Research Fellow, Centre for Primary Care and Health Services Research, 5292University of Manchester, UK.
Professor of Employment Relations, Alliance Manchester Business School, 5292University of Manchester, UK.
J Health Serv Res Policy. 2023 Jan;28(1):5-13. doi: 10.1177/13558196221117647. Epub 2022 Aug 17.
The objectives are to determine the factors that motivated GP practice managers in England to employ non-medical roles, and to identify an ideal hypothetical GP practice workforce.
Cross-sectional survey of GP practice managers in England ( = 1205). The survey focused on six non-medical roles: advanced nurse practitioner, specialist nurse, health care assistant, physician associate, paramedic and pharmacist.
The three most commonly selected motivating factors were: (i) to achieve a better match between what patients need and what the practitioner team can deliver; (ii) to increase overall appointment availability and (iii) to release GP time. Employment of pharmacists and physician associates was most commonly supported by additional funding. Practice managers preferred accessing new non-medical roles through a primary care network or similar, while there was a clear preference for direct employment of additional GPs, advanced nurse practitioners or practice nurses. The ideal practice workforce would comprise over 70% of GPs and nurses, containing, on average, fewer GPs than the current GP practice workforce.
This study confirms that more diverse teams of practitioners are playing an increasing role in providing primary care in England. Managers prefer not to employ all new roles directly within the practice. A more detailed investigation of future workforce requirements is necessary to ensure that health policy supports the funding (whether practice or population based), recruitment, training, deployment and workloads associated with the mix of roles needed in an effective primary care workforce.
确定促使英格兰全科医生实践经理雇用非医疗角色的因素，并确定理想的全科医生实践人员配置。
对英格兰全科医生实践经理进行横断面调查（=1205）。调查重点关注六种非医疗角色：高级执业护师、专科护士、医疗保健助理、医师助理、护理人员和药剂师。
三个最常被选择的激励因素是：（i）在患者需求与医生团队提供的服务之间实现更好的匹配；（ii）增加总体预约量；（iii）释放全科医生的时间。药剂师和医师助理的雇用最常得到额外资金的支持。实践经理更喜欢通过初级保健网络或类似的方式获得新的非医疗角色，而直接雇用更多的全科医生、高级执业护师或执业护士则更为优先。理想的实践人员配置将由超过 70%的全科医生和护士组成，平均来说，全科医生的数量比当前的全科医生实践人员配置要少。
本研究证实，更多样化的从业者团队在提供英国初级保健方面发挥着越来越重要的作用。经理们更愿意不在实践中直接雇用所有新角色。需要更详细地调查未来的劳动力需求，以确保卫生政策支持与有效初级保健人员配置所需的角色组合相关的资金（无论是基于实践还是基于人群）、招聘、培训、部署和工作量。
