Understanding and improving compound pressures in primary care: a realist review and embedded study within a review (SWAR)

Our research aims to understand how, why, and in which circumstances ‘compound pressures’ in primary care can be addressed in order to maximise more effective and equitable patient care. The NIHR defines compound pressures as an “increasingly complex set of challenges facing health and social care. They impact on patients, service users, carers and the health and care workforce” (1).
Reducing compound pressures on the NHS and social care is a crucial issue. Our research aims to explore the characteristics of compound pressures in UK primary care, the reported solutions and interventions to compound pressures, the intended and unintended outcomes of these interventions,
how general practice can support approaches to compound pressures, and how patients and the public can work with services to approach such pressures. Embedded within this proposal is a study within a review (SWAR) which will inform future realist review methodology. This will examine: i) how ‘key’ versus ‘all’ text includes contribute to the review programme theory and; ii) how use of AI technology can be used to support a) identification of relevant literature and b) contribution to our analysis.