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92 Making General Practice Attractive: Encouraging GP attraction and Retention KCE Reports 90 6.3.4 Development of policy criteria o To diversify the remuneration modalities of the general practice by remunerating the realization of objectives or the quality of the taking care of the patient • Work organization and work-life balance policies (5 policies) o To allow or to encourage an evolving career associating ambulatory curative medicine and other activities like research, teaching, public health, hospitals, … o Not to penalize the work of general practitioners with regular working hours or who are working part-time (for example, by modulating the accreditation rules) o To organize provincial groups of professional GPs responsible in the replacement o To finance the GPs for their accreditation activities during the week and the day o To replace the individual duty obligation by a professional service like “SOS médecins” and/or secured duty places • Health care organization policies (10 policies). o To remove the Numerus Clausus o To tend towards a more equitable geographical distribution, by improving the incentives to work in less covered areas. o To support the creation of local agencies in charge of promoting the attractiveness and the retention of the general practitioners according to the local needs (for example: in partnership with the Circles) o To create another training of nurses in advanced practice to back the general practitioner (for example, in the follow-up of the chronically ill patients) o To encourage the delegation of some clinical tasks to other existing health professions (nurses, physiotherapists…) o To encourage the delegation of some social, tax activities, administrative or computer tasks to administrative staff o To encourage the GPs to have a common infrastructure or a common secretariat o To encourage the GPs to work together (by having the same patients or not) o To financially discourage the excessive or the premature recourse of the second line o To reinforce the role of the GPs in the multi-field dialogue. The criteria are the objectives the decision-maker wishes to complete through the policies. These criteria are the dimensions on which the options are to be assessed. Several sources of information helped to identify those criteria: • the literature review carried out in the first part of the study, • the criteria suggested by the GPs themselves as collected in the qualitative interviews mentioned in part 5, • the criteria used in previous priority settings in the health sector , 206 , 207 , 208 , 209 or in multi-criteria analysis 198 , 199 . 204 , 205
KCE Reports 90 Making General Practice Attractive: Encouraging GP attraction and Retention 93 Several group-discussion sessions allowed to finalize the following list of criteria (see detailed list in appendix 5.3.): 1. Policy efficiency in improving GPs’ attraction, recruitment and retention, 2. Cost-benefit of the policy from a societal point of view, 3. Acceptance by the other health professionals, 4. Accessibility of care delivered by a GP from a geographical and financial point of view as well as the patient’s freedom of choice of a GP. 6.3.5 Development of the scoring and the ranking Two indicators describe the rating of the policies i.e., a rank and a score. The rank varies between 1 and 5: it is equal to 1 if the stakeholder chooses it as his/her first choice policy, 2 for his/her 2 nd choice, 3 for his/her 3 rd choice, 4 if a policy was not cited and 5 if it was discarded. The lower the value of the rank, the better the policy. The score represents the prioritization of the policies in relation with the 4 criteria bb (a score >4 implies a positive effect averaged on the 4 criteria, a score
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