GPs' views of health policy changes: a qualitative 'netnography' study of UK general practice online magazine commentary

Abstract

Background: Shifts in health policy since 2010 have brought major structural changes to the English NHS, with government stating intentions to increase GPs' autonomy and improve access to care. Meanwhile, GPs' levels of job satisfaction are low, while stress levels are high. PulseToday is a popular UK general practice online magazine that provides a key discussion forum on news relevant to general practice. Aim: To analyse readers' reactions to news stories about health policy changes published in an online general practice magazine. Design: and setting A qualitative 'netnography' was undertaken of readers' comments to PulseToday. Method: A sample of readers' comments on articles published in PulseToday was collated and subjected to thematic analysis. Results: Around 300 comments on articles published between January 2012 and March 2016 were included in the analysis, using 'access to care' as a tracer theme. Concern about the demand and strain on general practice was perhaps to be expected. However, analysis revealed various dimensions to this concern: GPs' underlying feelings about their work and place in the NHS; constraints to GPs' control of their own working practices; a perceived loss of respect for the role of GP; and disappointment with representative bodies and GP leadership. Conclusion: This study shows a complex mix of resistance and resignation in general practice about the changing character of GPs' roles. This ambivalence deserves further attention because it could potentially shape responses to further change in primary care in ways that are as yet unknown.