton ◽  
Imelda McDermott ◽  
Mhorag Goff ◽  
...  
Keyword(s):  
Data Collection ◽  
Financial Assistance ◽  
Motivating Factors ◽  
Online Questionnaire ◽  
Employment Decisions ◽  
Skill Mix ◽  
Early Results ◽  
Primary Care Workforce ◽  
Varied Range ◽  
Appointment Availability

BackgroundThe expansion of the primary care workforce by employing a varied range of practitioners (‘skill mix’) is a key component of the General Practice Forward View (GPFV). The extent of skill mix change and where that has occurred has been examined using publicly available practice level workforce data. However, such data does not provide information regarding specific motivating factors behind employment decisions for individual practices nor future workforce plans.AimTo identify key motivating factors behind practice workforce decisions and their future workforce plans.MethodAn online questionnaire was sent to practice managers in England. Data collection is ongoing; however, 1000 practices have responded to the survey so far. The questionnaire was composed of questions related to current workforce, motivating factors behind employment decisions, planned future workforce changes, financial assistance with employing staff (for example, HEE or CCG funding) and ideal workforce.ResultsEarly results indicate that practices that have employed physician associates have done so to increase appointment availability (78% of practices) and release GP time (68%). Sixty-six per cent of practices who have employed pharmacists have received some form of financial assistance with 21% of practices still receiving assistance. When asked to construct an ideal workforce, ‘new’ roles accounted for 20% of that workforce on average, which is a significantly larger proportion than those roles currently account for.ConclusionAlthough data collection and analysis are ongoing, the results of the survey provide novel insights into the underlying motivating factors behind employment decisions, specifically for new roles such as pharmacists, PAs and paramedics.

scholarly journals Skill mix in primary care: the scale and distribution of skill mix in GP practice across England

2019 ◽  
Vol 69 (suppl 1) ◽  
pp. bjgp19X702869
Author(s):  
Imelda McDermott ◽  
Sharon Spooner ◽  
Jon Gibson ◽  
Matt Sutton ◽  
Mark Hann ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Descriptive Analysis ◽  
Significant Proportion ◽  
Data Set ◽  
Diverse Range ◽  
Skill Mix ◽  
Practice Level ◽  
New Ways Of Working ◽  
The Government

BackgroundDecades of under investment in primary care and inattention to suboptimal recruitment and retention of GPs and nurses have contributed to a workforce crisis. The General Practice Forward View sets out how the government is planning to achieve a strengthened model of general practice. A key element of this proposal is to expand the workforce by employing an increasingly diverse range of practitioners i.e. ‘skill mix’. The commitment to broadening skill mix in primary care is reiterated in the NHS Long Term Plan (LTP), with the announcement of a 5-year deal to boost investment in primary care. A significant proportion of this investment focuses on increasing the number of ‘new’ roles such as clinical pharmacists, physiotherapists, physician associates, and paramedics.AimThis presentation offers an early analysis of the scale and distribution of current skill mix in general practice across England. This is part of a wider study about how skill mix is affecting outcomes, costs, and experiences of healthcare in England.MethodDescriptive analysis of a longitudinal practice-level workforce data set using the practice-level workforce Minimum Data Set (wMDS).ResultsWe will present early findings about how staffing has changed and average changes within a region or a clinical commissioning group.ConclusionThese data will indicate the extent of progress towards achievement of the LTP vision of skill mix employment. Findings will inform our future analysis of the structures, contexts, and processes of these new ways of working and provide policymakers, commissioners, and practices with evidence about the wider effects of skill mix.

scholarly journals Acceptability of physician associate interns in primary care: results from a service evaluation

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Elizabeth Cottrell ◽  
Victoria Silverwood ◽  
Alex Strivens-Joyce ◽  
Lucy Minshull ◽  
John J. Edwards ◽  
...  
Keyword(s):  
Primary Care ◽  
Analysis Data ◽  
Service Evaluation ◽  
Full Potential ◽  
Patient Acceptability ◽  
Practice Characteristics ◽  
Primary Care Workforce ◽  
Data Collection And Analysis ◽  
Or Practice ◽  
Five Practices

Abstract Background Physician associates (PA) form part of the policy-driven response to increased primary care demand and a general practitioner (GP) recruitment and retention crisis. However, they are novel to the primary care workforce and have limitations, for example, they cannot prescribe. The novel 1 year Staffordshire PA Internship (SPAI) scheme, introduced in 2017, was established to support the integration of PAs into primary care. PA interns concurrently worked in primary and secondary care posts, with protected weekly primary care focussed education sessions. This evaluation established the acceptability of PA interns within primary care. Methods All ten PAs from the first two SPAI cohorts, the nine host practices (supervising GPs and practice managers) and host practice patients were invited to participate in the evaluation. A conceptual framework for implementing interventions in primary care informed data collection and analysis. Data were gathered at three time points over the internship from practices, through discussions with the supervising GP and/or practice manager, and from the PAs via discussion groups. To enrich discussion data, PA and practices were sent brief surveys requesting information on PA/practice characteristics and PA primary care roles. Patient acceptability data were collected by the host practices. Participation at every stage was optional. Results By evaluation end, eight PAs had completed the internship. Seven PAs and six practices provided data at every time point. Five practices provided patient acceptability data. Overall PA interns were acceptable to practices and patients, however ambiguity about the PA role and how best to communicate and operationalise PA roles was revealed. An expectation-preparedness gap resulted in PAs needing high levels of supervision early within the internship. SPAI facilitated closure of the expectation-preparedness gap and its funding arrangements made the high supervision requirements more acceptable to practices. Conclusions The test-of-concept SPAI successfully integrated new PAs into primary care. However, the identified challenges risk undermining PAs roles in primary care before they have attained their full potential. Nationally, workforce leaders should develop approaches to support new PAs into primary care, including commitments to longer-term, sustainable, cohesive and appropriately funded schemes, including structured and standardised education and supervision.

scholarly journals Stakeholders’ Perspective of Role of Policy and Legislation in Achieving Medicines’ Security

2020 ◽  
pp. 66-73
Author(s):  
Obi Peter Adigwe
Keyword(s):  
Pharmaceutical Industry ◽  
Age Groups ◽  
Significant Proportion ◽  
Access To Medicines ◽  
Pharmaceutical Products ◽  
Similar Proportion ◽  
Security Issue ◽  
The Government ◽  
Almost All

Background: The role of the pharmaceutical industry in a country such as Nigeria in the provision of safe, high quality and efficacious pharmaceutical products to meet the healthcare need of the populace, cannot be over-emphasized. This study was undertaken to critically look at the issues affecting Medicines’ Security in Nigeria. Methods: A self-completion questionnaire was used for data collection. The questionnaire was administered to participants of an Industry event in September 2017. Data collected were analyzed using Statistical Package for Social Science. Results: A total number of 800 questionnaires were administered to the participants and 529 of the questionnaires were included for analysis. Male participants (58.6%) were more than female participants, all age groups were well represented and more than a third of the respondents had first degree as their minimum qualification. Majority of the respondents (91.3%) indicated that Ministry of Health and its agencies were key to protecting the pharmaceutical sector, while slightly less of that proportion (79.1%) indicated that they patronized Nigeria pharmaceutical products. Almost all the participants (91.7%) supported the need for the local pharmaceutical industry to have access to sustainable funding and other incentives. A similar proportion (89.6%) of the respondents indicated that the local pharmaceutical industry should be prioritized in policy making and implementation. A significant proportion of the study participants (82.3%) indicated that access to medicines in Nigeria is a security issue. Conclusion: To ensure Medicines’ Security and attain medicines self-sufficiency in Nigeria, radical policies must therefore be put in place, together with enabling good business and industrial environment by the government in order to protect, promote and grow the local pharmaceutical industry in Nigeria.

Ever-Widening Ripples: The Impact of Specialist Industrial Tribunals on Management Practice

1994 ◽  
Vol 36 (2) ◽  
pp. 285-298 ◽  
Author(s):  
Louise Thornthwaite
Keyword(s):  
Management Practice ◽  
Industrial Relations ◽  
Employment Relations ◽  
Employment Decisions ◽  
Public Role ◽  
South Wales ◽  
Wide Range ◽  
The Government ◽  
The Impact

While conciliation and arbitration tribunals have been at the forefront of Austral ian research on industrial relations institutions, numerous specialist tribunals enforcing individual workers' rights in employment have been virtually hidden from view. This paper examines the role of two such tribunals in New South Wales, the Government and Related Employees' Appeal Tribunal and the Equal Opportu nity Tribunal. It argues that although their most direct and public role is to resolve individuals' grievances, equally significant is the contribution of these agencies to the detailed regulation of employment relations and hence the increasing sophisti cation of labour management in public sector organizations since the late 1970s, and the institutionalization of management prerogatives and conflicts over an increasingly wide range of employment decisions.

scholarly journals Attitudes of newly qualified doctors towards a career in general practice: a qualitative focus group study

2017 ◽  
Vol 67 (657) ◽  
pp. e253-e259 ◽  
Author(s):  
Alexandra Merrett ◽  
Daniel Jones ◽  
Kim Sein ◽  
Trish Green ◽  
Una Macleod
Keyword(s):  
Job Satisfaction ◽  
General Practice ◽  
Universal Access ◽  
Focus Group Study ◽  
Skill Levels ◽  
The Public ◽  
Audio Recordings ◽  
The Government ◽  
Training Skill

BackgroundA key element of the NHS is universal access to a GP. Recently, UK general practice has been described as being in crisis, with training places unfilled and multiple practices reporting vacancies or facing closure. The recruitment of GPs continues to be a key focus for both the Royal College of General Practitioners (RCGP) and the government.Aim To understand the attitudes of newly qualified doctors towards a career in general practice, to appreciate potential reasons for the crisis in GP recruitment, and to recommend ways to improve recruitment.Design and setting A qualitative study comprising five focus groups with 74 Foundation Year 1 (FY1) doctors from one Yorkshire deanery.MethodAudio recordings were transcribed verbatim and thematic analysis undertaken.ResultsFoundation Year 1 doctors’ thoughts towards a career in general practice were summarised in four themes: quality of life, job satisfaction, uncertainty surrounding the future of general practice, and the lack of respect for GPs among both doctors and the public. Participants felt that general practice could provide a good work–life balance, fair pay, and job stability. Job satisfaction, with the ability to provide care from the cradle to the grave, and to work within a community, was viewed positively. Uncertainties around future training, skill levels, pay, and workload, together with a perceived stigma experienced in medical schools and hospitals, were viewed as a deterrent to a career in general practice.ConclusionThis study has gathered the opinions of doctors at a critical point in their careers, before they choose a future specialty. Findings highlight areas of concern and potential deterrents to a career in general practice, together with recommendations to address these issues.

Adolescent health in Asia: insights from India

2016 ◽  
Vol 28 (3) ◽  
pp. 321-325
Author(s):  
Mona M. Basker
Keyword(s):  
Adolescent Health ◽  
Health Care Professionals ◽  
Total Population ◽  
Indian Subcontinent ◽  
Significant Proportion ◽  
Hospital Setting ◽  
Health Centers ◽  
Adolescent Medicine ◽  
The Government ◽  
Uniform Manner

Abstract Adolescents living in the Indian subcontinent form a significant proportion of the general population. India is home to 236 million adolescents, who make up one-fifth of the total population of India. Adolescent health is gradually considered an important issue by the government of India. Awareness is increasing about adolescent needs. Health care professionals in particular are becoming more interested in the specific needs of adolescent age. Adolescent medicine as a subspecialty of pediatrics has also gained importance gradually over the last decade. In a hospital setting, adolescent-specific needs are met, albeit not in a uniform manner in all the health centers. After having been trained in adolescent medicine in India and abroad, I present this paper as a bird’s eye view of the practice of adolescent health and medicine in India.

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