Extended training to prepare GPs for future workforce needs: a qualitative investigation of a 1-year fellowship in urgent care

Matthew Aiello

doi:10.3399/bjgp18X696953

Abstract

Background It has been argued that UK general practice specialist training should be extended, to better prepare GPs for challenges facing 21st-century health care. Evidence is needed to inform how this should occur.

Aim To investigate the experience of recently trained GPs undertaking a 1-year full-time fellowship programme; in particular, workforce impact and career development potential. The fellowship was designed to provide advanced skills training in urgent care, integrated care, leadership, and academic practice.

Method Semi-structured interviews conducted longitudinally over 2 years, augmented by observational data in West Midlands, England. Participants were interviewed on at least three occasions: twice while undertaking the fellowship, and at least once post-completion. Participants’ clinical and academic activities were observed. Data were analysed using a framework approach.

Results Seven GPs participated in the pilot scheme. The fellowship was highly rated and felt to be balanced in terms of the opportunities for skill development, academic advancement, and confidence building. GPs experienced enhanced employability on completing the scheme, and at follow-up were working in a variety of primary care/urgent care interface clinical and leadership roles. Participants believed the fellowship made general practice a more attractive career option for newly qualified doctors.

Conclusion The fellowship provides a defined framework for training GPs to work in an enhanced manner across organisational interfaces, with the skills to support service improvement and integration. The fellowship model appears appropriate to prepare GPs for portfolio roles. Its impact on NHS service delivery continues to be investigated by Health Education England.

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Extended training to prepare GPs for future workforce needs: a qualitative investigation of a 1-year fellowship in urgent care

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