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Lifelong learning, its facilitators and barriers in primary care settings: a qualitative study

Although the need for lifelong learning, with implications for the development of all primary healthcare team members has been emphasized by policy documents and the new General Medical Services (nGMS) contracts, inter-professional facilitators and barriers for lifelong learning have not been fully investigated. This article presents common facilitators and barriers to lifelong learning as perceived by both implementers and recipients of a regional primary care workforce development strategy. It is based on a wider formative explorative evaluation study involving semi-structured interviews and focus groups in 22 primary care trusts (PCTs) and associated general practitioner (GP) practices in South East England. Twenty-nine strategy implementers, comprising Associate Deans, Lifelong Learning Advisors, Primary Care Workforce Tutors, GP Tutors, PCT Educators, were interviewed and 12 took part in two focus groups. Thirty-one strategy recipients, GPs, Practice Managers, Practice Nurses were also interviewed. Interviews and focus groups were recorded, transcribed verbatim and analysed using thematic framework analysis. This study provides evidence that traditional cultures, marked by a lack of inter-professional learning still exist in primary care settings and may obscure lifelong learning. Common facilitators to both implementers and recipients were influential professional networks, managerial and peer support, recent policy changes and protected learning time. Common barriers to both groups were insufficient organizational support, time constraints, lack of funding and boundaries between PCTs and general practices. Strategies to overcome barriers and reinforce facilitators need further exploration. PCTs and general practices should become learning organizations that provide continuous learning opportunities, support collaboration and foster links between organizations and individuals. Lifelong learning development can only flourish when a support system is created, composed of clearly allocated time, budgets and a sustainable support framework.