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Most patients who need non-emergency healthcare in England go to their local doctors’ surgeries, otherwise known as general practices. For several reasons, general practices are getting busier, and this is making it harder for patients to access the care they need. This is bad for patients, but it is also bad for the staff working in general practice, who are under increasing pressure to see patients with limited staff and resources. 

Policymakers are trying to help general practices by encouraging them to employ different types of healthcare staff who are not doctors and/or nurses but have other healthcare specific skills. These include physiotherapists, pharmacists, physician associates and paramedics. These different types of healthcare professionals are called ‘additional role practitioners’. The hope is that they can treat certain groups of patients and allow GPs to focus on the patients who need them most. 

We would like to learn more about how they help ensure GPs workloads are manageable and that patients who need care from a GP can still be seen by them. We would also like to know more about the quality of care they provide to patients and their relationships with GPs and nurses. Finally, we would like to understand if using these new workers affects health outcomes for patients and health care costs. 


We will try to answer the following questions: 

1) How are these new staff spread across England? Which roles exist and how do practices differ in the type of services that they offer? How has the hiring of additional roles changed over the years? 

2) What is the role of these new staff in their practices? Which type of patients tend to use these staff? Are there differences across practices in the type of patients who use these staff? 

3) How can hiring staff for these additional roles help to reduce workloads and staff shortages in general practices, and increase the health outcomes of patients? Are these additional roles making things easier for GPs and nurses or are they creating more work for them? What are the costs and the benefits for practices and patients when these new roles are introduced? 

4) How can GPs and the new staff work well together to achieve the best patient care? 

Our study will provide new information on the effectiveness of additional roles in general practices in England. This information will help policymakers design better policies and systems to treat patients in the future. So that we can tell policymakers and other researchers about our work, we will present our ongoing results at conferences and submit our findings to top economic and medical journals. We will also hold events to share our work with the general public. 


Project Dates: January 2022 – December 2023