Skill-mix and service transfer to primary care settings

Area of Science:

• Healthcare Services Research
• Health Workforce Studies
• Primary Care Innovation

Background:

• This review examines innovative healthcare roles and service delivery models in the UK.
• It focuses on practitioners with special interests (PwSIs) and their impact on healthcare access, patient satisfaction, and cost-effectiveness.
• Studies involving medical, nursing, and dental professionals were included, with a UK focus.

Discussion:

• Specialist outreach clinics demonstrate effectiveness in improving access and patient satisfaction, though costs may be higher.
• The effectiveness and cost-benefit of medical practitioners with special interests (PwSIs) remain controversial with limited evidence.
• Integrating specialist care into primary settings via trained nurse practitioners appears effective but not always cost-effective.

Key Insights:

• Evidence suggests specialist outreach and PwSI roles can enhance patient access and satisfaction.
• Nurse practitioners in primary care can be an effective use of resources, but cost-effectiveness requires further study.
• Dental care professionals show potential for expanded roles, but evidence quality varies.

Outlook:

• There is a significant need for well-designed studies with robust evaluations.
• Future research should focus on cost-effectiveness and health outcomes of skill-mix and setting changes.
• Further investigation into the benefits for patients and the healthcare workforce is crucial.