Abstract
A range of measures to improve service delivery have been introduced among persisting concerns about staff shortages in general practice. Innovations include practice networks, multidisciplinary roles, and use of digital technologies. Yet challenges remain that affect both patient care delivery and staff. Therefore, identifying what matters from a workforce perspective will help identify what matters to those delivering services.
To prioritise strengths, challenges, and possible solutions for service delivery from the perspective of the workforce.
An online survey (3 open questions) was circulated to NHS general practice employees in the UK by NHS England communication channels and other professional networks. Data were analysed thematically. Priorities were cross checked against existing literature to identify and map knowledge. Priorities were ranked by survey responders to produce a final top ten.
There were 93 staff including clinical and non-clinical groups who participated. Four themes emerged from survey data including: 1) core strengths; 2) patient-workforce interface; 3) working environment; and 4) service integration.Twenty priorities were consolidated from survey responses and cross-checked against 270 identified articles. The top 10 priorities included: volume of work; consultations; patient behaviour; patient health education; complex patient needs (patient-workforce interface); employment pay and conditions; overwhelming pressure (working conditions); funding; workload dumping; and interfaces with secondary care (service integration). These priorities span the patient-workforce-service delivery nexus and were determined as interconnected.
The top 10 service delivery priorities require future policy solutions that are holistic and address underlying causes. Future research needs to explore interdependencies across the patient-workforce-service delivery nexus.