Identifying policies and strategies for general practitioner retention in direct patient care in the United Kingdom: a RAND/UCLA appropriateness method panel study

BMC Family Practice

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[1] 0000 0004 1936 7603, grid.5337.2, Centre for Academic Primary Care, Population Health Sciences, University of Bristol, BS8 2PS, Bristol, UK;0000 0004 1936 8024, grid.8391.3, Primary Care Research Group, University of Exeter Medical School, Smeall Building, St Luke’s Campus, EX1 2LU, Exeter, UK;Academic Unit of Primary Care, Leeds Institute of Health Sciences, Worsley Building, Clarendon Way, LS2 9NL, Leeds, UK;University of Exeter Medical School, College House, St Luke’s Campus, EX1 2LU, Exeter, UK;

关键词: Primary care physicians;    Health workforce;    Work engagement;    Job description;    Staff development;    Personnel turnover;    Health care reform;    Consensus method;   

DOI  :  10.1186/s12875-019-1020-x

来源: publisher

【 摘 要 】

BackgroundThe United Kingdom (UK) is experiencing a general practitioner (GP) workforce retention crisis. Research has focused on investigating why GPs intend to quit, but less is known about the acceptability and effectiveness of policies and strategies to improve GP retention. Using evidence from research and key stakeholder organisations, we generated a set of potential policies and strategies aimed at maximising GP retention and tested their appropriateness for implementation by systematically consulting with GPs.Methods28 GP Partners and GPs working in national stakeholder organisations from South West England and London were purposively sampled, and asked to take part in a RAND/UCLA Appropriateness Method panel. Panellists were asked to read an evidence briefing summary, and then complete an online survey on two occasions. During each round, participants rated the appropriateness of policies and strategies aimed at improving GP retention using a nine point scale (1 ‘extremely inappropriate’ to 9 ‘extremely appropriate’). Fifty-four potential policies and strategies (equating to 100 statements) were tested, focusing on factors influencing job satisfaction (e.g. well-being, workload, incentives and remuneration, flexible working, human resources systems). Ratings were analysed for panel consensus and categorised based on appropriateness (‘appropriate’, ‘uncertain’, ‘inappropriate’).Results12/28 GPs approached agreed to take part, 9/28 completed two rounds of the online survey between February and June 2018. Panellists identified 24/54 policy and strategy areas (41/100 statements) as ‘appropriate’. Examples included providing GP practices ‘at risk’ of experiencing GP shortages with a toolkit for managing recruitment and retention, and interventions to facilitate peer support to enhance health and wellbeing, or support portfolio careers. Strategies to limit GP workload, and manage patient demand were also endorsed.ConclusionsThe panel of experienced GPs identified a number of practical ways to improve GP retention through interventions that might enhance job satisfaction and work-life balance. Future research should evaluate the impact of implementing these recommendations.

【 授权许可】

CC BY