GP Teams
Research type
Research Study
Full title
How general practice team composition and climate relate to quality, effectiveness and human resource costs: a mixed-methods study in England
IRAS ID
256757
Contact name
Heather Gage
Contact email
Sponsor organisation
University of Surrey
Duration of Study in the UK
1 years, 4 months, 30 days
Research summary
General practice is under pressure due to increasing workload and a shortage of GPs and other primary care staff. New forms of practice are also emerging. Our aim is to explore how the composition of GP teams, and the relationships among team members (called team climate) affects the quality of care and health outcomes for patients, and the costs for the practice.
The study uses mixed methods in 7 work packages (WPs):
WP1: Overview of relevant policy and new practice models. A ‘Practices Database’ covering, all English practices (n~7200) will be constructed containing data on skill mix and other practice characteristics from routinely available NHS England data.
WP2: Systematic review of existing evidence on impact of team composition and climate on staff and patient outcomes from the UK and other countries that have similar health care systems to the NHS.
WP3: Explores associations (using the Practices Database) between skill mix and quality of care indicators (QOF data, CQC ratings, Patient Experience Survey responses), controlling for practice characteristics.
WP4: Analyses associations between practice skill mix and clinical effectiveness, indicated by hospitalisations for ambulatory care sensitive conditions for 546 practices from the Clinical Practice Research Datalink provided by the Farr Institute.
WP5: In-depth analysis involving qualitative and quantitative data collection and analysis. Synthesis of findings from (i) focus groups with service users for their perspectives on workforce issues, (ii) a survey of staff in some 240 practices to explore how workforce affects burnout and job satisfaction, (iii) 12 case study sites in varied practices using interviews, patient and staff surveys and observations.
WP6: Develop implementation recommendations from findings of WPs 1-5 through a consensus-building exercise.
WP7: Active dissemination of findings.
Two panels (Service Users, and Professionals and Commissioners) and an External Steering Committee of experts support the research.REC name
North of Scotland Research Ethics Committee 2
REC reference
19/NS/0188
Date of REC Opinion
13 Jan 2020
REC opinion
Further Information Favourable Opinion