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Skill mix, roles and remuneration in the primary care workforce: who are the healthcare professionals in the primary care teams across the world?

Skill mix, roles and remuneration in the primary care workforce: who are the healthcare professionals in the primary care teams across the world?
Skill mix, roles and remuneration in the primary care workforce: who are the healthcare professionals in the primary care teams across the world?
World-wide, shortages of primary care physicians and an increased demand for services
have provided the impetus for delivering team-based primary care. The diversity of the
primary care workforce is increasing to include a wider range of health professionals such
as nurse practitioners, registered nurses and other clinical staff members. Although this
development is observed internationally, skill mix in the primary care team and the speed
of progress to deliver team-based care differs across countries. This work aims to provide
an overview of education, tasks and remuneration of nurses and other primary care team
members in six OECD countries.
Based on a framework of team organization across the care continuum, six national
experts compare skill-mix, education and training, tasks and remuneration of health
professionals within primary care teams in the United States, Canada, Australia, England,
Germany and the Netherlands. Nurses are the main non-physician health professional
working along with doctors in most countries although types and roles in primary care
vary considerably between countries. However, the number of allied health professionals
and support workers, such as medical assistants, working in primary care is increasing.
Shifting from ‘task delegation’ to ‘team care’ is a global trend but limited by traditional role
concepts, legal frameworks and reimbursement schemes. In general, remuneration
follows the complexity of medical tasks taken over by each profession.
Clear definitions of each team-member’s role may facilitate optimally shared
responsibility for patient care within primary care teams. Skill mix changes in primary
care may help to maintain access to primary care and quality of care delivery. Learning
from experiences in other countries may inspire policy makers and researchers to work on
efficient and effective teams care models worldwide.
primary health care, workforce, skill mix, review, nurses, nurse practitioners
0020-7489
Freund, Tobias
acae2a66-02e5-4d39-b759-9c7761f561a3
Everett, Christine
bd7d46eb-73f7-4826-baa9-eb1f8c07e1b4
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
Hudon, Catherine
dd50e92a-2aeb-43be-9703-c5ed699ca782
Naccarella, Lucio
f334b6a8-8259-47bb-98db-79901ea48ad4
Laurant, Miranda
cbb53d53-384d-4482-8359-841fbf8e39a9
Freund, Tobias
acae2a66-02e5-4d39-b759-9c7761f561a3
Everett, Christine
bd7d46eb-73f7-4826-baa9-eb1f8c07e1b4
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
Hudon, Catherine
dd50e92a-2aeb-43be-9703-c5ed699ca782
Naccarella, Lucio
f334b6a8-8259-47bb-98db-79901ea48ad4
Laurant, Miranda
cbb53d53-384d-4482-8359-841fbf8e39a9

Freund, Tobias, Everett, Christine, Griffiths, Peter, Hudon, Catherine, Naccarella, Lucio and Laurant, Miranda (2014) Skill mix, roles and remuneration in the primary care workforce: who are the healthcare professionals in the primary care teams across the world? International Journal of Nursing Studies. (doi:10.1016/j.ijnurstu.2014.11.014).

Record type: Article

Abstract

World-wide, shortages of primary care physicians and an increased demand for services
have provided the impetus for delivering team-based primary care. The diversity of the
primary care workforce is increasing to include a wider range of health professionals such
as nurse practitioners, registered nurses and other clinical staff members. Although this
development is observed internationally, skill mix in the primary care team and the speed
of progress to deliver team-based care differs across countries. This work aims to provide
an overview of education, tasks and remuneration of nurses and other primary care team
members in six OECD countries.
Based on a framework of team organization across the care continuum, six national
experts compare skill-mix, education and training, tasks and remuneration of health
professionals within primary care teams in the United States, Canada, Australia, England,
Germany and the Netherlands. Nurses are the main non-physician health professional
working along with doctors in most countries although types and roles in primary care
vary considerably between countries. However, the number of allied health professionals
and support workers, such as medical assistants, working in primary care is increasing.
Shifting from ‘task delegation’ to ‘team care’ is a global trend but limited by traditional role
concepts, legal frameworks and reimbursement schemes. In general, remuneration
follows the complexity of medical tasks taken over by each profession.
Clear definitions of each team-member’s role may facilitate optimally shared
responsibility for patient care within primary care teams. Skill mix changes in primary
care may help to maintain access to primary care and quality of care delivery. Learning
from experiences in other countries may inspire policy makers and researchers to work on
efficient and effective teams care models worldwide.

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e-pub ahead of print date: 19 December 2014
Keywords: primary health care, workforce, skill mix, review, nurses, nurse practitioners
Organisations: Faculty of Health Sciences

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Local EPrints ID: 373316
URI: https://eprints.soton.ac.uk/id/eprint/373316
ISSN: 0020-7489
PURE UUID: 6ba9e99d-808f-4061-bfac-30dfd288f64a
ORCID for Peter Griffiths: ORCID iD orcid.org/0000-0003-2439-2857

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Date deposited: 14 Jan 2015 17:16
Last modified: 19 Jul 2019 00:45

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