Operational failures in general practice (OFIG): A consensus-building study of the operational failures on GPs’ and patients’ priorities for improvement

Conference:

SAPC ASM 2023 - Brighton

Talk Code:

6E.4

Presenter:

Ahmed Alboksmaty

Twitter:

@alboksmaty

Co-authors:

Ahmed Alboksmaty, Jordan M Moxey, Jenni Burt, Mary Dixon-Woods, Carol Sinnott

Author institutions:

THIS Institute (The Healthcare Improvement Studies Institute) at University of Cambridge

Problem

System issues (operational failures) can interrupt and frustrate the work of GPs, and may negatively influence patient experience. This study aims to build consensus amongst GPs and patients on operational failures to prioritise for improvement in NHS general practice.

Approach

We conducted two consecutive modified Delphi surveys using Thiscovery, THIS Institute’s online research and development platform, between Feb-Oct 2021. GPs were recruited via professional bodies and social media. Patients were recruited through seven local Healthwatch organisations. We compiled a list of operational failures (n=45) from three previous studies by our team. Over two survey rounds, GPs rated the importance of these operational failures for improvement. The resulting shortlist was then presented to patients for rating, also over two survey rounds. Data were analysed using medians and interquartile ranges. Consensus was defined as 80% of responses falling within one value below and above the median.

Findings

Sixty-two GPs responded to the first GP Delphi survey, with 53.2% (n=33) retained through round two. GPs identified fourteen failures as priorities for improvement. Thirty-seven patients responded to the first patient Delphi survey, with 89.2% (n=33) retained through round two. Patients rated all fourteen failures as important for improvement, with consensus on thirteen. The top three failures related to inaccuracies in patients’ medical notes, unavailable or missing test results and difficulties referring patients to other healthcare services because of problems in referral forms.

Consequences

This study has identified the highest priority operational failures in general practice and indicates where GPs and patients feel improvement efforts in general practice should be concentrated.

Submitted by:

Ahmed Alboksmaty

Funding acknowledgement:

This work has been supported by an NIHR (UK) Clinical Lectureship (C.S.), an Academy for Medical Sciences (UK) Starter Grant (SGL018\1023) (C.S), and a Wellcome Trust Senior Investigator Award (WT09789) (M.D.-W.). M.D.-W. is supported by the Health Foundation’s grant to the University of Cambridge for The Healthcare Improvement Studies Institute. The Health Foundation is an independent charity committed to bringing about better health and healthcare for people in the United Kingdom. M.D.-W. is a senior investigator in the National Institute for Health Research (NF-SI-0617-10026). The views expressed in this article are those of the authors and not necessarily those of the NHS, the National Institute for Health Research, the Department of Health and Social Care, the Health Foundation, the Academy for Medical Sciences or the Wellcome Trust.