Relationships and advocacy are at the core of women’s health – but threats to these values and skills could undermine the service practices provide, a new study concludes today.

The research, by Oxford University, concludes that care is needed to ensure service configuration changes do not result in clinician deskilling or making services inaccessible for some patients.

Dr Francine Toye, qualitative research lead at Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, said: “GPs are committed to providing equitable care despite social, economic, and systems challenges. We need to make sure that relationship-based longitudinal knowledge of individuals, families, and communities remain at the core of equitable primary care, and that service changes do not contribute to deskilling of primary care practitioners.”

The study, reported in the British Journal of General Practice, took place after a consultation for the Women’s Health Strategy for England in 2022 highlighted a need to understand and develop how general practice can support women’s health needs. The authors aimed to understand the perspectives and experiences of primary care practitioners (PCPs) about supporting women’s healthcare needs. They recruited 46 PCPs, all of whom had a range of roles and worked in a variety of primary care settings.

The findings show that relationships and advocacy are valued as fundamental for women’s health in general practice, and threats to these on staff and services could have an impact. While developing specialist roles and bespoke services can foster staff wellbeing and could support retention, the authors said care is needed to ensure that service configuration changes do not result in clinician deskilling or rendering services inaccessible.

“Care is needed when services evolve to ensure that core aspects of general practice are not diminished or devalued,” they write. “GP teams are well placed to advocate for their patients, including commitment to seeking equitable care, and these skills and specialist knowledge should be actively recognised, valued, and nurtured.”

The results of the study are presented within six themes: being alongside a person from cradle to grave; maintaining the balance between general and specialist skills; generalists and specialists combined make more than the sum of their parts; striving for equity in a collapsing system; firefighting with limited resources; and the GP is being cast as the villain.

“Further research would usefully explore the interface between specialist interests and services, GP retention and sustainability, how and where these services ideally sit, and actively consider and evaluate both the intended and unintended consequences of these,” conclude the authors.