Tackling the crisis in general practice

Sinnott, Carol; Dorban-Hall, Barbara; Dixon‐Woods, Mary

doi:10.1136/bmj.p966

Cited by 12 publications

(6 citation statements)

References 12 publications

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“…An alternative approach would be to address operational failures collaboratively and at scale through a learning-system approach that includes patients, diverse staff groups, primary care networks, and the power of the NHS’s routinely collected general practice data to codesign, implement, and test changes that aim to improve operational processes and practice efficiency. 22 The Care Quality Commission could, potentially, be engaged in such processes to ensure that learning and innovation are captured through regulatory processes, as appropriate. System-level changes have the potential to produce new operational challenges for GPs — for example, by further fragmenting care or duplicating effort — so high-quality design, implementation, and evaluation will be critical, as has happened in the area of skill-mix, for example.…”

Section: Discussionmentioning

confidence: 99%

Operational failures in general practice: a consensus-building study on the priorities for improvement

Sinnott,

Alboksmaty,

Moxey

et al. 2023

Br J Gen Pract

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Background: System problems known as operational failures can impact greatly on the work of general practitioners (GPs), with negative consequences for patient and professional experience, efficiency, and effectiveness. Many operational failures are tractable to improvement, but which should be prioritised is less clear. Aim: To build consensus amongst GPs and patients on the operational failures to prioritise for improvement in NHS general practice. Methods: We conducted two modified Delphi exercises online between Feb-Oct 2021: one with NHS GPs, and a subsequent exercise with patients. Over two rounds, GPs rated the importance of a list of operational failures (n=45) that had been compiled using existing evidence. The resulting shortlist was presented to patients for rating over two rounds. Data were analysed using medians and interquartile ranges. Consensus was defined as 80% of responses falling within one value below and above the median. Results: Sixty-two GPs responded to the first Delphi survey, with 53.2% (n=33) retained through round two. This exercise yielded consensus on fourteen failures as a priority for improvement which were presented to patients. Thirty-seven patients responded to the first patient Delphi survey, with 89.2% (n=33) retained through round two. Patients identified thirteen failures as priorities. The highest scoring failures included inaccuracies in patients’ medical notes, missing test results and difficulties referring patients to other providers because of problems in referral forms. Conclusion: This study has identified the highest priority operational failures in general practice, and indicates where GPs and patients feel improvement efforts in general practice should be focused.

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Section: Discussionmentioning

confidence: 99%

Operational failures in general practice: a consensus-building study on the priorities for improvement

Sinnott,

Alboksmaty,

Moxey

et al. 2023

Br J Gen Pract

Self Cite

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“…Fait à noter, l'inscription auprès des omniprati ciens est automatique, obligatoire ou fortement encouragée, puisque les systèmes préconisent la continuité relationnelle entre patientèle et centre de soins primaires à proximité du domicile. Tous les pays éprouvent des difficultés sur le plan des effectifs en soins primaires en raison de la charge qui ne cesse de s'alourdir pour les médecins, du nombre croissant d'omnipraticiens qui travaillent à temps partiel, de l'épuisement professionnel et des défis de recrutement et de maintien en poste [31][32][33][34] .…”

Section: Quelles Stratégies Systémiques Favorisent La Continuité Rela...unclassified

Soins primaires pour tous : Le Canada peut s’inspirer de pays semblables ayant un niveau élevé de continuité relationnelle entre patientèle et centres de soins primaires

Shahaed,

Glazier,

Anderson

et al. 2024

CMAJ

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“…There are troubling themes in recent primary care challenges that cross borders, such as clinician burnout [19], aging populations [17], chronic disease burden [18], administrative burden [20], and mismatch of patient demand and clinician supply [18], which in turn threaten the health of communities globally. However, the authors are optimistic that greater awareness of the opportunities and changes possible through intentional applications of primary care informatics, building on the last 25 years of evidence-based advancements and development in the field, can pave a way forward for continued primary care and, consequently, overall health system improvements.…”

Section: Common Challenges In Primary Carementioning

confidence: 99%

Primary Care Informatics: Vitalizing the Bedrock of Healthcare (Preprint)

You,

Leung,

Pandita

et al. 2024

Preprint

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UNSTRUCTURED Primary care informatics professionals address workflow and technology solutions in a wide spectrum of health, ranging from optimizing the experience of the individual patient in the clinic room to supporting the health of populations. Primary care informatics overlaps uniquely with two key disciplines with immense impact on societal health - primary care and health informatics. Primary care is often a hub or gateway to accessing healthcare, and has a primary aim of synthesizing and coordinating numerous and potentially complex elements of patients’ health and medical care in a holistic manner. However, over the past 25 years, primary care has become a specialty in crisis: in a post-COVID world, worsening workforce shortages, clinician burnout, and continuing challenges in healthcare access all contribute to difficulties in sustaining primary care. informatics professionals are poised to change this trajectory. In this viewpoint, we aim to inform readers of the discipline of primary care informatics and its importance in the design, support, and maintenance of essential primary care services. Although the focus of this work is on primary care in the United States, which includes general internal medicine, family medicine, and pediatrics, many of the principles outlined can also be applied to comparable healthcare services and settings in other countries. We highlight the challenges in primary care and how primary care informatics professionals can address these challenges. We discuss current and emerging technologies in primary care informatics. In summary, primary care informatics offers important contributions to healthcare and to the informatics field, and there are many opportunities for informatics professionals to enhance the primary care experience for patients, families, and their care teams.

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Tackling the crisis in general practice

Abstract: Support to develop better systems will go a long way

Cited by 12 publications

References 12 publications

Operational failures in general practice: a consensus-building study on the priorities for improvement

Operational failures in general practice: a consensus-building study on the priorities for improvement

Soins primaires pour tous : Le Canada peut s’inspirer de pays semblables ayant un niveau élevé de continuité relationnelle entre patientèle et centres de soins primaires

Primary Care Informatics: Vitalizing the Bedrock of Healthcare (Preprint)

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