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Examining the practice of generalist expertise : a qualitative study identifying constraints and solutions
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Reeve, Joanne L., Dowrick, Christopher, Freeman, George K., Gunn, Jane, Mair, Frances S., May, Carl, Mercer, Stewart, Palmer, Victoria, Howe, Amanda, Irving, Greg, Shiner, Alice and Watson, Jessica (2013) Examining the practice of generalist expertise : a qualitative study identifying constraints and solutions. JRSM Short Reports, Volume 4 (Number 12). doi:10.1177/2042533313510155 ISSN 2042-5333.
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Official URL: http://dx.doi.org/10.1177/2042533313510155
Abstract
Objectives: Provision of person-centred generalist care is a core component of quality primary care systems. The World Health Organisation believes that a lack of generalist primary care is contributing to inefficiency, ineffectiveness and inequity in healthcare. In UK primary care, General Practitioners (GPs) are the largest group of practising generalists. Yet GPs fulfil multiple roles and the pressures of delivering these roles along with wider contextual changes create real challenges to generalist practice. Our study aimed to explore GP perceptions of enablers and constraints for expert generalist care, in order to identify what is needed to ensure health systems are designed to support the generalist role.
Design: Qualitative study in General Practice.
Setting: UK primary care.
Main outcome measures: A qualitative study – interviews, surveys and focus groups with GPs and GP trainees. Data collection and analysis was informed by Normalisation Process Theory.
Design and setting: Qualitative study in General Practice. We conducted interviews, surveys and focus groups with GPs and GP trainees based mainly, but not exclusively, in the UK. Data collection and analysis were informed by Normalization Process Theory.
Participants: UK based GPs (interview and surveys); European GP trainees (focus groups).
Results: Our findings highlight key gaps in current training and service design which may limit development and implementation of expert generalist practice (EGP). These include the lack of a consistent and universal understanding of the distinct expertise of EGP, competing priorities inhibiting the delivery of EGP, lack of the consistent development of skills in interpretive practice and a lack of resources for monitoring EGP.
Conclusions: We describe four areas for change: Translating EGP, Priority setting for EGP, Trusting EGP and Identifying the impact of EGP. We outline proposals for work needed in each area to help enhance the expert generalist role.
Item Type: | Journal Article | ||||||
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Subjects: | R Medicine > R Medicine (General) | ||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Physicians (General practice), Primary care (Medicine) | ||||||
Journal or Publication Title: | JRSM Short Reports | ||||||
Publisher: | Royal Society of Medicine Press Ltd. | ||||||
ISSN: | 2042-5333 | ||||||
Official Date: | December 2013 | ||||||
Dates: |
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Volume: | Volume 4 | ||||||
Number: | Number 12 | ||||||
DOI: | 10.1177/2042533313510155 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 28 July 2016 | ||||||
Date of first compliant Open Access: | 28 July 2016 | ||||||
Funder: | National Institute for Health Research (Great Britain) (NIHR) |
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