Author:
Abrams Ruth,Wong Geoff,Mahtani Kamal R,Tierney Stephanie,Boylan Anne-Marie,Roberts Nia,Park Sophie
Abstract
BackgroundUK general practice is being shaped by new ways of working. Traditional GP tasks are being delegated to other staff with the intention of reducing GPs’ workload and hospital admissions, and improving patients’ access to care. One such task is patient-requested home visits. However, it is unclear what impact delegated home visits may have, who might benefit, and under what circumstances.AimTo explore how the process of delegating home visits works, for whom, and in what contexts.Design and settingA review of secondary data on home visit delegation processes in UK primary care settings.MethodA realist approach was taken to reviewing data, which aims to provide causal explanations through the generation and articulation of contexts, mechanisms, and outcomes. A range of data has been used including news items, grey literature, and academic articles.ResultsData were synthesised from 70 documents. GPs may believe that delegating home visits is a risky option unless they have trust and experience with the wider multidisciplinary team. Internal systems such as technological infrastructure might help or hinder the delegation process. Healthcare professionals carrying out delegated home visits might benefit from being integrated into general practice but may feel that their clinical autonomy is limited by the delegation process. Patients report short-term satisfaction when visited by a healthcare professional other than a GP. The impact this has on long-term health outcomes and cost is less clear.ConclusionThe delegation of home visits may require a shift in patient expectation about who undertakes care. Professional expectations may also require a shift, having implications for the balance of staffing between primary and secondary care, and the training of healthcare professionals.
Publisher
Royal College of General Practitioners
Reference60 articles.
1. Kaffash J GPs vote for home visits to be removed from contract Pulse 2019 22 Nov http://www.pulsetoday.co.uk/news/gps-vote-for-home-visits-to-be-removed-from-contract/20039743.article (accessed 28 Apr 2020).
2. British Medical Association Agreed new contract deal for junior doctors in England 2020 https://www.bma.org.uk/collective-voice/influence/key-negotiations/terms-and-conditions/junior-doctor-contract-negotiations/agreed-new-contract-deal-for-junior-doctors-in-england (accessed 28 Apr 2020).
3. NHS The NHS long term plan 2019 https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf (accessed 28 Apr 2020).
4. Baird B Reeve H Ross S Innovative models of general practice London King’s Fund 2018
5. Park S Abrams R Wong G Reorganisation of general practice: be careful what you wish for Br J Gen Pract 2019 DOI: https://doi.org/10.3399/bjgp19X705941.
Cited by
16 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献