Changes in work tasks and organization of general practice in Norway during the COVID-19 pandemic: results from the Pricov-19 study

Torunn Bjerve Eide, Esther Van Poel, Sara Willems, Frode Fadnes Jacobsen

Keywords: COVID-19; PRICOV-19; Quality of Care; Infection Prevention and Control; Patient Flow Management; Primary Care Workforce

Background:

The COVID-19 pandemic led to huge and rapid changes in general practice in Norway as in the rest of Europe. Knowledge regarding these changes can inform measures in similar future situations.

Research questions:

We aimed to obtain more knowledge on the changes in use of alternative consultation forms, workload, tasks and delegated responsibilities of both the GPs and other personnel in the GP offices, adaptations in routines related to hygiene measures, triage of patients, and how the official rules and recommendations affected the practices.

Method:

We analysed data from the Norwegian part of the PRICOV-19 study, collecting data from general practice via an online self-reported questionnaire. We included 130 Norwegian general practices, representing an estimated 520 Norwegian general practitioners (GPs). All Norwegian GPs were invited to participate.

Results:

During the pandemic, Norwegian GPs significantly increased their use of alternative consultation forms and the implementation of infection prevention measures in their clinics. There was a large and significant increase in the use of all forms of alternative consultation forms (Digital text-based, video- and telephone consultations). The use of several different infection prevention measures were significantly increased, and the provision of hand sanitizer to patients increased from 29.6% pre-pandemic to 95.1% since the pandemic. More than half of the GPs (59.5%) reported that their responsibilities in the practice had increased, and 41% were happy with the task shift. 27% felt that they received adequate support from the government; however, 20% reported that guidelines from the government posed a threat to the well-being of the practice staff. We found no associations with the rurality of the practice location or size of the municipalities.

Conclusions:

Norwegian GPs adapted well to the need for increased use of alternative consultation forms, and reported a high acceptance of their increased responsibilities. However, only one in four experienced adequate support from the government.

Points for discussion:

How do the Norwegian findings differ from the changes related to the COVID-19 pandemic in other European countries?

To what degree are national results and conclusions transferable to other countries with very different health services systems?

How can health authorities help GP practices through future pandemics?