Stressed and overworked: What the Commonwealth Fund’s 2022 International Health Policy Survey of Primary Care Physicians in 10 Countries means for the UK

Beech, Jake; Fraser, Caroline; Gardner, Tim; Buzelli, Luiza; Williamson, Skeena; Alderwick, Hugh

doi:10.37829/hf-2023-p12

Cited by 21 publications

(6 citation statements)

References 30 publications

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“…A reduction in administrative burden and an improvement in the communication skills of GP could increase the average time dedicated to visiting and the quality of listening to patients; at the same time, the use of tools such as the teleconsultation and the digitalized medical record shared among all the professionals involved could facilitate their interaction increasing the effectiveness of health care action. [6][7][8][9]…”

Section: Discussionmentioning

confidence: 99%

Functional neurological disorder mimicking stroke: A case report

Venturini,

Sarti

2024

Clinical Case Reports

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KEY CLINICAL MESSAGEEven in the era of technology‐guided medicine, the clinician must integrate into his daily practice a careful anamnesis and physical examination to be conducted within a close doctor–patient relationship. All these elements, together with tools such as teleconsultation and digitalized medical records, are able to significantly increase the effectiveness of health care action.

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Section: Discussionmentioning

confidence: 99%

Functional neurological disorder mimicking stroke: A case report

Venturini,

Sarti

2024

Clinical Case Reports

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“…Increasing demand on UK EDs is multifactorial including an ageing society with increasing multimorbidity, 29 a reduction in the number of community GPs coping with an increasing workload, 30 inadequate social care preventing hospital discharge for medically fit patients causing 'exit block' 31 and the impact on the general health and social care workforce following the COVID-19 pandemic and Brexit. 32 Internationally, GP-ED service models have been introduced to address increasing ED attendances.…”

Section: Context Of Current Literaturementioning

confidence: 99%

Programme theories to describe how different general practitioner service models work in different contexts in or alongside emergency departments (GP-ED): realist evaluation

Cooper,

Edwards,

Davies

et al. 2024

Emerg Med J

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BackgroundAddressing increasing patient demand and improving ED patient flow is a key ambition for NHS England. Delivering general practitioner (GP) services in or alongside EDs (GP-ED) was advocated in 2017 for this reason, supported by £100 million (US$130 million) of capital funding. Current evidence shows no overall improvement in addressing demand and reducing waiting times, but considerable variation in how different service models operate, subject to local context.MethodsWe conducted mixed-methods analysis using inductive and deductive approaches for qualitative (observations, interviews) and quantitative data (time series analyses of attendances, reattendances, hospital admissions, length of stay) based on previous research using a purposive sample of 13 GP-ED service models (3 inside-integrated, 4 inside-parallel service, 3 outside-onsite and 3 with no GPs) in England and Wales. We used realist methodology to understand the relationship between contexts, mechanisms and outcomes to develop programme theories about how and why different GP-ED service models work.ResultsGP-ED service models are complex, with variation in scope and scale of the service, influenced by individual, departmental and external factors. Quantitative data were of variable quality: overall, no reduction in attendances and waiting times, a mixed picture for hospital admissions and length of hospital stay. Our programme theories describe how the GP-ED service models operate: inside the ED, integrated with patient flow and general ED demand, with a wider GP role than usual primary care; outside the ED, addressing primary care demand with an experienced streaming nurse facilitating the ‘right patients’ are streamed to the GP; or within the ED as a parallel service with most variability in the level of integration and GP role.ConclusionGP-ED services are complex . Our programme theories inform recommendations on how services could be modified in particular contexts to address local demand, or whether alternative healthcare services should be considered.

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“…Such an approach could take advantage of two key strengths of UK primary care. The first is the excellence of general practice data routinely collected by the NHS and high levels of GP data literacy1 Although security concerns, incompatible and outdated IT systems, lack of training in data coding and entry, and insufficient administrative and data analytics support will all need to be resolved,10 general practice data represent a key asset for improvement efforts. The second is the practice cluster and network infrastructure now in place in all four countries of the UK, which provides a way of coordinating and supporting improvement at scale 1112…”

Section: Learning System Approachmentioning

confidence: 99%

“…The Health Foundation’s report on the Commonwealth Fund’s 2022 international health policy survey of primary care physicians in 10 countries makes for sobering reading. 1 Illustrating some worrying trends, its standout findings include rising workloads, higher levels of burnout, and worsening job satisfaction. Strikingly, UK general practitioners score lowest of all countries in terms of satisfaction with the amount of time they spend with patients.…”

mentioning

confidence: 99%