Why do some practices innovate: a qualitative study of the views of primary care professionals

Author： de Lusignan Simon Shaw Adrienne Wells Sally Rowlands Gill

ISSN： 1475-9926

Source： Clinician in Management, Vol.13, Iss.3-4, 2005-08, pp. : 135-143

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Abstract

Background The Personal Medical Services (PMS) contract is an innovation which allows general practices to provide locally sensitive, quality-based primary care, unlike the traditional contract based on a complex formula of fees.Aim To determine from the primary care professionals in 33 second-wave PMS practices their perceptions of the factors associated with both positive outcomes and also with slow progress.Design A qualitative study, adopting an iterative thematic approach.Method Semi-structured interviews were conducted with one practice nurse, practice manager and general practitioner from each practice. Interview transcripts were analysed for emerging themes using QSR N-VIVO software.Results Analysis of the interviews revealed a general enthusiasm for PMS by the primary care professionals. They felt that critical success factors included the provision of additional clinical staff, and a cohesive, communicative team with a visionary leader and good management systems. The perceived barriers to progress were inadequate premises and the difficulty in recruiting and retaining staff.Conclusion PMS provides a framework for quality orientated, locally sensitive care. In the best practices it allows the development of services that cross the health and social care divide.