Complexity as a factor for task allocation among general practitioners and nurse practitioners: a narrative review

Area of Science:

• Healthcare delivery
• Primary care
• Health workforce studies

Background:

• Rising demand and general practitioner (GP) shortages necessitated the integration of nurse practitioners (NPs) into primary care settings.
• Task sharing among healthcare professionals presents complex challenges in primary care.
• Complexity is a key concept influencing the allocation of tasks between GPs and NPs.

Purpose of the Study:

• To review and analyze the concept of complexity in the context of task allocation between GPs and NPs in primary care.
• To understand how complexity is utilized as a criterion for distributing responsibilities between GPs and NPs.
• To provide a reference for practitioners on task allocation methods in collaborative primary care.

Main Methods:

• Systematic literature search of PubMed and CINAHL databases adhering to PRISMA guidelines.
• Inclusion of studies on GPs, NPs, primary care, and complexity in task allocation.
• Narrative analysis of extracted information from 37 studies across seven countries.

Main Results:

• Complexity was applied to patient needs and health professional tasks across diverse settings.
• Task allocation factors included patient population, setting, number of professionals, and NP role.
• While NPs manage varied care levels, a trend shows them handling socially complex patients and GPs medically complex ones.

Conclusions:

• Complexity is a significant but broadly and inconsistently applied concept in primary care task allocation between GPs and NPs.
• The findings offer a foundational understanding for developing effective task allocation strategies in collaborative primary care.
• Further research may refine the application of complexity in optimizing team-based care models.