Involving the public in general practice in an urban district: levels and type of activity and perceptions of obstacles

This paper reports on a study of the level and type of activity used to inv olve the public in general practice in a city district in the north of Engl and. The association of these activities with features of the general pract ice organisation and environment were studied. Service providers' perceptio ns of obstacles were also studied. Data were collected in a survey of all g eneral practice organisations in the district using a postal questionnaire completed by a practice manager. Interviews were conducted with health serv ice managers responsible for primary care development in the district. The study showed that the district had a good track record for innovation in pr imary care development and in giving emphasis to developing public involvem ent. However, it also showed that it was difficult to translate policy rhet oric into practical initiatives at the general practice level without evide nce of models of best practice, and with limited resources. The survey had a high response of over 84%. it showed that levels of activity were low acr oss the district and only a small minority of general practice teams had un dertaken a range of activities to involve the public. The socio-economic en vironment did not appear to be a factor, but small practices (one or two pa rtners and/or practice population under 3000) were much less likely to deve lop activities. Pressures of existing workload, lack of resources and publi c apathy were given as among the main obstacles by survey respondents. The study indicates the challenges faced by Primary Care Groups iii developing strands of public involvement. Primary care teams need a dear strategic fra mework, models of best practice, and adequate resources to manage, change a nd develop initiatives.