ABS51: Can you be a generalist and a specialist? Stakeholders' views on a respiratory General Practitioner with a Special Interest service

Abstract

General Practitioners with Special Interests (GPwSIs) have a potentially important role in delivery care for people with long-term respiratory diseases. The development of a GPwSI service within a Primary Care Trust (PCT) involves a process of ‘transitional change’ which impacts on all stakeholders, who may embrace or resist change. The objective of the current study is to explore the attitudes and views of stakeholders to the provision of a respiratory GPwSI service within the six PCTs in Leicester, UK. Using a qualitative design, GPs, nurses, secondary care doctors, nurse specialists, physiotherapists, a healthcare manager and patients with respiratory disease took part in focus groups and interviews. The 25 participants expressed diverse opinions about the challenge of integrating specialist services with generalist care and the specific contribution that GPs might make to the care of people with chronic respiratory disease. A range of potential roles for a respiratory GPwSI, working as part of a multi-disciplinary team, were suggested, and a number of practical issues were highlighted. For the role to succeed, the GPwSI needs to have the trust of their primary and secondary care colleagues as well as the patients, to be a credible practitioner, and to be politically astute potentially enabling them to act as a champion supporting the transition process within the local health service. The introduction of a respiratory GPwSI service represents a challenge to traditional roles which, whilst broadly acceptable, raised a number of important issues for the stakeholders in our study. These perspectives need to be taken into account if workforce change is to be implemented successfully. Conflict of interest and funding GPIAG funded.