PhD dissertation examines task shifting in out-of-hours primary care clinics
Out-of-hours primary care faces significant challenges, including high workloads and staff shortage. A PhD project has explored the value of task shifting from GPs to nurses in out-of-hours primary care clinics.
Out-of-hours primary care (OOH-PC) clinics are under pressure due to high service demand and shortage of healthcare staff. Task shifting from general practitioners (GPs) to other healthcare professionals could be a solution.
This PhD project aimed to investigate the potential value of task shifting from GPs to nurses in OOH-PC clinics.
The first study, a systematic literature review, evaluated the content and quality of task shifting from GPs to other healthcare professionals in OOH-PC clinics and at home visits. The second study, an exploratory case study, examined how task shifting from GPs to nurses could be integrated into OOH-PC clinics. The third study, a cross-sectional registry study, described the relationship between task shifting with patient pathways and use of resources.
Task shifting maintains the quality of care
The results show that nurses with additional training can safely and effectively manage a large share of patient contacts in OOH-PC, especially patients with less urgent and less complex health issues. Successful implementation of task shifting requires a supportive organisational framework, such as formal protocols, training, supervision and informal team dynamics like familiarity and trust between GPs and nurses. Therefore, staff continuity is essential.
A team-based model, with a GP and a nurse working together, can reduce waiting times and free up more GP hours for complex health problems. The team-based approach promotes job satisfaction among healthcare professionals, improves the patient flow and maintains the quality of care.
Tasks should not be moved to replace GPs with nurses. Instead, the roles and competences of the two types of professionals should be seen as complementary, more like task sharing. However, to ensure long-term scalability and sustainability of task sharing in emergency care, it is crucial to invest in the education of healthcare professionals and establish clear regulatory frameworks.
Oral defence on 19 June 2025
Katrine Bjørnshave Bomholt will defend her PhD dissertation ”Task shifting in out-of-hours primary care: exploring the potential value of task shifting from general practitioners to nurses in clinics” on Thursday 19 June 2025 at 14:00 in the Eduard Biermann Auditorium (1252-204), Lakeside Lecture Theatres, Aarhus University, Bartholins Allé 3, 8000 Aarhus C.
The defence is public. Everyone is welcome. After the defence, the Research Unit for General Practice will host a small reception (1261-118) at the Department of Public Health, Aarhus University.
About the project
The PhD dissertation and the three included scientific papers present the results of a three-year enrolment at the Graduate School of Health, Aarhus University. The project was conducted in collaboration between the Research Unit for General Practice and the Department of Public Health at Aarhus University.
The project was supported by grants from the “Sygeforsikringen danmark” foundation, the Department of Public Health at Aarhus University, the Committee for Quality Improvement and Continuing Medical Education in the General Practice in the Central Denmark Region, the Research Unit for General Practice in Aarhus, and the General Practitioners’ Foundation for Education and Development.
Further information
PhD student Katrine Bjørnshave Bomholt
Department of Public Health, Aarhus University &
Research Unit for General Practice, Aarhus
kbb@ph.au.dk
Three studies of the project
- Task shifting from general practitioners to other health professionals in out-of-hours primary care – a systematic literature review. Bomholt KB, Nebsbjerg AM, Burau V, Mygind A, Christensen MB, Huibers L. Eur J Gen Pract. 2024 Dec;30(1):2351807.
- Task shifting from general practitioners to nurses in out-of-hours primary care: an explorative case study of team-based practices. Bomholt KB, Mygind A, Nebsbjerg MA, Christensen MB, Huibers L, Burau V. Scand J Prim Health Care. 2025 Apr 15:1-13.
- Task shifting and the association with patient flow and resource use in out-of-hours primary care: an observational register-based study. Bomholt KB, Nebsbjerg MA, Vestergaard D, Mygind A, Burau V, Christensen MB, Huibers L. Manuscript in review.