What did we do?
As part of their Primary Care (General Practice) Workforce Strategy, NHS Salford Clinical Commissioning Group (CCG) piloted the implementation of the following three new roles in Salford general practices: Advanced Practitioner, Physician Associate and Practice Pharmacist.
We sought to evaluate the implementation of these three roles, to understand the opportunities and challenges involved in introducing new types of ‘skill-mix’ in general practice and provide valuable insight for future workforce development.
Why was it important?
General practice is facing a significant workforce challenge, with a shortage of GPs and practice nurses against the need to manage an ageing population with increasingly complex health care needs. As one solution to easing the pressure, health policy is promoting the introduction of non-GP roles into general practice teams to work alongside GPs in ever greater numbers. This in-depth process evaluation offers broad learning about skill-mix changes in general practice beyond specific role types, that can inform dialogue and decision-making for those considering skill-mix changes and may increase the likelihood of roles being retained in the future, both within Salford and further afield.
Furthermore it has indicated areas for further research to better understand the process and impact of implementing skill-mix changes into primary care teams.
How did we do it?
Between April 2017 and March 2018 we conducted a process evaluation drawing on data derived from:
● Semi-structured interviews/focus groups with key individuals (from commissioners to frontline providers) involved in the Salford new roles initiatives;
● Training and development documents linked to the new roles schemes.
From these data we identified a number of factors that affect the success of skill-mix changes in the general practice setting including: adequate communication and engagement between stakeholders, clearer definition/differentiation of roles, appropriate general-practice focused training and improved ways of showing the impact and sustainability of new roles initiatives.
Who did we work with?
- Evaluation Reports
Nelson P, Bradley F, Martindale AM, McBride A & Hodgson D; 2019; Skill-mix change in general practice: a qualitative comparison of three ‘new’ non-medical roles in English primary care; BJGP
- Rapid Literature Review