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Future-proofing the primary care workforce: A qualitative study of home visits by emergency care practitioners in the UK

Lookup NU author(s): Dr Robert Barker, Dr Rachel Stocker, Dr Siân Russell, Professor Barbara Hanratty



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


BackgroundBroadening the skill-mix in general practice is advocated to build resilience into the primary care workforce. However, there is little understanding of how extended-scope practitioners from different disciplines, such as paramedicine and nursing, embed into roles traditionally ascribed to general practitioners (GPs).ObjectivesThis study sought to explore patients' and professionals' experiences of a primary care home visiting service delivered by emergency care practitioners (ECPs), in place of GPs; to determine positive impacts/unintended consequences and establish whether interdisciplinary working was achieved.MethodsThree practices in England piloted an ECP (extended-scope practitioners with a paramedic or nursing background) home visiting service (November 2018–March 2019). Following the pilot, focus groups were conducted with each of the three primary healthcare teams (14 participants, including eight GPs), and one with ECPs (five participants) and nine individual patient interviews. Data were analysed using a modified framework approach.ResultsThe impact of ECP home visiting on GP workload and patient care was perceived as positive by patients, GPs and ECPs. Initial preconceptions of GPs and patients about the ECP role and expertise, and reservations about the appropriacy of ECPs for home visiting, were perceived to have been overcome by the expertise and interpersonal skills of ECPs. Fostering a culture of collaboration between ECPs and GPs was instrumental to remodelling professional boundaries at the practice level.ConclusionBroadening the skill-mix to incorporate extended-scope practitioners such as ECPs, to deliver primary care home visiting, presents an opportunity to increase resilience in the general practice workforce.

Publication metadata

Author(s): Barker RO, Stocker R, Russell S, Hanratty B

Publication type: Article

Publication status: Published

Journal: European Journal of General Practice

Year: 2021

Volume: 27

Issue: 1

Pages: 68-76

Online publication date: 12/05/2021

Acceptance date: 19/03/2021

Date deposited: 19/12/2022

ISSN (print): 1381-4788

ISSN (electronic): 1751-1402

Publisher: Taylor & Francis


DOI: 10.1080/13814788.2021.1909565


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Funder referenceFunder name
IPF-2018-12-010National Institute for Health Research (NIHR)
North of England Commissioning Support Unit (NECS) NIHR Research Capacity Funding