Getting ‘bang for your buck’ for good quality general practice, and why hybrid working leads to fragmented and inefficient care

Today, we’re speaking to Dr Rebecca Payne and Professor Trish Greenhalgh. Rebecca is a GP and an NIHR In Practice Fellow, and works alongside Trish at the Nuffield Department of Primary Health Care Sciences at the University of Oxford. Title of paper: What are the challenges to quality in modern, hybrid general practice? A multi-site longitudinal studyAvailable at: https://doi.org/10.3399/BJGP.2024.0184Quality in primary care is a multidimensional construct embracing effectiveness, efficiency, safety, patient-centredness, equity, continuity, accessibility, and more. We report on how UK practices have striven to deliver on these aspects of quality as they move to a hybrid model that combines in-person with remote and digital care. The context for quality is currently very challenging, with resource constraints, staff shortages, and weak infrastructure. Digital systems intended to increase efficiency have produced some benefits for some people but have created new forms of inefficiency, increased fragmentation of care, contributed to staff stress, and widened inequities of access.