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A new role for the general practitioner? Reframing 'inappropriate attenders' to inappropriate services

A new role for the general practitioner? Reframing 'inappropriate attenders' to inappropriate services
A new role for the general practitioner? Reframing 'inappropriate attenders' to inappropriate services
This qualitative study describes the impact of deploying general practitioners (GPs) as primary care physicians (PCPs) in three Accident and Emergency (A&E) departments in Greater Manchester as part of a Health Action Zone initiative to promote integration of systems of care more responsive to the needs of inner city population groups. The setting was three Accident and Emergency Units in Greater Manchester. Semi-structured interviews with the PCPs and key A & E staff (n = 32) before the PCPs were deployed, then at intervals throughout the project. Interviews were audiotaped and transcribed. Transcripts were analysed using constant comparison to identify emerging themes. Key themes centred on the assumptions and negotiation surrounding the emerging roles of the PCPs (as seen by themselves and other staff), particularly the conflict between operational (day-to-day work with patients) and strategic (forward planning) roles. The PCP appeared to act as a catalyst for the view that patients were not presenting “inappropriately”, rather, the problems presented at A&E might be best dealt with in different parts of the healthcare system, or by different personnel, and it is the service currently available that is inappropriate. By deploying the GP in a new role as PCP, but with the traditional autonomy associated with being a GP, and allowing him/her to develop the role according to local need, the new service evolved to identify and meet the needs of patients more appropriately. The use of the expanded role of the GP may be more successful in achieving ‘joined-up’ services than deploying other professional groups, such as nurses, to fulfil a specific role
1463-4236
60-67
Chew-Graham, Carolyn
530beade-2b1c-4eea-846f-1fcef0585ca5
Rogers, Anne
cac0b774-b6bf-4e22-bee6-03551d0730c7
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Sheaff, Rod
53b55ebd-fade-47cd-a8a1-c73487fcda52
Ball, Elaine
ab492c11-966f-4f5a-8b37-3cd13ecf4cf7
Chew-Graham, Carolyn
530beade-2b1c-4eea-846f-1fcef0585ca5
Rogers, Anne
cac0b774-b6bf-4e22-bee6-03551d0730c7
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Sheaff, Rod
53b55ebd-fade-47cd-a8a1-c73487fcda52
Ball, Elaine
ab492c11-966f-4f5a-8b37-3cd13ecf4cf7

Chew-Graham, Carolyn, Rogers, Anne, May, Carl, Sheaff, Rod and Ball, Elaine (2004) A new role for the general practitioner? Reframing 'inappropriate attenders' to inappropriate services. Primary Health Care Research & Development, 5 (1), 60-67. (doi:10.1191/1463423604pc188oa).

Record type: Article

Abstract

This qualitative study describes the impact of deploying general practitioners (GPs) as primary care physicians (PCPs) in three Accident and Emergency (A&E) departments in Greater Manchester as part of a Health Action Zone initiative to promote integration of systems of care more responsive to the needs of inner city population groups. The setting was three Accident and Emergency Units in Greater Manchester. Semi-structured interviews with the PCPs and key A & E staff (n = 32) before the PCPs were deployed, then at intervals throughout the project. Interviews were audiotaped and transcribed. Transcripts were analysed using constant comparison to identify emerging themes. Key themes centred on the assumptions and negotiation surrounding the emerging roles of the PCPs (as seen by themselves and other staff), particularly the conflict between operational (day-to-day work with patients) and strategic (forward planning) roles. The PCP appeared to act as a catalyst for the view that patients were not presenting “inappropriately”, rather, the problems presented at A&E might be best dealt with in different parts of the healthcare system, or by different personnel, and it is the service currently available that is inappropriate. By deploying the GP in a new role as PCP, but with the traditional autonomy associated with being a GP, and allowing him/her to develop the role according to local need, the new service evolved to identify and meet the needs of patients more appropriately. The use of the expanded role of the GP may be more successful in achieving ‘joined-up’ services than deploying other professional groups, such as nurses, to fulfil a specific role

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Published date: January 2004

Identifiers

Local EPrints ID: 163515
URI: https://eprints.soton.ac.uk/id/eprint/163515
ISSN: 1463-4236
PURE UUID: 140e72dc-71d7-42d2-a528-eac9ee5060ca
ORCID for Carl May: ORCID iD orcid.org/0000-0002-0451-2690

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Date deposited: 13 Sep 2010 13:55
Last modified: 20 Jul 2019 00:46

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Contributors

Author: Carolyn Chew-Graham
Author: Anne Rogers
Author: Carl May ORCID iD
Author: Rod Sheaff
Author: Elaine Ball

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