ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2019
Skill-mix change in general practice: a qualitative comparison of three 'new' non-medical roles in English primary care.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 34 papers, 3 of them syntheses that pooled it.
What it found
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Who cites it
34 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Perspectives of patients on the role of general practice pharmacists: a systematic review and meta-synthesis of qualitative studies.BMC primary care · 2025Pooled it
- Physician associates and anaesthetic associates in UK: rapid systematic review of recent UK based research.BMJ (Clinical research ed.) · 2025Pooled it
- Physician associate/assistant contributions to cancer diagnosis in primary care: a rapid systematic review.BMC health services research · 2021Pooled it
- Examples of Systemic Solutions for Skill-Mix Issues-An Analysis of International Experiences with a Focus on Rural Areas.Healthcare (Basel, Switzerland) · 2026Review
- GP workforce sustainability to maximise effective and equitable patient care: a realist review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Review
- Developing A Complex Intervention to Integrate Community Paramedics in GP Out-of-Hours Care in Ireland: A Qualitative Study.HRB open research · 2026Article
- Article
- Factors associated with link workers considering leaving their role: a cross-sectional survey.BJGP open · 2025Article
- Developing Integrated Extended Pharmacist Roles and Services for Equitable Access and Outcomes in Primary Healthcare: A Realist Evaluation.International journal of health policy and management · 2025Article
- What knowledge and skills are needed for community volunteers to take on a signposting role in community-based palliative care? A qualitative study.Palliative care and social practice · 2025Article
- Article
- Implementing the Additional Roles Reimbursement Scheme in seven English Primary Care Networks: a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Negotiating new roles in general practice: a qualitative study of clinical pharmacists.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Article
- Frailty nurse and GP-led models of care in care homes: the role of contextual factors impacting Enhanced health in care homes framework implementation.BMC geriatrics · 2023Article
- Primary care trainee nursing associates in England: a qualitative study of higher education institution perspectives.Primary health care research & development · 2023Article
- Processes supporting effective skill-mix implementation in general practice: A qualitative study.Journal of health services research & policy · 2022Article
- Organization of primary care.Primary health care research & development · 2022Review
- The standards of practice for delivery of polypharmacy and chronic disease medication reviews by general practice clinical pharmacists: a consensus study.International journal of clinical pharmacy · 2022Article
- Article
Corrections and comments
- Commented on by
- Erratum issuedCorrection.2019
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGeneral practice is currently facing a significant workforce challenge. Changing the general practice skill mix by introducing new non-medical roles is recommended as one solution; the literature highlights that organisational and/or operational difficulties are associated with skill-mix changes.
aimTo compare how three non-medical roles were being established in general practice, understand common implementation barriers, and identify measurable impacts or unintended consequences. DESIGN AND
settingIn-depth qualitative comparison of three role initiatives in general practices in one area of Greater Manchester, England; that is, advanced practitioner and physician associate training schemes, and a locally commissioned practice pharmacist service.
methodSemi-structured interviews and focus groups with a purposive sample of stakeholders involved in the implementation of each role initiative were conducted. Template analysis enabled the production of pre-determined and researcher-generated codes, categories, and themes.
resultsThe final sample contained 38 stakeholders comprising training/service leads, role holders, and host practice staff. Three key themes captured participants' perspectives: purpose and place of new roles in general practice, involving unclear role definition and tension at professional boundaries; transition of new roles into general practice, involving risk management, closing training-practice gaps and managing expectations; and future of new roles in general practice, involving demonstrating impact and questions about sustainability.
conclusionThis in-depth, in-context comparative study highlights that introducing new roles to general practice is not a simple process. Recognition of factors affecting the assimilation of roles may help to better align them with the goals of general practice and harness the commitment of individual practices to enable role sustainability.
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