Perspectives of GPs working in or alongside emergency departments in England: qualitative findings from the GPs and Emergency Departments Study

The British journal of general practice: the journal of the Royal College of General Practitioners

article

Helen Anderson¹  Arabella Scantlebury¹  Heather Leggett¹  Chris Salisbury²  Jonathan Benger³  Joy Adamson¹ 

[1] York Trials Unit, Department of Health Sciences, University of York;Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School;School of Health and Social Wellbeing, University of the West of England

关键词: emergency department;    general practice;    general practitioners;    qualitative research;   

DOI  :  10.3399/BJGP.2021.0713

学科分类：卫生学

来源: Royal College of General Practitioners

【 摘 要 】

Background Around 43% of emergency department (ED) attendances can be managed in general practice. Strategies to address this include directing appropriate patients to GPs working in or alongside EDs (GPED). Views of GPs choosing to work in GPED roles may inform planning and implementation of GPED services as well as wider general practice provision.Aim To explore the experiences and motivations of GPs choosing to work in GPED services in England, and to identify factors that may support or hinder GPs working in GPED roles.Design and setting Thematic analysis of 42 semi-structured interviews of GPs working in 10 GPED case sites across England.Method Qualitative GP interviews from a mixed-methods study of GPs in GPED roles were thematically analysed in relation to research aims.Results Four themes were generated: the ‘pull’ of a portfolio career; the ‘push’ of disillusionment with general practice; professional reciprocity; sustainability of GPED services and core general practice. Flexible, favourable working conditions, collaboration, and professional development made GPED an attractive workplace, often as part of a portfolio career or after retiring from core general practice. Working in GPED services was largely driven by disillusionment with core general practice. Both GPED and core general practice were thought to benefit from GPED GPs’ skills. There were concerns about GPED sustainability and destabilisation of core general practice.Conclusion GPED may extend the clinical careers of experienced GPs and support recruitment and retention of more recently qualified GPs. Despite some benefits, GPED may destabilise core general practice and increase pressure on both environments.

【 授权许可】

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