Exploring the evidence base for the benefits of generalism to patients, professionals, and the health system in modern healthcare.

Introduction: There are many challenges we must adapt to in healthcare - health inequalities, environmental concern, ageing populations and multimorbidity to name a few. The English health system has responded by restructuring into Integrated Care Systems1. These are collaborative, place-based partnerships tackling health inequalities and improving care coordination. Additional skills are likely needed for professionals to thrive in and potentiate the promise of ICSs for patients. One key component identified in the Future Doctor Report2, was cultivating generalism. This led to the inception of the Enhance programme for generalism3 - a developing multiprofessional educational offer in England. Aim and Method: Any change is best supported by academically rigorous evidence. Some published evidence was anticipated, as the generalism concept has existed for centuries and some professionals practice in this way today. Three literature searches were commissioned from the Health Education England library service around the evidence for generalism. This presentation will focus on "what are the benefits of generalism to patients, the healthcare system and healthcare professionals". A second search was performed by a HEE fellow. All included papers were critically analysed. Results: 32 papers were identified by the library service. No further papers were included from the second search due to their age (approx. 30 years). All were written in English, 19 from the UK and 13 from across Europe, Asia and Africa, published between 2017-2020. Papers were methodologically diverse, predominantly qualitative, reviews, opinion pieces or project evaluations. Common themes included doctor preparedness, CPD and skills learning. Two papers each, respectively, explored professional and patient satisfaction. A subset of 8 papers felt to be of most relevance to the question were then analysed. Article types were similar to the above, originating from the UK, Thailand or Norway. Four common themes were identified: QI; CPD; preparedness and professional satisfaction. Only one examined patient satisfaction. Interestingly, this paper's findings aligned closely with the principles and aims of the Enhance programme and ICSs - person-centred, well-coordinated care, understanding realworld causes of ill health4. Conclusion: Although there are some proponent opinion pieces and indirect evidence, no papers have been identified that examine this question directly. There is a distinct lack of robust academic exploration of the actual (as opposed to posited potential) benefits to patients, professionals other than doctors and system-wide impacts from generalism. Implications: This work highlights several new and exciting areas for future research - likely to be interdisciplinary. How best to research applying a generalist approach for its benefits to stakeholders in terms of the Institute of Medicine's 6 domains of quality may be a future key question to consider. [ABSTRACT FROM AUTHOR]