What policies and strategies aimed at improving GP retention do GPs think might work? A RAND/UCLA Appropriateness Method Panel study

Conference:

SAPC ASM 2018 - London

Talk Code:

4D.6

Presenter:

Suzanne Richards

Twitter:

@RichaSuzy

Co-authors:

Rupa Chilvers, Emily Fletcher, John Campbell, on behalf of the ReGROUP Investigators

Author institutions:

University of Leeds, University of Exeter

Problem

The UK is experiencing a GP retention crisis, with up to a third of GPs reporting an intention to quit/retire from the workforce, or reduce their working hours providing direct patient care. This is taking place against the backdrop of rising patient demand in primary care. Research has focused on investigating why GPs are intending to quit; much less is known about the effectiveness of policies and strategies aimed at improving GP retention. Using evidence from research and key stakeholder organisations, we generated a set of potential policies and strategies aimed at maximising GP retention and tested their appropriateness and feasibility for implementation by systematically consulting with GPs.

Approach

28 GP Partners and GPs working in national stakeholder organisations from South West England and London were purposively sampled and approached to take part in an online RAND/UCLA Appropriateness Method (RAM) panel. Panellists were asked to complete an online survey on two occasions. During each round, participants were asked to rate the appropriateness of potential policies and strategies aimed at improving GP retention using a nine point scale (1 extremely inappropriate to 9 extremely appropriate. 54 potential policies and strategies (aimed at national/regional, GP Practice, and individual GP levels), were developed into 100 summarising statements for rating based on the research evidence and current policy directions. We focused on policies and strategies that were likely to influence job satisfaction (e.g. well-being, workload, incentives and remuneration, flexible working, human resources systems) within the next five years. Ratings were analysed for panel consensus and categorised based on appropriateness (appropriate, uncertain, inappropriate).

Findings

Data collection took place between February and June 2018. 12/28 GPs approached agreed to take part, 9/28 completed 2 rounds of the online survey. RAM panellists identified 24/54 policies and strategies (41/100 statements) as ‘appropriate’. Examples included providing GP practices ‘at risk’ of experiencing GP shortages with specialist support for managing recruitment and retention, or providing new incentive/support packages for GPs setting up new practices in under-doctored areas. Different types of support for GPs re-entering the work place after a break were endorsed, as was providing optional, tailored support for GPs in the first 5 years following qualification to help them establish healthy, productive careers.

Consequences

Focusing on solutions, we sought the views of experienced GPs regarding practical ways to improve the retention of GPs. As our panel was restricted to assessing policies and strategies influencing job satisfaction, future research evaluating the appropriateness of other potentially relevant interventions falling outside this scope (e.g. primary care skills mix) is warranted.

Submitted by:

Suzanne Richards

Funding acknowledgement:

This article presents independent research commissioned by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme (ReGROUP study, ref: 14/196/02). The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.