Interprofessionnel collaboration & financing at GP level to face primary care challenges in Belgium

New-deal for Belgian GP’s : interprofessional collaboration and a mixed method of payment : a qualitative research
• Purpose : Primary care in Belgium is facing multiple challenges. Shortage of general practitioners (GP’s), multimorbidity and chronic conditions, population aging, triage and out-of-patient tasks challenges primary care (PC) organization. After a difficult period of COVID crisis where GP’s were particularly impacted, the ministry of health initiated the development of a new-deal for GP delivery.

• Theory : Belgium provides a complete freedom of choice to GP’s to organise their practice. Even though most of the GP’s work in solo or mono professional associations , different other modalities exist such as multi professional practices and community health centres. Renumeration systems also vary from fee-for service to capitation-fee.

• Methods : We conducted 2 sessions of 11 focus-groups with GP’s from different organisational and remuneration models countrywide in autumn 2022. We firstly asked GP’s what are the professionals they would work with, to do what tasks and what were the conditions to realize this. The second session focussed on reconsidering the remuneration system in order to address the challenges they are facing.

• Findings : The first session highlights the central role of the primary care nurse as well as the receptionist. Practice assistants could be a solution in some cases. The need for physiotherapists, psychologists and social workers varies according practice context.
The second session shows opportunities to increase the capitation-fee portion of funding, particularly for complex consultations, out-of- contact work and task delegation. Nevertheless, fee-for-service financing remains attractive to stimulate productivity.

• Discussion : The implementation of interprofessional team work with a mixed-method of payment seems to potentially introduce an improvement in the Belgian context.