A mixed-methods evaluation of patients’ views on primary care multi-disciplinary teams in Scotland

Abstract

AbstractBackgroundExpanding the primary care multi-disciplinary team (MDT) is a key aim of the 2018 Scottish GP contract, and over 3,000 new MDT-staff have been appointed since then.AimTo explore patients’ views on MDT expansion in primary care in Scotland.Design and methodsSurvey of patients aged 18 years and over who had consulted a GP in the previous four weeks, in three population settings (deprived urban (DU), affluent urban (AU) and remote and rural (RR)), followed by 30 semi-structured individual interviews. The survey assessed awareness of five key new MDT roles, and attitudes towards reception signposting. Interviews explored views regarding MDT-care generally.ResultsOf the 1,053 survey respondents, most were unaware of the possibility of being offered MDT, rather than GP, consultations, for three out of five roles (69% unaware of link worker appointments; 68% mental health nurse; 58% pharmacist). Reception signposting to MDT was viewed significantly more negatively in DU areas than elsewhere (34% quite or very unhappy vs 21% AU vs 29% RR; p<0.001).Most of the 30 patients interviewed were accepting of MDT-care, and many reported positive first-hand experiences. Improved access and added expertise were perceived benefits. However, many had reservations about MDT expansion and an overriding preference for holistic, relationship-based GP-care.ConclusionFour years since the introduction of the new Scottish GP contract, patient awareness of MDT expansion is limited, views on reception signposting mixed, though experiences of MDT-care generally positive. However, patients still want to see a known GP when they feel it is important, and report this as being challenging especially in deprived areas.