Research protocol: general practice organ donation intervention-a feasibility study (GPOD)

BACKGROUND: New interventions are required to increase the number of people donating their organs after death. In the United States of America (USA), general practice has proved to be a successful location to increase organ donor registration. However, a dearth of research exists examining this in the United Kingdom (UK). due to the unique challenges presented by the National Health Service (NHS). This protocol outlines a feasibility study to assess whether UK general practice is a feasible and acceptable location for organ donation intervention targeting NHS Organ Donor Register (NHS ODR) membership. METHODS: The primary intervention element, prompted choice, requires general practice to ask patients in consultations if they wish to join the NHS ODR. Two additional intervention techniques will be used to support prompted choice: staff training and leaflets and posters. The intervention will run for 3 months (April-July 2018) followed by a period of data collection. The following methods will be used to assess feasibility, acceptability and fidelity: registration data, a training evaluation survey, focus groups with staff and online surveys for staff and patients. DISCUSSION: By examining the feasibility, acceptability and fidelity of a prompted choice intervention in UK general practice, important knowledge can be gathered on whether it is a suitable location to conduct this. Additional learning can also be gained generally for implementing interventions in general practice. This could contribute to the knowledge base concerning the feasibility of NHS general practice to host interventions

What are General Practitioner perceptions of workload in England? A qualitative study

Background General Practitioner (GP) morale is the lowest amongst doctors, job satisfaction is low, and the GP workforce is diminishing. Workload is frequently cited as negatively impacting on commitment to a career in general practice, and many GPs report their workload to be unmanageable. Aim To gather in-depth understanding of GPs’ perceptions and attitudes towards workload. Design and Setting All GPs working within NHS England were eligible. Of those who responded to advertisements, a maximum variation sample was selected until data saturation was reached. Semi-structured, qualitative interviews were conducted. Data were analysed thematically. Results 171 GPs responded, and 34 were included. GPs described an increase in workload over recent years, with current working days being long and intense, which raised concerns over wellbeing of GPs and patients. Full-time partnership was generally not considered to be possible, and many participants felt workload was unsustainable, particularly given the diminishing workforce. Four major themes emerged to explain increased workload: 1) increased patient needs and expectations, 2) changing relationship between primary and secondary care, 3) bureaucracy and resources, and 4) the balance of workload within a practice. Continuity of care was perceived to be being eroded by changes in contracts and working patterns to deal with workload. Conclusion This study highlights the urgent need to address perceived lack of investment and clinical capacity in general practice; and suggests that influencing patient expectations of what primary care can deliver and reducing bureaucracy have become key issues, at least until the capacity issues are resolved.</p

What are General Practitioner perceptions of workload in England? A qualitative study

Background General Practitioner (GP) morale is the lowest amongst doctors, job satisfaction is low, and the GP workforce is diminishing. Workload is frequently cited as negatively impacting on commitment to a career in general practice, and many GPs report their workload to be unmanageable. Aim To gather in-depth understanding of GPs’ perceptions and attitudes towards workload. Design and Setting All GPs working within NHS England were eligible. Of those who responded to advertisements, a maximum variation sample was selected until data saturation was reached. Semi-structured, qualitative interviews were conducted. Data were analysed thematically. Results 171 GPs responded, and 34 were included. GPs described an increase in workload over recent years, with current working days being long and intense, which raised concerns over wellbeing of GPs and patients. Full-time partnership was generally not considered to be possible, and many participants felt workload was unsustainable, particularly given the diminishing workforce. Four major themes emerged to explain increased workload: 1) increased patient needs and expectations, 2) changing relationship between primary and secondary care, 3) bureaucracy and resources, and 4) the balance of workload within a practice. Continuity of care was perceived to be being eroded by changes in contracts and working patterns to deal with workload. Conclusion This study highlights the urgent need to address perceived lack of investment and clinical capacity in general practice; and suggests that influencing patient expectations of what primary care can deliver and reducing bureaucracy have become key issues, at least until the capacity issues are resolved.</p