Factors affecting general practice collaboration with voluntary and community sector organisations.

Collaborative working between general practice (GP) and voluntary and community sector (VCS) organisations is increasingly championed as a means of primary care doing more with less and of addressing patients' "wicked problems". This paper aims to add to the knowledge base around collaborative practice between GPs and VCS organisations by examining the factors that aid or inhibit such collaboration. A case study design was used to examine the lived-experience of GPs and VCS organisations working collaboratively. Four cases, each consisting of a GP and a VCS organisation with whom they work collaboratively, were identified. Interviews (n = 18) and a focus group (n = 1) were conducted with staff within each organisation. Transcribed data were analysed thematically. Whilet there are similarities across cases in their use of, for example, Health Trainers and social prescribing, the form and function of GP-VCS collaborations were unique to their local context. The identified factors affecting GP-VCS collaboration reflect those found in previous service evaluations and the broader literature on partnership working; shared understanding, time and resources, trust, strong leadership, operational systems and governance and the "negotiation" of professional boundaries. While the current political environment may represent an opportunity for collaborations to develop, there are issues yet to be resolved before collaboration-especially more holistic and integrated approaches-becomes systematically embedded into practice

Lifestyle risk factor communication by nurses in general practice: Understanding the interactional elements

Aim: This paper seeks to explore general practice nurses\u27 perceptions of interactional factors supporting communication with patients about lifestyle risk. Design: Qualitative descriptive study embedded in a concurrent mixed methods design. Methods: Fifteen Australian general practice nurses were interviewed following video-recorded chronic disease management consultations between August 2017 - March 2018. Results: The theme of \u27Interactional Factors\u27 comprised of the subthemes \u27Relational factors\u27 and \u27Patient factors\u27. Relational factors referred to communication techniques and methods supporting temporal continuity with patients about lifestyle risk. Patient factors included consumers\u27 motivation, willingness, and readiness to prioritize lifestyle changes. Lack of awareness of the nurses\u27 role was perceived to have an impact on initiation of lifestyle risk conversations. Conclusion: Strategies optimizing continuity of nursing care enhance the capacity for lifestyle risk reduction conversations with patients. Ongoing training in patient-centred communication and increasing patients\u27 awareness of general practice nurses\u27 roles would also better support these discussions. Impact: This research identifies ways the general practice nurses\u27 role in supporting lifestyle risk reduction can be improved. Optimizing the general practice nurses\u27 role in lifestyle risk communication can enhance the behaviour change and chronic disease management