Challenges in implementing GP clusters in Scotland: a qualitative study comparing the views of senior primary care stakeholders in 2016 with those in 2021
Background: Formation of GP clusters began in Scotland in April 2016 as part of a new Scottish GP contract. They aim to improve the care quality for local populations (intrinsic role) and the integration of health and social care (extrinsic role). Aim: To compare predicted challenges of cluster impl...
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| Format: | Article |
| Language: | English |
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Royal College of General Practitioners
2023-06-01
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| Series: | BJGP Open |
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| Online Access: | https://bjgpopen.org/content/7/2/BJGPO.2022.0152 |
| _version_ | 1797787717440897024 |
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| author | Catherine Kidd Eddie Donaghy Huayi Huang Rhian Noble-Jones Sharon Ogilvie Julia McGregor Margaret Maxwell John Gillies David AG Henderson Harry HX Wang Stewart W Mercer |
| author_facet | Catherine Kidd Eddie Donaghy Huayi Huang Rhian Noble-Jones Sharon Ogilvie Julia McGregor Margaret Maxwell John Gillies David AG Henderson Harry HX Wang Stewart W Mercer |
| author_sort | Catherine Kidd |
| collection | DOAJ |
| description | Background: Formation of GP clusters began in Scotland in April 2016 as part of a new Scottish GP contract. They aim to improve the care quality for local populations (intrinsic role) and the integration of health and social care (extrinsic role). Aim: To compare predicted challenges of cluster implementation in 2016 with reported challenges in 2021. Design & setting: Qualitative study of senior national stakeholders in primary care in Scotland. Method: Qualitative analysis of semi-structured interviews with 12 senior primary care national stakeholders in 2016 (n = 6) and 2021 (n = 6). Results: Predicted challenges in 2016 included balancing intrinsic and extrinsic roles, providing sufficient support, maintaining motivation and direction, and avoiding variation between clusters. Progress of clusters in 2021 was perceived as suboptimal and was reported to vary significantly across the country, reflecting differences in local infrastructure. Practical facilitation (data, administrative support, training, project improvement support, and funded time) and strategic guidance from the Scottish Government was felt to be lacking. GP engagement with clusters was felt to be hindered by the significant time and workforce pressures facing primary care. These barriers were considered as collectively contributing to cluster lead ‘burnout’ and loss of momentum, exacerbated by inadequate opportunities for shared learning between clusters across Scotland. Such barriers preceded, but were perpetuated by, the impact of the COVID-19 pandemic. Conclusion: Apart from the COVID-19 pandemic, many of the challenges reported by stakeholders in 2021 were predicted in 2016. Accelerating progress in cluster working will require renewed investment and support applied consistently across the country. |
| first_indexed | 2024-03-13T01:25:49Z |
| format | Article |
| id | doaj.art-02b0acd9311d409ab10bd2ff8ec18046 |
| institution | Directory Open Access Journal |
| issn | 2398-3795 |
| language | English |
| last_indexed | 2024-03-13T01:25:49Z |
| publishDate | 2023-06-01 |
| publisher | Royal College of General Practitioners |
| record_format | Article |
| series | BJGP Open |
| spelling | doaj.art-02b0acd9311d409ab10bd2ff8ec180462023-07-04T14:41:43ZengRoyal College of General PractitionersBJGP Open2398-37952023-06-017210.3399/BJGPO.2022.0152Challenges in implementing GP clusters in Scotland: a qualitative study comparing the views of senior primary care stakeholders in 2016 with those in 2021Catherine Kidd0Eddie Donaghy1Huayi Huang2Rhian Noble-Jones3Sharon Ogilvie4Julia McGregor5Margaret Maxwell6John Gillies7David AG Henderson8Harry HX Wang9Stewart W Mercer10College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UKUsher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UKUsher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UKNursing and Health Care, School of Medicine, University of Glasgow, Glasgow, UKNursing, Midwifery, and Allied Health Professionals Research Unit, University of Stirling, Scotland, UKNursing, Midwifery, and Allied Health Professionals Research Unit, University of Stirling, Scotland, UKNursing, Midwifery, and Allied Health Professionals Research Unit, University of Stirling, Scotland, UKUsher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UKUsher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UKSchool of Public Health, Sun Yat-Sen University, Guangzhou, ChinaUsher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UKBackground: Formation of GP clusters began in Scotland in April 2016 as part of a new Scottish GP contract. They aim to improve the care quality for local populations (intrinsic role) and the integration of health and social care (extrinsic role). Aim: To compare predicted challenges of cluster implementation in 2016 with reported challenges in 2021. Design & setting: Qualitative study of senior national stakeholders in primary care in Scotland. Method: Qualitative analysis of semi-structured interviews with 12 senior primary care national stakeholders in 2016 (n = 6) and 2021 (n = 6). Results: Predicted challenges in 2016 included balancing intrinsic and extrinsic roles, providing sufficient support, maintaining motivation and direction, and avoiding variation between clusters. Progress of clusters in 2021 was perceived as suboptimal and was reported to vary significantly across the country, reflecting differences in local infrastructure. Practical facilitation (data, administrative support, training, project improvement support, and funded time) and strategic guidance from the Scottish Government was felt to be lacking. GP engagement with clusters was felt to be hindered by the significant time and workforce pressures facing primary care. These barriers were considered as collectively contributing to cluster lead ‘burnout’ and loss of momentum, exacerbated by inadequate opportunities for shared learning between clusters across Scotland. Such barriers preceded, but were perpetuated by, the impact of the COVID-19 pandemic. Conclusion: Apart from the COVID-19 pandemic, many of the challenges reported by stakeholders in 2021 were predicted in 2016. Accelerating progress in cluster working will require renewed investment and support applied consistently across the country.https://bjgpopen.org/content/7/2/BJGPO.2022.0152primary care reformclustersgeneral practicequality of health carequalitative research |
| spellingShingle | Catherine Kidd Eddie Donaghy Huayi Huang Rhian Noble-Jones Sharon Ogilvie Julia McGregor Margaret Maxwell John Gillies David AG Henderson Harry HX Wang Stewart W Mercer Challenges in implementing GP clusters in Scotland: a qualitative study comparing the views of senior primary care stakeholders in 2016 with those in 2021 BJGP Open primary care reform clusters general practice quality of health care qualitative research |
| title | Challenges in implementing GP clusters in Scotland: a qualitative study comparing the views of senior primary care stakeholders in 2016 with those in 2021 |
| title_full | Challenges in implementing GP clusters in Scotland: a qualitative study comparing the views of senior primary care stakeholders in 2016 with those in 2021 |
| title_fullStr | Challenges in implementing GP clusters in Scotland: a qualitative study comparing the views of senior primary care stakeholders in 2016 with those in 2021 |
| title_full_unstemmed | Challenges in implementing GP clusters in Scotland: a qualitative study comparing the views of senior primary care stakeholders in 2016 with those in 2021 |
| title_short | Challenges in implementing GP clusters in Scotland: a qualitative study comparing the views of senior primary care stakeholders in 2016 with those in 2021 |
| title_sort | challenges in implementing gp clusters in scotland a qualitative study comparing the views of senior primary care stakeholders in 2016 with those in 2021 |
| topic | primary care reform clusters general practice quality of health care qualitative research |
| url | https://bjgpopen.org/content/7/2/BJGPO.2022.0152 |
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