Kent and Medway ICB Primary Care Transformation
In the UK, digital transformation has taken centre stage to support the delivery of health and social care. The Kent and Medway Neighbourhood Transformation Programme was created to model the hybrid future of health and social care using the right tools and networks to make a positive difference to people across the system.
The programme consists of three pillars of Leadership, Digital & Innovation and Quality Improvement to support clinical leaders across the Kent and Medway ICB region to become digital transformation leaders.
Delivered over 10-months, the programme is to support clinical leaders to transform healthcare using digital innovations.
A General Practitioner (physician) on Primary Care Transformation programme conducted a qualitative research project. The project included engaging stakeholders and stakeholder analysis to deepen understanding about perspectives on the stressors impacting the wellbeing of General Practitioners across Kent and Medway. The qualitative was part of on-going work to create a work environment where professionals working in primary can all thrive, fulfil their purpose and foster excellence in patient care.
Kent and Medway is really diverse, with 1.8million people living in the region. It is an integrated care system that runs from the outer London boroughs to the coast of England and the border with France. The region has 42 Primary Care Networks. Due to the challenges unique to the region, the Kent and Medway ICB has invested in digital work and work in our workforce. However, across the wider healthcare system primary care can be quite a lonely place. Kent and Medway identified that one of the important things is bringing people together and having a conversation.
The Fellow was looking for a solution that could support meaningful facilitated group conversations at scale. In Kent and Medway focus groups and meaningful stakeholder engagement that informs decision-making is difficult because the demand on primary care is so great, making it very difficult to have meaningful conversations.
The Fellow tried sending an email survey and holding 1:1 phone calls to learn more about perception of the stressors impacting the wellbeing of General Practitioners. However, the problem of busy work schedules meant the primary research had to be conducted without additional burden to clinical staff and patients. It was difficult via surveys to quickly reach a big enough sample size and deliver quick insights that could be shared with the leads of the People Directorate and Director of Adult Social Care in KCC in Kent & Medway within a month.
PSi supported the Fellow by delivering two workshops, a strategic planning workshop and an analysis and insights workshop. As well as two facilitated online focus groups using PSi’s focus group software.
The PSi discussion was part of a rapid primary research, which kicked off with a 1 hour strategic planning workshop held online. During the workshop the team defined:
The project goals
The audience (who would be taking part in the conversations and the best channels to reach them).
The discussion topic ( including supporting information so that participants can confidently take part in the discussion)
Data segmentation (deciding participant profile variables so that the conversation data can be segmented to find insights from sub groups of interest).
Data privacy (agreeing whether participants should take part anonymously)
Date and time (when to schedule the discussion to improve engagement).
Based on the strategic planning workshop PSi sourced 169 members of the public to join a PSi discussion that generates public attitudes data about GP wellbeing and job satisfaction.
The strategic planning workshop took place on 30th May 2023 and the discussion was held on 30th June 2023.
The discussion asked the question: "What are the main threats to GP wellbeing and job satisfaction?". 167 joined the conversation. The discussion lasted for about 30 minutes. In that time, PSi collected 650 minutes (or 10.83 hours) of conversation.
The answer with the most support was:
‘I think the biggest threat to the GP well being and job satisfaction is the fact they are constantly understaffed. So that means that they need to fill the space that is needed, that gap. There's not enough practice to attend to all residents everywhere, so they need to see more people in a shorter amount of time. And the budget means they can not always order full tests and everything, and it needs all tied up together, so it's actually a combination of things.’
The idea that came second was:
‘I think there are a number of threats to GP well-being and job satisfaction. Um, firstly, I think that in this country there is chronic underfunding to the National Health Service. Um, all parts of the NHS, I think. Secondly, there are a lot of government initiatives that put additional pressure on General Practitioners.’
The polarisation index (based on whether the same people supported both ideas) was 69.01%. This means almost 70% of people supported that threats to GP job stratification was down to understaffing, budget and the pressure of government initiatives’.
Opinion clusters from qualitative analysis
PSi immediately ran qualitative analysis on all 167 ideas shared in the discussion and identified three major opinion clusters for how the 167 people framed the threat of GP understaffing:
Burnout. GP burnout is the main threat to GP well-being and job satisfaction. The main threats to GP job satisfaction used to be paperwork, but that's changed now. GPs are understaffed and they are under time pressure to see as many patients as possible.
Operations. The main threat to GP well-being and job satisfaction at the moment is the number of patients they are seeing. The NHS is underfunded and doesn't have enough resources to give to GPs so they can do their job properly and satisfactorily. GPs are overworked due to understaffing and increasing demands.
Political will. The government should modernise and update the digital infrastructure of the systems GPs use to make their daily work lives easier and more efficient. The government should increase the amount of admin staff and reduce the red tape so that GPS have more time to focus on their patients. He would also encourage more GPs into the profession and give them more flexibility in their work. The government should improve the funding of the NHS and improve the quality of healthcare, increase the number of GPs and part-time doctors.
PSi dashboard and reporting research findings
The data collected was automatically analysed, summarised and presented back to the client via PSi’s analysis dashboard. The dashboard provides qualitative data analysis using behavioural metrics, natural language processing models and statistics. The client (GP) has access to the dashboard and the raw data , which the client owns as the Data Controller (we report some of the insights here with the client's consent). PSi is the Data Processor providing a primary research and qualitative data analysis service.
The research results were presented to the lead of the People Directorate and the Director of Adult Social Care, KCC in Kent & Medway. The data and analysis informed the Directorate's strategy to improve conditions for GPs in Kent & Medway.
The team supported me with my research from the beginning till the very last minute. They went above and beyond to ensure that the vision remained centre stage. I really enjoyed working with PSi and the process has been very enlightening.
I really enjoyed it. I found it easy to engage with other participants and it has actually been really thought-provoking.