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General practitioners' views of clinically led commissioning: cross-sectional survey in England.

ABSTRACT: OBJECTIVES:Involving general practitioners (GPs) in the commissioning/purchasing of services has been an important element in English health policy for many years. The Health and Social Care Act 2012 handed responsibility for commissioning of the majority of care for local populations to GP-led Clinical Commissioning Groups (CCGs). In this paper, we explore GP attitudes to involvement in commissioning and future intentions for engagement. DESIGN AND SETTING:Survey of a random sample of GPs across England in 2015. METHOD:The Eighth National GP Worklife Survey was distributed to GPs in spring 2015. Responses were received from 2611 respondents (response rate = 46%). We compared responses across different GP characteristics and conducted two sample tests of proportions to identify statistically significant differences in responses across groups. We also used multivariate logistic regression to identify the characteristics associated with wanting a formal CCG role in the future. RESULTS:While GPs generally agree that they can add value to aspects of commissioning, only a minority feel that this is an important part of their role. Many current leaders intend to quit in the next 5?years, and there is limited appetite among those not currently in a formal role to take up such a role in the future. CCGs were set up as 'membership organisations' but only a minority of respondents reported feeling that they had 'ownership' of their local CCG and these were often GPs with formal CCG roles. However, respondents generally agree that the CCG has a legitimate role in influencing the work that they do. CONCLUSION:CCGs need to engage in active succession planning to find the next generation of GP leaders. GPs believe that CCGs have a legitimate role in influencing their work, suggesting that there may be scope for CCGs to involve GPs more fully in roles short of formal leadership.

SUBMITTER: Moran V

PROVIDER: S-EPMC5734491 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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General practitioners' views of clinically led commissioning: cross-sectional survey in England.

Moran Valerie V Checkland Kath K Coleman Anna A Spooner Sharon S Gibson Jonathan J Sutton Matt M

BMJ open 20170608 6

<h4>Objectives</h4>Involving general practitioners (GPs) in the commissioning/purchasing of services has been an important element in English health policy for many years. The Health and Social Care Act 2012 handed responsibility for commissioning of the majority of care for local populations to GP-led Clinical Commissioning Groups (CCGs). In this paper, we explore GP attitudes to involvement in commissioning and future intentions for engagement.<h4>Design and setting</h4>Survey of a random samp ...[more]

PMID: 28596217

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Project description:BackgroundThere is limited United Kingdom (UK) literature on general practice-based pharmacists' (PBPs') role evolution and few studies have explored general practitioners' (GPs') experiences on pharmacist integration into general practice. Therefore, this study aimed to investigate GPs' experiences with, views of, and attitudes towards PBPs in Northern Ireland (NI).MethodsA paper-based self-administered questionnaire comprising four sections was mailed in 2019 to 329 general practices across NI and was completed by one GP in every practice who had most contact with the PBP. Descriptive analyses were used and responses to open-ended questions were analysed thematically.ResultsThe response rate was 61.7% (203/329). There was at least one PBP per general practice. All GPs had face-to-face meetings with PBPs, with three-quarters (78.7%, n = 159) meeting with the PBP more than once a week. Approximately two-thirds of GPs (62.4%, n = 126) reported that PBPs were qualified as independent prescribers, and 76.2% of these (n = 96/126) indicated that prescribers were currently prescribing for patients. The majority of GPs reported that PBPs always/very often had the required clinical skills (83.6%, n = 162) and knowledge (87.0%, n = 167) to provide safe and effective care for patients. However, 31.1% (n = 61) stated that PBPs only sometimes had the confidence to make clinical decisions. The majority of GPs (> 85%) displayed largely positive attitudes towards collaboration with PBPs. Most GPs agreed/strongly agreed that PBPs will have a positive impact on patient outcomes (95.0%, n = 192) and can provide a better link between general practices and community pharmacists (96.1%, n = 194). However, 24.8% of GPs (n = 50) were unclear if the PBP role moved community pharmacists to the periphery of the primary care team. An evaluation of the free-text comments indicated that GPs were in favour of more PBP sessions and full-time posts.ConclusionMost GPs had positive views of, and attitudes towards, PBPs. The findings may have implications for future developments in order to extend integration of PBPs within general practice, including the enhancement of training in clinical skills and decision-making. Exploring PBPs', community pharmacists' and patients' views of this role in general practice is required to corroborate study findings.

Project description:BackgroundJob satisfaction of general practitioners (GPs) is important because of the consequences of low satisfaction for GPs, their patients and the health system, such as higher turnover, health problems for the physicians themselves, less satisfied patients, poor clinical outcomes and suboptimal health care delivery. In this study, we aim to explain differences in the job satisfaction of GPs within and between countries.MethodsWe performed a secondary analysis of cross-sectional survey data, collected between 2010 and 2012 on 7379 GPs in 34 (mostly European) countries, as well as data on country and health system characteristics from public databases. Job satisfaction is measured through a composite score of six items about self-reported job experience. Operationalisation of the theoretical constructs includes variables, such as the range of services GPs provide, working hours, employment status, and feedback from colleagues. Data were analysed using linear multilevel regression analysis, with countries and GPs as levels. We developed hypotheses on the basis of the Social Production Function Theory, assuming that GPs 'produce' job satisfaction through stimulating work that provides a certain level of comfort, adds to their social status and provides behavioural confirmation.ResultsJob satisfaction varies between GPs and countries, with high satisfaction in Denmark and Canada (on average 2.97 and 2.77 on a scale from 1-4, respectively) and low job satisfaction in Spain (mean 2.15) and Hungary (mean 2.17). One-third of the total variance is situated on the country level, indicating large differences between countries, and countries with a higher GDP per capita have more satisfied GPs. Health system characteristics are not related to GP job satisfaction. At the GP and practice level, performing technical procedures and providing preventive care, feedback from colleagues, and patient satisfaction are positively related to GP job satisfaction and working more hours is negatively related GP job satisfaction.ConclusionOverall and in terms of our theoretical approach, we found that GPs are able to 'produce' work-related well-being through activities and resources related to stimulation, comfort and behavioural confirmation, but not to status.

Dataset Information

General practitioners' views of clinically led commissioning: cross-sectional survey in England.

Publications

General practitioners' views of clinically led commissioning: cross-sectional survey in England.

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