RT Journal Article
SR Electronic
T1 Challenges in implementing GP clusters in Scotland: a qualitative study comparing the views of senior primary care stakeholders in 2016 with those in 2021
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP BJGPO.2022.0152
DO 10.3399/BJGPO.2022.0152
A1 Catherine Kidd
A1 Eddie Donaghy
A1 Huayi Huang
A1 Rhian Noble-Jones
A1 Sharon Ogilvie
A1 Julia McGregor
A1 Margaret Maxwell
A1 John Gillies
A1 David AG Henderson
A1 Harry HX Wang
A1 Stewart W Mercer
YR 2023
UL http://bjgpopen.org/content/early/2023/05/16/BJGPO.2022.0152.abstract
AB Background Formation of GP clusters began in Scotland in April 2016 as part of a new Scottish GP contract. They aim to improve the care quality for local populations (intrinsic role) and the integration of health and social care (extrinsic role).Aim To compare predicted challenges of cluster implementation in 2016 with reported challenges in 2021.Design & setting Qualitative study of senior national stakeholders in primary care in Scotland.Method Qualitative analysis of semi-structured interviews with 12 senior primary care national stakeholders in 2016 (n = 6) and 2021 (n = 6).Results Predicted challenges in 2016 included balancing intrinsic and extrinsic roles, providing sufficient support, maintaining motivation and direction, and avoiding variation between clusters. Progress of clusters in 2021 was perceived as suboptimal and was reported to vary significantly across the country, reflecting differences in local infrastructure. Practical facilitation (data, administrative support, training, project improvement support, and funded time) and strategic guidance from the Scottish Government was felt to be lacking. GP engagement with clusters was felt to be hindered by the significant time and workforce pressures facing primary care. These barriers were considered as collectively contributing to cluster lead ‘burnout’ and loss of momentum, exacerbated by inadequate opportunities for shared learning between clusters across Scotland. Such barriers preceded, but were perpetuated by, the impact of the COVID-19 pandemic.Conclusion Apart from the COVID-19 pandemic, many of the challenges reported by stakeholders in 2021 were predicted in 2016. Accelerating progress in cluster working will require renewed investment and support applied consistently across the country.