Transformation of primary care during the COVID-19 pandemic: experiences of healthcare professionals in eight European countries

Primary care has a crucial role in responding to the COVID-19 pandemic as the first point of patient care and gatekeeper to secondary care. Qualitative studies exploring the experiences of healthcare professionals during the COVID-19 pandemic have mainly focused on secondary care. To gain an underst...

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Veröffentlicht in:	British journal of general practice Jg. 71; H. 709; S. e634
Hauptverfasser:	Wanat, Marta, Hoste, Melanie, Gobat, Nina, Anastasaki, Marilena, Böhmer, Femke, Chlabicz, Slawomir, Colliers, Annelies, Farrell, Karen, Karkana, Maria-Nefeli, Kinsman, John, Lionis, Christos, Marcinowicz, Ludmila, Reinhardt, Katrin, Skoglund, Ingmarie, Sundvall, Pär-Daniel, Vellinga, Akke, Verheij, Theo Jm, Goossens, Herman, Butler, Christopher C, van der Velden, Alike, Anthierens, Sibyl, Tonkin-Crine, Sarah
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	England 01.08.2021
Schlagworte:	Belgium COVID-19 Delivery of Health Care England Europe - epidemiology Germany Humans Ireland Netherlands Pandemics Poland Primary Health Care Qualitative Research SARS-CoV-2 Sweden Netherlands Sweden Belgium Europe Ireland England Poland Germany COVID-19 primary health care semi-structured interviews qualitative research
ISSN:	1478-5242, 1478-5242
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Abstract	Primary care has a crucial role in responding to the COVID-19 pandemic as the first point of patient care and gatekeeper to secondary care. Qualitative studies exploring the experiences of healthcare professionals during the COVID-19 pandemic have mainly focused on secondary care. To gain an understanding of the experiences of European primary care professionals (PCPs) working during the first peak of the COVID-19 pandemic. An exploratory qualitative study, using semi-structured interviews in primary care in England, Belgium, the Netherlands, Ireland, Germany, Poland, Greece, and Sweden, between April and July 2020. Interviews were audiorecorded, transcribed, and analysed using a combination of inductive and deductive thematic analysis techniques. Eighty interviews were conducted with PCPs. PCPs had to make their own decisions on how to rapidly transform services in relation to COVID-19 and non-COVID-19 care. Despite being overwhelmed with guidance, they often lacked access to practical training. Consequently, PCPs turned to their colleagues for moral support and information to try to quickly adjust to new ways of working, including remote care, and to deal with uncertainty. PCPs rapidly transformed primary care delivery despite a number of challenges. Representation of primary care at policy level and engagement with local primary care champions are needed to facilitate easy and coordinated access to practical information on how to adapt services, ongoing training, and access to appropriate mental health support services for PCPs. Preservation of autonomy and responsiveness of primary care are critical to preserve the ability for rapid transformation in any future crisis of care delivery.
AbstractList	Primary care has a crucial role in responding to the COVID-19 pandemic as the first point of patient care and gatekeeper to secondary care. Qualitative studies exploring the experiences of healthcare professionals during the COVID-19 pandemic have mainly focused on secondary care. To gain an understanding of the experiences of European primary care professionals (PCPs) working during the first peak of the COVID-19 pandemic. An exploratory qualitative study, using semi-structured interviews in primary care in England, Belgium, the Netherlands, Ireland, Germany, Poland, Greece, and Sweden, between April and July 2020. Interviews were audiorecorded, transcribed, and analysed using a combination of inductive and deductive thematic analysis techniques. Eighty interviews were conducted with PCPs. PCPs had to make their own decisions on how to rapidly transform services in relation to COVID-19 and non-COVID-19 care. Despite being overwhelmed with guidance, they often lacked access to practical training. Consequently, PCPs turned to their colleagues for moral support and information to try to quickly adjust to new ways of working, including remote care, and to deal with uncertainty. PCPs rapidly transformed primary care delivery despite a number of challenges. Representation of primary care at policy level and engagement with local primary care champions are needed to facilitate easy and coordinated access to practical information on how to adapt services, ongoing training, and access to appropriate mental health support services for PCPs. Preservation of autonomy and responsiveness of primary care are critical to preserve the ability for rapid transformation in any future crisis of care delivery. Primary care has a crucial role in responding to the COVID-19 pandemic as the first point of patient care and gatekeeper to secondary care. Qualitative studies exploring the experiences of healthcare professionals during the COVID-19 pandemic have mainly focused on secondary care.BACKGROUNDPrimary care has a crucial role in responding to the COVID-19 pandemic as the first point of patient care and gatekeeper to secondary care. Qualitative studies exploring the experiences of healthcare professionals during the COVID-19 pandemic have mainly focused on secondary care.To gain an understanding of the experiences of European primary care professionals (PCPs) working during the first peak of the COVID-19 pandemic.AIMTo gain an understanding of the experiences of European primary care professionals (PCPs) working during the first peak of the COVID-19 pandemic.An exploratory qualitative study, using semi-structured interviews in primary care in England, Belgium, the Netherlands, Ireland, Germany, Poland, Greece, and Sweden, between April and July 2020.DESIGN AND SETTINGAn exploratory qualitative study, using semi-structured interviews in primary care in England, Belgium, the Netherlands, Ireland, Germany, Poland, Greece, and Sweden, between April and July 2020.Interviews were audiorecorded, transcribed, and analysed using a combination of inductive and deductive thematic analysis techniques.METHODInterviews were audiorecorded, transcribed, and analysed using a combination of inductive and deductive thematic analysis techniques.Eighty interviews were conducted with PCPs. PCPs had to make their own decisions on how to rapidly transform services in relation to COVID-19 and non-COVID-19 care. Despite being overwhelmed with guidance, they often lacked access to practical training. Consequently, PCPs turned to their colleagues for moral support and information to try to quickly adjust to new ways of working, including remote care, and to deal with uncertainty.RESULTSEighty interviews were conducted with PCPs. PCPs had to make their own decisions on how to rapidly transform services in relation to COVID-19 and non-COVID-19 care. Despite being overwhelmed with guidance, they often lacked access to practical training. Consequently, PCPs turned to their colleagues for moral support and information to try to quickly adjust to new ways of working, including remote care, and to deal with uncertainty.PCPs rapidly transformed primary care delivery despite a number of challenges. Representation of primary care at policy level and engagement with local primary care champions are needed to facilitate easy and coordinated access to practical information on how to adapt services, ongoing training, and access to appropriate mental health support services for PCPs. Preservation of autonomy and responsiveness of primary care are critical to preserve the ability for rapid transformation in any future crisis of care delivery.CONCLUSIONPCPs rapidly transformed primary care delivery despite a number of challenges. Representation of primary care at policy level and engagement with local primary care champions are needed to facilitate easy and coordinated access to practical information on how to adapt services, ongoing training, and access to appropriate mental health support services for PCPs. Preservation of autonomy and responsiveness of primary care are critical to preserve the ability for rapid transformation in any future crisis of care delivery.
Author	Colliers, Annelies Wanat, Marta Reinhardt, Katrin Tonkin-Crine, Sarah Böhmer, Femke Skoglund, Ingmarie Sundvall, Pär-Daniel Chlabicz, Slawomir Karkana, Maria-Nefeli Anthierens, Sibyl Vellinga, Akke Goossens, Herman Butler, Christopher C Gobat, Nina Hoste, Melanie Farrell, Karen Kinsman, John Marcinowicz, Ludmila Anastasaki, Marilena Verheij, Theo Jm Lionis, Christos van der Velden, Alike
Author_xml	– sequence: 1 givenname: Marta surname: Wanat fullname: Wanat, Marta organization: Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK – sequence: 2 givenname: Melanie surname: Hoste fullname: Hoste, Melanie organization: Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium – sequence: 3 givenname: Nina surname: Gobat fullname: Gobat, Nina organization: Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK – sequence: 4 givenname: Marilena surname: Anastasaki fullname: Anastasaki, Marilena organization: Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Crete, Greece – sequence: 5 givenname: Femke surname: Böhmer fullname: Böhmer, Femke organization: Rostock University Medical Centre, Rostock, Germany – sequence: 6 givenname: Slawomir surname: Chlabicz fullname: Chlabicz, Slawomir organization: Department of Family Medicine, Medical University of Bialystok, Bialystok, Poland – sequence: 7 givenname: Annelies surname: Colliers fullname: Colliers, Annelies organization: Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium – sequence: 8 givenname: Karen surname: Farrell fullname: Farrell, Karen organization: School of Medicine, National University of Ireland, Galway, Ireland – sequence: 9 givenname: Maria-Nefeli surname: Karkana fullname: Karkana, Maria-Nefeli organization: Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Crete, Greece – sequence: 10 givenname: John surname: Kinsman fullname: Kinsman, John organization: Expert social and behaviour change, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden – sequence: 11 givenname: Christos surname: Lionis fullname: Lionis, Christos organization: Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Crete, Greece – sequence: 12 givenname: Ludmila surname: Marcinowicz fullname: Marcinowicz, Ludmila organization: Department of Obstetrics, Gynaecology and Maternity Care, Medical University of Bialystok, Bialystok, Poland – sequence: 13 givenname: Katrin surname: Reinhardt fullname: Reinhardt, Katrin organization: Institute of General Practice, Rostock University Medical Centre, Rostock, Germany – sequence: 14 givenname: Ingmarie surname: Skoglund fullname: Skoglund, Ingmarie organization: General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden – sequence: 15 givenname: Pär-Daniel surname: Sundvall fullname: Sundvall, Pär-Daniel organization: General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden – sequence: 16 givenname: Akke surname: Vellinga fullname: Vellinga, Akke organization: School of Medicine, National University of Ireland, Galway, Ireland – sequence: 17 givenname: Theo Jm surname: Verheij fullname: Verheij, Theo Jm organization: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands – sequence: 18 givenname: Herman surname: Goossens fullname: Goossens, Herman organization: Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium – sequence: 19 givenname: Christopher C surname: Butler fullname: Butler, Christopher C organization: Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK – sequence: 20 givenname: Alike surname: van der Velden fullname: van der Velden, Alike organization: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands – sequence: 21 givenname: Sibyl surname: Anthierens fullname: Anthierens, Sibyl organization: Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium – sequence: 22 givenname: Sarah surname: Tonkin-Crine fullname: Tonkin-Crine, Sarah organization: Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Title	Transformation of primary care during the COVID-19 pandemic: experiences of healthcare professionals in eight European countries
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