A longitudinal qualitative study of the UK general practice workforce experience of COVID-19

Abstract

Background: 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. Aim: 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. Method: 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. Findings: 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.

How Austrian primary care physicians formed their concept of care quality during the first ten months of the COVID-19 pandemic. A repeated cross-sectional survey research

“…Unlike most studies on shifting and rearranging duties and responsibilities during the COVID-19 pandemic, our study is quantitative with a good sample size. It resonates with several qualitative studies and con rms their results [17,24,43,45,49,50]. Additionally, independent data validate the quality perception of PCPs discussed in this paper [25].…”

“…This correlated with the that fear of infection keeping patients away from acute healthcare (a concern during the rst COVID-19 wave) was no driver of the assessment of care quality either. A possible reason is that the delivery of primary care services changed remarkably throughout 2020 [2,30,[42][43][44]. Face-to-face contacts declined from 70-23%, while the number of telemedicine contacts increased broadly [45].…”

The Impact of COVID-19 on Primary Care: A Scoping Review

“…There has been some major change in healthcare workers' decision-making in times of uncertainty in particular when allocating resources within this challenging clinical situation (29,30). This certainly has led to an impact on both the physical and mental health needs of healthcare workers, fears of transmitting the virus to family members, and lack of personal protection equipment, which has certainly led depleted workforce (31)(32)(33)(34)(35)(36).…”

“…However, with the supplement of a pandemic, it has certainly added a new dimension to how decision-making in times of uncertainty is managed and has since been quite difficult for some healthcare workers when allocating resources within this challenging clinical situation [29,30]. This extra burden has certainly played a role in both the physical and mental health needs of healthcare workers [31]. A study by Gu et al reveals that Primary Care practitioners felt overlooked and undervalued during the pandemic resulting in a negative impact [32], further highlighted by an article by Stephenson, where they mention Primary Care physicians suffering from burnout [33].…”

Managing multiple long-term conditions or multimorbidity across COVID-19 pandemic: a longitudinal qualitative study from India

“…(9, 10).The COVID-19 pandemic has signi cantly impacted healthcare systems worldwide. The rapid in ux of patients requiring hospitalisation and intensive care overwhelmed healthcare systems and engaged most healthcare workers, disrupting non-COVID-19 healthcare services like outpatient visits, diagnostics, and managing chronic illnesses or their complications (11)(12)(13)(14). Social distancing measures, lockdowns, and fear of contracting the virus have decreased access to healthcare facilities.…”