Enhancing generalist skills to support the primary care workforce in Humber Coast and Vale: The Catalyst programme

Problem

New to practice (NTP) GPs want to develop a fulfilling portfolio career, yet many report lacking skills and confidence managing the complexity of modern clinical practice. Catalyst is a career development programme that addresses today’s primary care challenges and is designed to recruit, support, and retain NTP GPs across the Humber Coast and Vale area. Drawing on a logic model developed from previous research, Catalyst is an evidence-informed complex intervention delivered using transformational learning theory to project a change in motivation, skills and ways of working. A theory-based evaluation has been conducted to understand if/how Catalyst can support motivation and retention of primary care workforce.

Approach

The evaluation of Catalyst employed a mixed-methods approach informed by Normalisation Process Theory, which describes the dynamics of embedding new ways of working into routine practice. All participants enrolled in the programme were invited to take part in the evaluation. Data collection used multiple approaches including surveys, interviews and focus groups at multiple points in time. Abductive reasoning using constant comparison approaches aimed to identify enablers and barriers to implementing the core concepts of Catalyst into daily practice, and explore health professionals’ and career development changes sought.

Findings

When Catalyst started, the delegates described limited access to their community of practice and lack of confidence in the person-centred knowledge work of primary care. Over the course of the programme, they reported feeling more confident in expert generalist practice describing changes in specific areas of work (e.g., medication reviews and care home work), increased sense of purpose and motivation working as a GP (e.g., seeing themselves as future consultants in primary care), and access to an extended network of like-minded peers.

Consequences

The delegates enrolled in Catalyst highlighted the importance of an interactive training programme that addresses the challenges of today’s clinical practice. They developed and reinforced shared models of practice by interacting with peers across different practices, and reflecting and applying what they learned to their own practice. As the first cohort of Catalyst started their second year, the evaluation is currently underway to explore the experiences of a second cohort of NTP GPs enrolled in Catalyst.