A shift to multidisciplinary teams in general practice

What this means for people experiencing health inequalities and frequent users of primary care services

The model of general practice is changing and, as part of this, it is moving away from a model of ‘seeing a GP’ to one where people will be offered consultations with a multi-disciplinary team. Primary care teams include over 15 skilled roles, such as paramedics and physiotherapists, yet for many people accessing care it remains the case that most still expect to see a GP when they book an appointment. 

Lived experience insights

At National Voices, we believe that changes in health and care should be driven and underpinned by what matters most to people who use and need it the most. This project set out to understand awareness and experience of multidisciplinary teams across two groups: frequent users of primary care services and those who experience health inequalities.   

We found:

• There was a low level of awareness of what multidisciplinary teams are, including amongst people who frequently use primary care.   
• In the current context of pressures in primary care, people often felt that the introduction of multidisciplinary teams were a cost reduction or rationing measure, rather than an initiative designed to improve their care. Despite this preconception most people reported positive experiences when they were treated by individual members of a multidisciplinary team.  
• For some groups, particularly those who have already experienced inequalities and barriers to primary care, the shift to multidisciplinary teams can be experienced as a further barrier to participation in health and care.   
• The other major themes that emerged were the importance of building trust within multidisciplinary teams, valuing the time and energy of patients, and setting clear and reasonable expectations of what primary care users can expect from a wider team.  

Recommendations

The report makes recommendations on how to improve experiences of multidisciplinary teams within general practice, especially amongst populations who experience health inequalities and frequent users of primary care services. In particular, the report highlights how primary care teams can build trust and assure people that general practice has oversight of their care. 

Acknowledgements

We would like to particularly thank National Voices’ Associate Jonathan Moore for his significant contributions on this project. 

We would also like to thank voluntary sector organisations and people with lived experience for their advice and input on this work, including Turning Point, Women in Prison, Ectodermal Dysplasia Society, Rethink Mental Illness, Faith Action, Salvation Army Housing Association, Hounslow Borough Respiratory Support Group, Cyclical Vomiting Syndrome Association, Hospice UK, LGBT+ Consortium, Caribbean and African Health Foundation, Pregnancy Sickness Support, Arthritis and Musculoskeletal Society, and the MS Society.  

We would also like to particularly thank Jean Ledger, Rosie Francis, James Raymond and Dr Minal Bakhai from NHS England for their input and advice on this independent report.  

The Department of Health and Social Care, NHS England and the UK Health Security Agency have provided a grant through the VCSE Health and Wellbeing Alliance for our independent work on multidisciplinary teams in primary care.