Impact of the 2004 GMS contract on practice nurses:

Mcgregor, Wendy; Jabareen, Hussein; O’Donnell, Catherine; Mercer, Stewart W; Watt, Graham

doi:10.3399/bjgp08x342183

Cited by 31 publications

(44 citation statements)

References 18 publications

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“…For example, several predominantly qualitative studies have explored the impact of the QOF on practice nurses McDonald et al, 2007;McGregor et al, 2008) -yet there is little policy-related discussion of negative impacts on practice nurse workload or morale.…”

Section: The Research Discourse On the Qof So Farmentioning

confidence: 99%

Research shapes policy: but the dynamics are subtle

Foy

Locock

Purdy

et al. 2013

Public Money & Management

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Section: The Research Discourse On the Qof So Farmentioning

confidence: 99%

Research shapes policy: but the dynamics are subtle

Foy

Locock

Purdy

et al. 2013

Public Money & Management

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show abstract

“…quantitative in nature and does not allow for an in-depth exploration of the perceived impact on those conducting the work. While the views and experiences of GP principals and practice nurses have been reported elsewhere, 13,14,23 only two studies have focused on salaried GPs and reported almost diametrically opposing findings. 17 Furthermore, both studies also had limitations.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…12 However, relatively little is known about this group of GPs as much of the post-2004 research has focused on GP principals and practice nurses. [13][14][15] Before 2004, salaried GPs were reported as experiencing lower stress levels than their principal counterparts, 16 and were located in democratic, collaborative practices conducting highly satisfying and varied 'nice work'. 17 By contrast they perceived their GP principals as conducting the 'unrewarding' or 'burdensome' work.…”

Section: Introductionmentioning

confidence: 99%

Experience of contractual change in UK general practice: a qualitative study of salaried GPs

Cheraghi-Sohi

McDonald²,

Harrison³

et al. 2012

Br J Gen Pract

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BackgroundGeneral practice in the UK underwent major change in 2004, with the introduction of new contracts and a significant element of pay for performance. Although salaried GPs form an increasing proportion of the general practice workforce, little is known of their experiences. AimTo explore the views and experiences of salaried GPs working in English general practice. Design and settingQualitative study using semi-structured interviews in 17 practices across England, between July 2007 and September 2009. MethodInterviews were conducted with 23 salaried GPs. A topic guide included questions on motivations for a career in general practice, descriptions of their daily working environment and duties, practice relationships, and future aspirations. ResultsThe new ability to opt out of out-of-hours responsibilities was deemed positive for the profession but not a major driver for choosing medical speciality. Views regarding the impact of the Quality and Outcomes Framework were ambivalent. Differences in pay were regarded as largely reflective of differences in responsibility between salaried GPs and principals. Most participants reported conducting varied work in collaborative practices. Participants held varying career aspirations. ConclusionSalaried GPs' working experiences were dependent upon personal aspirations and local context. Most salaried GPs were reportedly content with their current position but many also had aspirations of eventually attaining GP principal status. The current lack of available partnerships threatens to undo recent positive workforce progress and may lead to deep dissatisfaction within the profession and a future workforce crisis. Further large-scale quantitative work is required to assess the satisfaction and future expectations of those in salaried posts. Keywordsgeneral practice; primary care; workforce.

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“…This mirrors the increasingly important role that practice nurses play, particularly in the management of chronic diseases within practices. [35][36][37] It has been suggested that a health check approach is 'simplistic and flawed, in relation to the needs of patients with complex needs' as it does not address the long-term needs of patients. 1 The present study found that Keep Well was developing a system-wide approach, which was attempting to integrate approaches addressing both the health and social determinants of inequalities.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Delivering a national programme of anticipatory care in primary care: a qualitative study

O’Donnell

Mackenzie²,

Reid³

et al. 2012

Br J Gen Pract

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BackgroundPrimary prevention often occurs against a background of inequalities in health and health care. Addressing this requires practitioners and systems to acknowledge the contribution of health-related and social determinants and to deal with the lack of interconnectedness between health and social service providers. Recognising this, the Scottish Government has implemented a national programme of anticipatory care targeting individuals aged 45-64 years living in areas of socioeconomic deprivation and at high risk of cardiovascular disease. This programme is called Keep Well. AimTo explore the issues and tensions underpinning the implementation of a national programme of anticipatory care. Design and settingA qualitative study in five Wave 1 Keep Well pilot sites, located in urban areas of Scotland, and involving 79 general practices. MethodAnnual semi-structured interviews were conducted with 74 key stakeholders operating at national government level, local pilot level and within general practices, resulting in 118 interviews. Interview transcripts were analysed using the framework approach. ResultsFour underlying tensions were identified. First, those between a patient-focused generalpractice approach versus a population-level health-improvement approach, linking disparate health and social services; secondly, medical approaches versus wider social approaches; thirdly, a population-wide approach versus individual targeting; and finally, reactive versus anticipatory care. ConclusionImplementing an anticipatory care programme to address inequalities in cardiovascular disease identified several tensions, which need to be understood and resolved in order to inform the development of such approaches in general practice and to develop systems that reduce the degree of fragmentation across health and social services. Keywordsanticipatory care; cardiovascular diseases; inequalities, health; primary prevention. decisionmaking.

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Impact of the 2004 GMS contract on practice nurses:

Abstract: Background

Cited by 31 publications

References 18 publications

Research shapes policy: but the dynamics are subtle

Research shapes policy: but the dynamics are subtle

Experience of contractual change in UK general practice: a qualitative study of salaried GPs

Delivering a national programme of anticipatory care in primary care: a qualitative study

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