Building managed primary care practice networks to deliver better clinical care: a qualitative semi-structured interview study.
e764 - e774
Br J Gen Pract
MetadataShow full item record
BACKGROUND: Primary care practices are increasingly working in larger groups. In 2009, all 36 primary care practices in the London borough of Tower Hamlets were grouped geographically into eight managed practice networks to improve the quality of care they delivered. Quantitative evaluation has shown improved clinical outcomes. AIM: To provide insight into the process of network implementation, including the aims, facilitating factors, and barriers, from both the clinical and managerial perspectives. DESIGN AND SETTING: A qualitative study of network implementation in the London borough of Tower Hamlets, which serves a socially disadvantaged and ethnically diverse population. METHOD: Nineteen semi-structured interviews were carried out with doctors, nurses, and managers, and were informed by existing literature on integrated care and GP networks. Interviews were recorded and transcribed, and thematic analysis used to analyse emerging themes. RESULTS: Interviewees agreed that networks improved clinical care and reduced variation in practice performance. Network implementation was facilitated by the balance struck between 'a given structure' and network autonomy to adopt local solutions. Improved use of data, including patient recall and peer performance indicators, were viewed as critical key factors. Targeted investment provided the necessary resources to achieve this. Barriers to implementing networks included differences in practice culture, a reluctance to share data, and increased workload. CONCLUSION: Commissioners and providers were positive about the implementation of GP networks as a way to improve the quality of clinical care in Tower Hamlets. The issues that arose may be of relevance to other areas implementing similar quality improvement programmes at scale.
AuthorsPawa, J; Robson, J; Hull, S
- Population Health 
Showing items related by title, author, creator and subject.
Can we halt health workforce deterioration in failed states? Insights from Guinea-Bissau on the nature, persistence and evolution of its HRH crisis Russo, G; Pavignani, E; Guerreiro, CS; Neves, C (2017-02-07)
Social networks and health policy: the case of misoprostol and the WHO model essential medicine list. Millard, C; Brhlikova, P; Pollock, A (2015-05)The WHO Essential Medicines List (EML) was established to help countries prioritise medicines according to their health care needs. Selection for the List is based on rigorous scrutiny of public health relevance, evidence ...
McCrone, P; Seed, PT; Dowson, AJ; Clark, LV; Goldstein, LH; Morgan, M; Ridsdale, L (2011-12)This paper aims to estimate the service and social costs of headache presenting in primary care and to identify predictors of headache costs. Patients were recruited from GP practices in England and service use and lost ...