Abstract / Description of output
Background
Primary care transformation in Scotland aims to improve population health, reduce health inequalities and reduce GP workload. Two key strategies (formalised in April 2018 in the new Scottish GP contract though started in early 2016) are the expansion of the multidisciplinary team (MDT) and GP cluster working.
Aim
To explore progress in the implementation of the GP contract in Scotland in terms of MDT and cluster working.
Design and Setting
Qualitative study with key national primary care stakeholders (PCSs) (n=6) and Cluster Quality Leads (CQLs) in clusters serving urban high deprivation areas (n=4), urban mixed areas (n=4), and remote and rural areas (n=4).
Methods
Semi-structured interviews with thematic analysis.
Results
There was general support for the initial aims of the new GP contract but all interviewees felt that progress on both MDT expansion and cluster working was slow, even prior to the pandemic. None of the CQLs (and few PCSs) felt that GP workload had reduced significantly, nor that the care of patients with complex needs had improved. Lack of time and poorly developed relationships were key barriers, as was a lack of relevant primary care data, and additional support (including guidance, administration, training, and protected time).
Conclusion
Key PCSs and CQLs in different areas of Scotland report limited progress in primary care transformation, only partly related to the pandemic. There is a need for better workforce planning and support if the new GP contract is to succeed in transforming primary care in Scotland.
Key words: Primary care reform, multi-disciplinary working, clusters, multi-morbidity, health inequalities
Primary care transformation in Scotland aims to improve population health, reduce health inequalities and reduce GP workload. Two key strategies (formalised in April 2018 in the new Scottish GP contract though started in early 2016) are the expansion of the multidisciplinary team (MDT) and GP cluster working.
Aim
To explore progress in the implementation of the GP contract in Scotland in terms of MDT and cluster working.
Design and Setting
Qualitative study with key national primary care stakeholders (PCSs) (n=6) and Cluster Quality Leads (CQLs) in clusters serving urban high deprivation areas (n=4), urban mixed areas (n=4), and remote and rural areas (n=4).
Methods
Semi-structured interviews with thematic analysis.
Results
There was general support for the initial aims of the new GP contract but all interviewees felt that progress on both MDT expansion and cluster working was slow, even prior to the pandemic. None of the CQLs (and few PCSs) felt that GP workload had reduced significantly, nor that the care of patients with complex needs had improved. Lack of time and poorly developed relationships were key barriers, as was a lack of relevant primary care data, and additional support (including guidance, administration, training, and protected time).
Conclusion
Key PCSs and CQLs in different areas of Scotland report limited progress in primary care transformation, only partly related to the pandemic. There is a need for better workforce planning and support if the new GP contract is to succeed in transforming primary care in Scotland.
Key words: Primary care reform, multi-disciplinary working, clusters, multi-morbidity, health inequalities
| Original language | English |
|---|---|
| Journal | British Journal of General Practice Open (BJGP Open) |
| Early online date | 20 Jul 2022 |
| DOIs | |
| Publication status | E-pub ahead of print - 20 Jul 2022 |
Keywords / Materials (for Non-textual outputs)
- primary care reform
- multi-disciplinary working
- clusters
- multi-morbidity
- health inequalities