Abstract
Background:
Global and United Kingdom (UK) primary care face significant General
Practitioner (GP) workforce shortages. Worldwide strategies to address this issue include the introduction of additional healthcare professionals and increasing technology utilisation, to reduce GP workload. However, whether these strategies can sustain the GP workforce remains unclear. Our review examines the factors that sustain and enable GPs to flourish.
Aim:
To examine how general practice work and healthcare systems support GP workforce sustainability and effective and equitable patient care.
Design & setting:
A realist review of existing empirical and grey literature. The search
strategy encompassed six electronic databases.
Method:
Realist synthesis involved (1) finding existing theories, (2) searching for evidence,
(3) selecting articles, (4) extracting data, and (5) synthesising evidence/drawing conclusions.
Context-Mechanism-Outcome Configurations were developed using extracted data and
patient and public involvement/stakeholder suggestions to refine our programme theory.
Results:
168 documents were included. Findings underscore the importance of meaningful work and engagement; relationships across individuals, organisations, and communities; and learning and development. We emphasise the need for congruence between GPs’ core values and their work; cumulative-knowledge building; system agility; psychological safety; and direct human connections.
Conclusion:
General practice structures, policies, and practices, and the interactions they
facilitate, are crucial for the sustainability of the workforce. Collaboration among GPs, the public, and policymakers is essential for implementing the principles from this review. Future systems should enable personalised care; sustain meaningful work and relationships; facilitate meaning-making; and promote agency, agility, and flexibility to enable GPs to utilise, adapt,
and cultivate expertise.
Global and United Kingdom (UK) primary care face significant General
Practitioner (GP) workforce shortages. Worldwide strategies to address this issue include the introduction of additional healthcare professionals and increasing technology utilisation, to reduce GP workload. However, whether these strategies can sustain the GP workforce remains unclear. Our review examines the factors that sustain and enable GPs to flourish.
Aim:
To examine how general practice work and healthcare systems support GP workforce sustainability and effective and equitable patient care.
Design & setting:
A realist review of existing empirical and grey literature. The search
strategy encompassed six electronic databases.
Method:
Realist synthesis involved (1) finding existing theories, (2) searching for evidence,
(3) selecting articles, (4) extracting data, and (5) synthesising evidence/drawing conclusions.
Context-Mechanism-Outcome Configurations were developed using extracted data and
patient and public involvement/stakeholder suggestions to refine our programme theory.
Results:
168 documents were included. Findings underscore the importance of meaningful work and engagement; relationships across individuals, organisations, and communities; and learning and development. We emphasise the need for congruence between GPs’ core values and their work; cumulative-knowledge building; system agility; psychological safety; and direct human connections.
Conclusion:
General practice structures, policies, and practices, and the interactions they
facilitate, are crucial for the sustainability of the workforce. Collaboration among GPs, the public, and policymakers is essential for implementing the principles from this review. Future systems should enable personalised care; sustain meaningful work and relationships; facilitate meaning-making; and promote agency, agility, and flexibility to enable GPs to utilise, adapt,
and cultivate expertise.
| Original language | English |
|---|---|
| Journal | British Journal of General Practice |
| Publication status | Submitted - 29 Jan 2025 |