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Senior clinical and business managers’ perspectives on the influence of different funding mechanisms, and barriers and enablers to implementing models of employing General Practitioners in or alongside emergency departments: Quali...

Mazhar Choudhry, Michelle Edwards, Alison Cooper, Pippa Anderson, Andrew Carson-Stevens, Matthew Cooke, Jeremy Dale, Peter Hibbert, Thomas Hughes, Alison Porter Orcid Logo, Timothy Rainer, Aloysius Niroshan Siriwardena, Adrian Edwards

Health Policy, Volume: 125, Issue: 4, Pages: 482 - 488

Swansea University Authors: Pippa Anderson, Alison Porter Orcid Logo

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Abstract

PurposeHealth policy in England has advocated the use of primary care clinicians at emergencydepartments to address pressures from rising attendances. Thisstudy explored seniormanagers’ perspective son funding mechanisms used to implement the policy andexperiences of success or challenges in introdu...

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Published in: Health Policy
ISSN: 0168-8510
Published: Elsevier BV 2021
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa55884
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Abstract: PurposeHealth policy in England has advocated the use of primary care clinicians at emergencydepartments to address pressures from rising attendances. Thisstudy explored seniormanagers’ perspective son funding mechanisms used to implement the policy andexperiences of success or challenges in introducing GPs in or alongside emergencydepartments.MethodsThe perspectives of senior clinical, business and finance managers with responsibility foremergency department services and on-site primary care service implementation wereinvestigated in semi-structured interviews with 31 managers at 12 type-1 emergencydepartments in England and Wales (February 2018 - September 2019). Emergencydepartments operated one of three GP models or had prior experience of implementing aGP model. Interviews were thematically analysed.Manuscript (without Author Details) Click here to view linked References 1 2 3 4 5 6 7 8 91011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859606162636465 2ResultsPerceived successful GPs models in emergency departments were reliant on well-organisedand unified funding mechanisms, appropriate staffing and governance, and consideration ofpopulation demands and needs. Funding mechanisms and the flow of funds were reportedas complex, especially in Inside-parallel GP models. The most efficient mechanisms weredescribed at departments where funding was unified, in collaboration with health andcommunity care services. Staffing with local, experienced GPs was important. There werecautions from experiences with private locum providers.ConclusionOur findings contribute to debates about implementing policy on how primary careclinicians are effectively and safely deployed in emergency departments and how localcontext should be considered.
Keywords: Emergency services, Hospital; General Practitioners; Primary health care; Health policy; Leadership
College: College of Human and Health Sciences
Issue: 4
Start Page: 482
End Page: 488