Transformation of primary care during the COVID-19 pandemic: experiences of healthcare professionals in eight European countries

Abstract

Background: Primary care has a crucial role in responding to the COVID-19 pandemic as the first point of patient care and gatekeeper to secondary care. Qualitative studies exploring the experiences of healthcare professionals during the COVID-19 pandemic have mainly focused on secondary care. Aim: To understand the experiences of European PCPs working during the first peak of the COVID-19 pandemic. Design and Setting: An exploratory qualitative study, using semi-structured interviews in primary care in England, Belgium, the Netherlands, Ireland, Germany, Poland, Greece and Sweden, between April and July 2020. Method: Interviews were audio recorded, transcribed and analysed using a combination of inductive and deductive thematic analysis techniques. Results: Eighty interviews were conducted with PCPs. PCPs had to make their own decisions on how to rapidly transform services in relation to COVID-19 and non-COVID-19 care. Despite being overwhelmed with guidance, they often lacked access to practical training. Consequently, PCPs turned to their colleagues for moral support and information to try to quickly adjust to new ways of working, including remote care, and deal with uncertainty. Conclusion: PCPs rapidly transformed primary care delivery despite a number of challenges. Representation of primary care at policy level and engagement with local primary care champions will facilitate easy and coordinated access to practical information on how to adapt services, ongoing training and access to appropriate mental health support services for PCPs. Preservation of autonomy and responsiveness of primary care are critical to preserve the ability for rapid transformation in any future crisis of care delivery.

Supporting Primary Care Professionals to Stay in Work During the COVID-19 Pandemic: Views on Personal Risk and Access to Testing During the First Wave of Pandemic in Europe

“…Given the depth of data gathered across countries, here we report data on themes 1 and 2, which provide an insight into the barriers and facilitators to PCPs staying in work during the pandemic. The remaining themes have been reported elsewhere (15,18). Key information regarding the timing of the interviews and contextual information for each country is presented in Table 2.…”

“…Interviewers in each country invited PCPs to the study by email or telephone. More details on selection of countries is presented elsewhere (15).…”

“…Minimising the risk of infection among healthcare workforces is crucial to protect the physical and mental health of healthcare professionals and to prevent healthcare systems from becoming overwhelmed (14). Our study addressed the current gap by exploring the PCPs' views and experiences of providing care during the COVID-19 pandemic (15). We aimed to understand their views on perceived personal risk from COVID-19 and on COVID-testing in order to identify lessons facilitating safety of PCPs and functioning health care systems in preparedness for potential future health emergencies.…”

Antibiotic Prescribing Trends in Belgian Out-of-Hours Primary Care during the COVID-19 Pandemic: Observational Study Using Routinely Collected Health Data

“…The start of the COVID-19 pandemic raised new and radical logistical and clinical challenges for primary care physicians, who were forced to respond promptly to a fast-changing environment [ 1 , 2 , 3 , 4 ]. Out-of-hours (OOH) primary care rapidly reorganized itself.…”

General Practitioner perspectives and wellbeing during the COVID-19 Pandemic: a mixed method social media analysis

“…[6][7][8]. Two UK studies of GP pandemic experiences show greater work stress due to rapid change and uncertainty [9] and the importance of teams in creating a sense of solidarity [10]. These studies are relatively small -Trivedi [9] studied 111 GPs in Leicestershire and Wanat et al [10] is a cross-European qualitative interview study of primary care staff, but includes only seven GPs in England.…”