Research Fellow at University of Birmingham, Health Services Management Centre (HSMC), Birmingham, UK.
Senior Policy Fellow, The Health Foundation, London, UK.
Prim Health Care Res Dev. 2022 Aug 4;23:e45. doi: 10.1017/S1463423622000391.
The COronaVIrus Disease 2019 (COVID-19) pandemic has led to significant re-organisation of general practice in the United Kingdom and around the world. The general practice workforce has led changes to their services, often dealing with high levels of uncertainty. The way in which many practitioners consult has shifted significantly, and there has been an increase in the number of phone and online consultations. We know very little about how those working in general practice experienced the service reorganisation introduced in the first year of the COVID-19 pandemic.
The aim of this project was to describe the changes in the delivery of general practice in the United Kingdom in the first year of the COVID-19 pandemic. Furthermore, to explore primary care practitioners' and managers' experiences of change within general practice during this time and investigate shifts in perceptions of professional identities.
We conducted a longitudinal qualitative study that captured narrative accounts from 17 primary care practitioners and managers across England and Scotland. Each participant submitted narrative accounts in the first year of the COVID-19 pandemic using self-recorded or written contributions, or via an interview if preferred. These were analysed using a grounded theory approach, with thematic coding used to construct common themes.
Participants' narratives describe the challenges COVID-19 presented to general practice. Responses mirror the shifts in the pandemic and its management - from an initial sense of autonomy but uncertainty, to a period of stability and patients' increasing frustration. The re-organisation of general practice has affected practitioners' views of their work and their role as clinicians. Participants' narratives were framed profoundly by the importance of their relationships with patients. This analysis of practitioners' and managers' narratives highlights the need for further exploration of how to support the general practice workforce's well-being longer term in a context of increased demand and significant change.
2019 年冠状病毒病(COVID-19)大流行导致英国和世界各地的全科医学发生了重大重组。全科医生的工作队伍主导了服务的变革,他们经常应对高度的不确定性。许多从业者的咨询方式发生了重大转变,电话和在线咨询的数量有所增加。我们对在 COVID-19 大流行的第一年中从事全科医学工作的人员的体验知之甚少。
本项目旨在描述 COVID-19 大流行第一年英国全科医疗服务的变化。此外,探讨初级保健从业者和管理者在此期间在全科实践中经历的变革,并调查对专业身份的看法的转变。
我们进行了一项纵向定性研究,从英格兰和苏格兰的 17 名初级保健从业者和管理者那里收集了叙述性描述。每位参与者都在 COVID-19 大流行的第一年使用自我记录或书面贡献提交叙述性描述,或者如果愿意,可以通过访谈提交。使用扎根理论方法对这些描述进行分析,使用主题编码构建共同主题。
参与者的叙述描述了 COVID-19 给全科医学带来的挑战。这些反应反映了大流行及其管理的转变——从最初的自治感但不确定,到稳定期和患者越来越沮丧的时期。全科医学的重组影响了从业者对自己工作的看法以及作为临床医生的角色。参与者的叙述深受与患者关系的重要性的影响。对从业者和管理者叙述的这种分析突出了需要进一步探索如何在需求增加和重大变革的背景下,更长期地支持全科医疗工作队伍的福祉。