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Article: Senior clinical and business managers’ perspectives on the influence of different funding mechanisms, and barriers and enablers to implementing models of employing General Practitioners in or alongside emergency departments: Qualitative study

TitleSenior clinical and business managers’ perspectives on the influence of different funding mechanisms, and barriers and enablers to implementing models of employing General Practitioners in or alongside emergency departments: Qualitative study
Authors
KeywordsEmergency services
Hospital
General Practitioners
Primary health care
Health policy
Issue Date2021
PublisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/healthpol
Citation
Health Policy, 2021, v. 125 n. 4, p. 482-488 How to Cite?
AbstractPurpose: Health policy in England has advocated the use of primary care clinicians at emergency departments to address pressures from rising attendances. This study explored senior managers’ perspective son funding mechanisms used to implement the policy and experiences of success or challenges in introducing GPs in or alongside emergency departments. Methods: The perspectives of senior clinical, business and finance managers with responsibility for emergency department services and on-site primary care service implementation were investigated in semi-structured interviews with 31 managers at 12 type-1 emergency departments in England and Wales (February 2018 - September 2019). Emergency departments operated one of three GP models or had prior experience of implementing a GP model. Interviews were thematically analysed. Results: Perceived successful GPs models in emergency departments were reliant on well-organised and unified funding mechanisms, appropriate staffing and governance, and consideration of population demands and needs. Funding mechanisms and the flow of funds were reported as complex, especially in Inside-parallel GP models. The most efficient mechanisms were described at departments where funding was unified, in collaboration with health and community care services. Staffing with local, experienced GPs was important. There were cautions from experiences with private locum providers. Conclusion: Our findings contribute to debates about implementing policy on how primary care clinicians are effectively and safely deployed in emergency departments and how local context should be considered.
Persistent Identifierhttp://hdl.handle.net/10722/297247
ISSN
2023 Impact Factor: 3.6
2023 SCImago Journal Rankings: 1.206
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChoudhry, M-
dc.contributor.authorEdwards, M-
dc.contributor.authorCooper, A-
dc.contributor.authorAnderson, P-
dc.contributor.authorCarson-Stevens, A-
dc.contributor.authorCooke, M-
dc.contributor.authorDale, J-
dc.contributor.authorHibbert, P-
dc.contributor.authorHughes, T-
dc.contributor.authorPorter, A-
dc.contributor.authorRainer, TH-
dc.contributor.authorSiriwardena, AN-
dc.contributor.authorEdwards, A-
dc.date.accessioned2021-03-08T07:16:15Z-
dc.date.available2021-03-08T07:16:15Z-
dc.date.issued2021-
dc.identifier.citationHealth Policy, 2021, v. 125 n. 4, p. 482-488-
dc.identifier.issn0168-8510-
dc.identifier.urihttp://hdl.handle.net/10722/297247-
dc.description.abstractPurpose: Health policy in England has advocated the use of primary care clinicians at emergency departments to address pressures from rising attendances. This study explored senior managers’ perspective son funding mechanisms used to implement the policy and experiences of success or challenges in introducing GPs in or alongside emergency departments. Methods: The perspectives of senior clinical, business and finance managers with responsibility for emergency department services and on-site primary care service implementation were investigated in semi-structured interviews with 31 managers at 12 type-1 emergency departments in England and Wales (February 2018 - September 2019). Emergency departments operated one of three GP models or had prior experience of implementing a GP model. Interviews were thematically analysed. Results: Perceived successful GPs models in emergency departments were reliant on well-organised and unified funding mechanisms, appropriate staffing and governance, and consideration of population demands and needs. Funding mechanisms and the flow of funds were reported as complex, especially in Inside-parallel GP models. The most efficient mechanisms were described at departments where funding was unified, in collaboration with health and community care services. Staffing with local, experienced GPs was important. There were cautions from experiences with private locum providers. Conclusion: Our findings contribute to debates about implementing policy on how primary care clinicians are effectively and safely deployed in emergency departments and how local context should be considered.-
dc.languageeng-
dc.publisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/healthpol-
dc.relation.ispartofHealth Policy-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectEmergency services-
dc.subjectHospital-
dc.subjectGeneral Practitioners-
dc.subjectPrimary health care-
dc.subjectHealth policy-
dc.titleSenior clinical and business managers’ perspectives on the influence of different funding mechanisms, and barriers and enablers to implementing models of employing General Practitioners in or alongside emergency departments: Qualitative study-
dc.typeArticle-
dc.identifier.emailRainer, TH: thrainer@hku.hk-
dc.identifier.authorityRainer, TH=rp02754-
dc.description.naturepostprint-
dc.identifier.doi10.1016/j.healthpol.2020.11.016-
dc.identifier.pmid33526280-
dc.identifier.scopuseid_2-s2.0-85100178615-
dc.identifier.hkuros321453-
dc.identifier.volume125-
dc.identifier.issue4-
dc.identifier.spage482-
dc.identifier.epage488-
dc.identifier.isiWOS:000632729500008-
dc.publisher.placeIreland-

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