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    Building managed primary care practice networks to deliver better clinical care: a qualitative semi-structured interview study. 
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    Building managed primary care practice networks to deliver better clinical care: a qualitative semi-structured interview study.

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    Accepted version (72.41Kb)
    Volume
    67
    Pagination
    e764 - e774
    DOI
    10.3399/bjgp17X692597
    Journal
    Br J Gen Pract
    Issue
    664
    Metadata
    Show full item record
    Abstract
    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.
    Authors
    Pawa, J; Robson, J; Hull, S
    URI
    http://qmro.qmul.ac.uk/xmlui/handle/123456789/50883
    Collections
    • Centre for Primary Care and Public Health [1603]
    Language
    eng
    Copyright statements
    © British Journal of General Practice 2017

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