Abstract
ObjectivesEnglish general practice is suffering a workforce crisis, with general practitioners retiring early and trainees reluctant to enter the profession. To address this, additional funding has been offered, but only through participation in collaborations known as primary care networks (PCNs). This study explored national policy objectives underpinning PCNs and the mechanisms expected to help achieve these, from the perspective of those driving the policy.DesignQualitative semistructured interviews and policy document analysis.Setting and participantsNational-level policy maker and stakeholder interviewees (n=16). Policy document analysis of the Network Contract Direct Enhanced Service draft service specifications.AnalysisInterviews were transcribed, coded and organised thematically according to policy objectives and mechanisms. Thematic data were organised into a matrix so prominent elements can be identified and emphasised accordingly. Themes were considered alongside objectives embedded in PCN draft service delivery requirements.ResultsThree themes of policy objectives and associated mechanisms were identified: (1) supporting general practice, (2) place-based interorganisational collaboration and (3) primary care ‘voice’. Interviewees emphasised and sequenced themes differently, suggesting meeting objectives for one was necessary to realise another. Interviewees most closely linked to primary care emphasised the importance of theme 1. The objectives embedded in draft service delivery requirements primarily emphasised theme 2.ConclusionsThese policy objectives are not mutually exclusive but may imply different approaches to prioritising investment or necessitate more explicit temporal sequencing, with the stabilisation of a struggling primary care sector probably needing to occur before meaningful engagement with other community service providers can be achieved or a ‘collective voice’ is agreed. Multiple objectives create space for stakeholders to feel dissatisfied when implementation details do not match expectations, as the negative reaction to draft service delivery requirements illustrates. Our study offers policy makers suggestions about how confidence in the policy might be restored by crafting delivery requirements so all groups see opportunities to meet favoured objectives.
Highlights
Primary care in the UK is in crisis
We recognise that national policy makers and stakeholders may have particular perspectives about the state and needs of general practice that differ from those of others working in different parts of the system in different capacities
We identified three main groups of objectives espoused by those with senior-level responsibility for implementing or shaping the policy: use inter-general practitioners (GPs) practice collaboration to support a primary care sector which is struggling; align primary care more closely with other community services, improving integration and service delivery; and provide a collective ‘voice’ for primary care in the wider system
Summary
Primary care in the UK is in crisis. Young doctors are not entering, or remaining in, the specialty in sufficient numbers to cope with demand, and many older general practitioners (GPs) are increasingly dissatisfied with general practice due to various intrinsic and extrinsic factors and are choosing to retire early.[1 2]. A centrepiece of the new NHS Long Term Plan[7] is the creation and funding
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
