BJGP Interviews The British Journal of General Practice

In this episode, we talk to Dr Lynsey Warwick-Giles, a Research Associate based within the Centre for Primary Care and Health Services Research at the University of Manchester. 
Title of paper: Can Primary Care Networks contribute to the national goal of reducing health inequalities? A mixed method study
Available at: https://doi.org/10.3399/BJGP.2023.0258
Primary Care Networks are an important policy development in English primary care, with an additional contract supporting practices to work collaboratively. Policy makers intend that they will tackle local health inequalities. Our research suggests that there is potential for them to achieve this, but it will require: continued weighting of funding formulas to account for deprivation; redistribution of funds and other resources internally to support the most deprived practices; managerial support, particularly for PCNs with deprived populations; and realistic and achievable targets for PCN action.

In this episode, we talk to Dr Sahar Pahlavanyali, a doctor and PhD candidate based at the Department of Global Public Health and Primary Care at the University of Bergen in Norway. 
Title of paper: Continuity and breaches in GP care and their associations with mortality for patients with chronic disease: an observational study using Norwegian registry data
Available at: https://doi.org/10.3399/BJGP.2023.0211
There is a growing body of evidence on advantages of continuity, and a GP personal list is believed to be one of the positive measures to improve continuity, though not much researched. In a Norwegian setting with GP personal lists, we investigated the associations between GP continuity and mortality for patients with different chronic diseases. Our results showed that lower GP continuity was associated with increased risk of death, but the association was not significantly different for patients with the same RGP compared with those with different RGPs. This study suggests that high informational and management continuity provided by a GP personal list might lower and compensate for the adverse effects when changing GP.

In this episode, we talk to Dr Zoe Anchors, a Research Fellow based at the Centre for Health and Clinical Research at the University of the West of England. 
Title of paper: A qualitative investigation of the Additional Roles Reimbursement Scheme in primary care’
Available at: https://doi.org/10.3399/BJGP.2023.0433
The government has delivered on its commitment of recruiting 26,000 more primary care professionals through the ARRS in order to reduce patient waiting lists, widen the range of healthcare services and meet the needs of local populations. This qualitative analysis supports the positive impact of these additional roles in broadening the healthcare available to patients, and finds similar challenges (i.e., lack of career progression and supervision; lack of understanding of role descriptions and scope creep; problematic roadmaps; and poor integration) to implementation previously identified. However, our data reveals the scheme’s inflexibility and lack of available workforce particularly impacted Primary Care Networks in deprived areas resulting in the potential exacerbation of health inequalities, with the needs of populations not necessarily being met. More flexibility needs to be provided about who and what is funded under the scheme, with particular focus in areas of higher deprivation.

In this episode, we talk to Dr Lucy Potter, a GP and a doctoral research fellow based at the Centre for Academic Primary Care at the University of Bristol.
Title of paper: Improving access to general practice for and with people with severe and multiple disadvantage
Available at: https://doi.org/10.3399/BJGP.2023.0244
This study builds on previous work showing that continuity of care, being able to develop a trusting relationship and being proactive are of particular importance in providing care to highly people with SMD(3-7). This work describes co-designed strategies including prioritising patients on an inclusion patient list with more flexible access, continuity from a care coordinator and micro-team, and an information sharing tool, in addition to rich contextual information on how to shift ways of working to achieve this. These co-designed strategies are practical examples of proportionate universalism in general practice, where resources are prioritised to those most in need. They could be adapted and piloted in other practices and areas and may also offer promise in improving inclusion of other marginalised groups. Investing in this focused way of working may improve healthcare accessibility, health equity and staff wellbeing.

We are taking a break from the BJGP podcast this week for Easter, but we’ll be back on 9 April 2024. 

In this episode, we talk to Professor Miranda Pallan, a public health doctor who is Professor of Child and Adolescent Public Health at the University of Birmingham.
Title of paper: Supporting healthcare professionals to address child weight with parents: a qualitative study
Available at: https://doi.org/10.3399/BJGP.2023.0238
Healthcare professionals (HCPs) working in primary care and community settings are known to experience barriers in discussing child excess weight with parents. We conducted a qualitative study with General Practitioners, Primary Care Nurses and School Nurses to further explore these barriers and identify facilitating factors to inform recommendations for actions to support HCPs in addressing child weight with parents. Structural changes within primary/community care, joined up systems and data sharing across agencies, and development of HCP knowledge and skills through core training and continuing professional development will enable HCPs to discuss child weight and provide advice to parents.