Experiences of out-of-hours task-shifting from GPs: a systematic review of qualitative studies
Experiences of out-of-hours task-shifting from GPs: a systematic review of qualitative studies
BACKGROUND: The current GP workforce is insufficient to manage rising demand in patient care within out-of-hours (OOH) primary care services. To meet this challenge, non-medical practitioners (NMPs) are employed to fulfil tasks traditionally carried out by GPs. It is important to learn from experiences of task-shifting in this setting to inform optimal delivery of care.
AIM: To synthesise qualitative evidence of experiences of task-shifting in the OOH primary care setting.
DESIGN & SETTING: Systematic review of qualitative studies and thematic synthesis.
METHOD: Electronic searches were conducted across CINAHL (Cumulative Index of Nursing and Allied Health Literature), PsychINFO, Cochrane, MEDLINE, Embase, and OpenGrey for qualitative studies of urgent or OOH primary care services, utilising task-shifting or role delegation. Included articles were quality appraised and key findings collated through thematic synthesis.
RESULTS: A total of 2497 studies were screened, of which six met the inclusion criteria. These included interviews with 15 advanced nurse practitioners (ANPs), three physician assistants (PAs), two paramedics, and a focus group of 22 GPs, and focus groups with 33 nurses. Key findings highlight the importance of clearly defining and communicating the scope of practice of NMPs, and of building their confidence by appropriate training, support, and mentoring.
CONCLUSION: While NMPs may have the potential to make a substantial contribution to OOH primary care services, there has been very little research on experiences of task-shifting. Evidence to date highlights the need for further training specific to OOH services. Mentorship and support to manage the sometimes challenging cases presenting to OOH could enable more effective OOH services and better patient care.
after-hours care, out of hours, primary health care, task-shifting, workforce
1-9
Lyness, Emily
6d59d191-a210-4c77-b9eb-cb6b1d669042
Parker, Jennifer
08db544c-2af6-4c12-9d9a-34a4b66d62f5
Willcox, Merlin L.
dad5b622-9ac2-417d-9b2e-aad41b64ffea
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
24 August 2021
Lyness, Emily
6d59d191-a210-4c77-b9eb-cb6b1d669042
Parker, Jennifer
08db544c-2af6-4c12-9d9a-34a4b66d62f5
Willcox, Merlin L.
dad5b622-9ac2-417d-9b2e-aad41b64ffea
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Lyness, Emily, Parker, Jennifer, Willcox, Merlin L. and Dambha-Miller, Hajira
(2021)
Experiences of out-of-hours task-shifting from GPs: a systematic review of qualitative studies.
BJGP Open, 5 (4), .
(doi:10.3399/BJGPO.2021.0043).
Abstract
BACKGROUND: The current GP workforce is insufficient to manage rising demand in patient care within out-of-hours (OOH) primary care services. To meet this challenge, non-medical practitioners (NMPs) are employed to fulfil tasks traditionally carried out by GPs. It is important to learn from experiences of task-shifting in this setting to inform optimal delivery of care.
AIM: To synthesise qualitative evidence of experiences of task-shifting in the OOH primary care setting.
DESIGN & SETTING: Systematic review of qualitative studies and thematic synthesis.
METHOD: Electronic searches were conducted across CINAHL (Cumulative Index of Nursing and Allied Health Literature), PsychINFO, Cochrane, MEDLINE, Embase, and OpenGrey for qualitative studies of urgent or OOH primary care services, utilising task-shifting or role delegation. Included articles were quality appraised and key findings collated through thematic synthesis.
RESULTS: A total of 2497 studies were screened, of which six met the inclusion criteria. These included interviews with 15 advanced nurse practitioners (ANPs), three physician assistants (PAs), two paramedics, and a focus group of 22 GPs, and focus groups with 33 nurses. Key findings highlight the importance of clearly defining and communicating the scope of practice of NMPs, and of building their confidence by appropriate training, support, and mentoring.
CONCLUSION: While NMPs may have the potential to make a substantial contribution to OOH primary care services, there has been very little research on experiences of task-shifting. Evidence to date highlights the need for further training specific to OOH services. Mentorship and support to manage the sometimes challenging cases presenting to OOH could enable more effective OOH services and better patient care.
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More information
Accepted/In Press date: 19 April 2021
e-pub ahead of print date: 21 July 2021
Published date: 24 August 2021
Additional Information:
Funding
Emily Lyness is a National Institute for Health Research (NIHR) Academic Clinical Fellow. Hajira Dambha-Miller is a NIHR funded Academic Clinical Lecturer. Merlin L Willcox is an academic GP and his salary was funded by NIHR (grant reference number: CL-2016-26-005). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NIHR or the Department of Health and Social Care.
Keywords:
after-hours care, out of hours, primary health care, task-shifting, workforce
Identifiers
Local EPrints ID: 450703
URI: http://eprints.soton.ac.uk/id/eprint/450703
PURE UUID: 2d9174e6-6d47-4667-be50-e61be0ec2c45
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Date deposited: 06 Aug 2021 16:32
Last modified: 17 Mar 2024 03:54
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Author:
Jennifer Parker
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