Managing long-term worklessness in primary care: a focus group study

BACKGROUND: Evidence suggests that overall the benefits of work are greater than the harmful effects of long-term unemployment and prolonged sickness absence. General practitioners (GPs) often feel that work and health-related issues extend beyond their role. There is a paucity of research that focuses on GPs' attitudes to the management of long-term worklessness. AIMS: To explore GPs' perceptions of the management of individuals in receipt of long-term incapacity benefits and their attitudes to UK government funded return to work programmes such as the Want2Work scheme in Wales. METHODS: A qualitative study set in South Wales. Focus groups were conducted with GPs and explored the role of primary care and the challenges that GPs face when managing long-term worklessness and how the Want2Work programme might benefit GP practice. Data were analysed using the framework method of analysis. RESULTS: The main themes that emerged from the GP focus groups were role boundaries, responsibilities, negotiation and knowledge. A key finding was that many of the participants felt that their role in managing long-term worklessness was limited to providing support and management of health-related issues only. The perceived risk to their own personal safety in addressing these issues with some patients also impacted on GPs' decision making CONCLUSIONS: There seems to be a clear divide between managing patients' health concerns and their work-related activities. Some GPs recognized that patients became 'lost' in their system once receiving long-term benefits.