Skill-mix change in general practiceCitation formats

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Skill-mix change in general practice : A qualitative comparison of three 'new' non-medical roles. / Nelson, Pauline; Bradley, Fay; Martindale, Anne-Marie; Mcbride, Anne; Hodgson, Damian.

In: Br J Gen Pract (In Press), Vol. 69, No. 684, 08.07.2019, p. e489-e498.

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@article{dd82b8749082469a8c28f20c512b0efa,
title = "Skill-mix change in general practice: A qualitative comparison of three 'new' non-medical roles",
abstract = "Background General practice is currently facing a significant workforce challenge. Changing the general practice skill mix by introducing new non-medical roles is recommended as one solution; the literature highlights that organisational and/or operational difficulties are associated with skill-mix changes.Aim To compare how three non-medical roles were being established in general practice, understand common implementation barriers, and identify measurable impacts or unintended consequences.Design and setting In-depth qualitative comparison of three role initiatives in general practices in one area of Greater Manchester, England; that is, advanced practitioner and physician associate training schemes, and a locally commissioned practice pharmacist service.Method Semi-structured interviews and focus groups with a purposive sample of stakeholders involved in the implementation of each role initiative were conducted. Template analysis enabled the production of pre-determined and researcher-generated codes, categories, and themes.Results The final sample contained 38 stakeholders comprising training/service leads, role holders, and host practice staff. Three key themes captured participants{\textquoteright} perspectives: purpose and place of new roles in general practice, involving unclear role definition and tension at professional boundaries; transition of new roles into general practice, involving risk management, closing training–practice gaps and managing expectations; and future of new roles in general practice, involving demonstrating impact and questions about sustainability.Conclusion This in-depth, in-context comparative study highlights that introducing new roles to general practice is not a simple process. Recognition of factors affecting the assimilation of roles may help to better align them with the goals of general practice and harness the commitment of individual practices to enable role sustainability.",
author = "Pauline Nelson and Fay Bradley and Anne-Marie Martindale and Anne Mcbride and Damian Hodgson",
year = "2019",
month = jul,
day = "8",
doi = "10.3399/bjgp19X704117",
language = "English",
volume = "69",
pages = "e489--e498",
journal = "British Journal of General Practice",
issn = "0960-1643",
publisher = "Royal College of General Practitioners",
number = "684",

}

RIS

TY - JOUR

T1 - Skill-mix change in general practice

T2 - A qualitative comparison of three 'new' non-medical roles

AU - Nelson, Pauline

AU - Bradley, Fay

AU - Martindale, Anne-Marie

AU - Mcbride, Anne

AU - Hodgson, Damian

PY - 2019/7/8

Y1 - 2019/7/8

N2 - Background General practice is currently facing a significant workforce challenge. Changing the general practice skill mix by introducing new non-medical roles is recommended as one solution; the literature highlights that organisational and/or operational difficulties are associated with skill-mix changes.Aim To compare how three non-medical roles were being established in general practice, understand common implementation barriers, and identify measurable impacts or unintended consequences.Design and setting In-depth qualitative comparison of three role initiatives in general practices in one area of Greater Manchester, England; that is, advanced practitioner and physician associate training schemes, and a locally commissioned practice pharmacist service.Method Semi-structured interviews and focus groups with a purposive sample of stakeholders involved in the implementation of each role initiative were conducted. Template analysis enabled the production of pre-determined and researcher-generated codes, categories, and themes.Results The final sample contained 38 stakeholders comprising training/service leads, role holders, and host practice staff. Three key themes captured participants’ perspectives: purpose and place of new roles in general practice, involving unclear role definition and tension at professional boundaries; transition of new roles into general practice, involving risk management, closing training–practice gaps and managing expectations; and future of new roles in general practice, involving demonstrating impact and questions about sustainability.Conclusion This in-depth, in-context comparative study highlights that introducing new roles to general practice is not a simple process. Recognition of factors affecting the assimilation of roles may help to better align them with the goals of general practice and harness the commitment of individual practices to enable role sustainability.

AB - Background General practice is currently facing a significant workforce challenge. Changing the general practice skill mix by introducing new non-medical roles is recommended as one solution; the literature highlights that organisational and/or operational difficulties are associated with skill-mix changes.Aim To compare how three non-medical roles were being established in general practice, understand common implementation barriers, and identify measurable impacts or unintended consequences.Design and setting In-depth qualitative comparison of three role initiatives in general practices in one area of Greater Manchester, England; that is, advanced practitioner and physician associate training schemes, and a locally commissioned practice pharmacist service.Method Semi-structured interviews and focus groups with a purposive sample of stakeholders involved in the implementation of each role initiative were conducted. Template analysis enabled the production of pre-determined and researcher-generated codes, categories, and themes.Results The final sample contained 38 stakeholders comprising training/service leads, role holders, and host practice staff. Three key themes captured participants’ perspectives: purpose and place of new roles in general practice, involving unclear role definition and tension at professional boundaries; transition of new roles into general practice, involving risk management, closing training–practice gaps and managing expectations; and future of new roles in general practice, involving demonstrating impact and questions about sustainability.Conclusion This in-depth, in-context comparative study highlights that introducing new roles to general practice is not a simple process. Recognition of factors affecting the assimilation of roles may help to better align them with the goals of general practice and harness the commitment of individual practices to enable role sustainability.

U2 - 10.3399/bjgp19X704117

DO - 10.3399/bjgp19X704117

M3 - Article

VL - 69

SP - e489-e498

JO - British Journal of General Practice

JF - British Journal of General Practice

SN - 0960-1643

IS - 684

ER -