Interprofessional learning in Irish general practice: Building collaborative, patient-centred primary care through education, practice, and policy

Interprofessional learning (IPL) occurs when members of two or more professions learn with, from, and about one another to improve collaboration and, ultimately, the quality and safety of care.^1,2 The World Health Organisation (WHO) identifies interprofessional education (IPE) and collaborative practice as important approaches to strengthening health systems and responding to population health needs.^2,3 IPL places purposeful learning across professional boundaries at the centre of educational activity and distinguishes it from the simple co-location of different professional groups.

The three dimensions of IPL can be understood as follows:
✽ Learning with one another: Collaborating through case discussions, simulations, workshops, or other shared activities to explore clinical and social care challenges.
✽ Learning from one another: Exchanging profession-specific knowledge, expertise, and perspectives to develop a more comprehensive understanding of patient needs.
✽ Learning about one another: Understanding the roles, responsibilities, scopes of practice, and capabilities of other professions to promote mutual respect and effective teamwork.^2,3

IPL and IPE are closely related but distinct concepts.⁴ IPE generally refers to organised educational activities in which members of different professions learn interactively together, with the intention of improving collaboration and care. IPL is used here more broadly to describe the learning that takes place across professional boundaries, both through formal educational programmes and through informal, workplace-based experiences arising from shared patient care.

For the purposes of this article, IPL refers to the learning processes through which members of different health and social care professions working within or alongside an Irish general practice develop shared knowledge, mutual understanding, communication skills, and collaborative capabilities. These processes may include formal educational programmes, workplace-based learning, interprofessional clinical discussions, reflective practice, shared audit and quality improvement (QI), and learning arising from coordinated patient care.

IPL is not without challenges. Time pressures, competing clinical demands, professional hierarchies, geographical separation, and differences in employment or contractual arrangements can all restrict opportunities for meaningful shared learning. Recognising these barriers is an important first step towards embedding IPL in routine practice.

The forthcoming introduction of the Nursing and Midwifery Board of Ireland Professional Competence Scheme⁵ provides a timely opportunity to consider how nurses and midwives can be supported in maintaining and developing their professional competence. The scheme is expected to be formally introduced in January 2027. More broadly, the professional responsibility to maintain competence applies across healthcare disciplines. IPL can support this responsibility by enabling professionals to learn from one another, examine clinical practice, and respond collectively to changing evidence and patient needs.

IPL should therefore be considered an important component of continuing professional development (CPD), clinical governance, and the delivery of safe, effective, patient-centred care.

Why does IPL matter in Irish general practice?

The development of integrated community services under Sláintecare and the HSE Enhanced Community Care Programme creates an important opportunity to strengthen collaboration across Irish primary care.^6,7 General practice is central to delivering accessible, continuous, and person-centred healthcare. Its responsibilities include first-contact care, the management of acute and chronic conditions, referral coordination, prevention, and supporting patients throughout their lives.

These responsibilities increasingly require contributions from a range of health and social care professionals (HSCPs), whose expertise extends beyond the traditional boundaries of medical practice. As the population ages and multimorbidity, frailty, and complex social needs become more prominent, effective care increasingly depends on professionals sharing information, coordinating decisions, and understanding one another’s contributions.

Traditionally, healthcare professionals have largely undertaken discipline-specific education, with opportunities for interprofessional learning varying across educational and clinical settings.⁸ Although profession-specific training remains essential, learning in professional silos can limit understanding of other roles and reinforce assumptions about responsibilities, authority, and expertise. IPL offers an opportunity to address these limitations by developing the shared understanding and communication needed for effective collaborative practice.

However, the presence of several professions in the same building, primary care centre, or community healthcare network (CHN) does not automatically result in IPL. Professionals may work alongside one another while retaining separate clinical responsibilities, communication patterns, and educational experiences. Effective collaboration requires purposeful opportunities to learn across professional boundaries.

The WHO framework highlights the importance of aligning professional education with collaborative practice and the organisational conditions needed to support it.² This is particularly relevant in Irish general practice, where professionals may work for different employers, operate under different contractual arrangements, or have unequal access to clinical information, decision-making structures, and educational resources.

The defining feature of IPL is therefore not simply professional diversity, but purposeful learning that improves how professionals understand, communicate, and work with one another.

Evidence also calls for a measured approach. Reeves and Colleagues’ 2016 Cochrane review found that evidence for the effects of practice-based interventions designed to improve interprofessional collaboration was of low to very low certainty, with insufficient evidence to draw firm conclusions about their overall effects.⁹ This does not contradict the educational rationale for IPL, but it does reinforce the importance of designing interventions around clearly defined needs and evaluating their effects, rather than assuming that every multidisciplinary activity undertaken in general practice will improve patient outcomes.

Introducing IPL into general practice consequently requires more than occasional joint teaching sessions. It involves examining professional relationships, organisational structures, educational opportunities, and the conditions that allow collaborative learning to become part of everyday practice. Leadership is essential to creating these conditions and ensuring that IPL is purposeful, supported, and sustained.

Ideally, IPL should begin during undergraduate education and continue throughout professional careers.¹⁰ In the workplace, it can be facilitated through shared clinical discussions, student placements, reflective practice, joint guideline reviews, audit, QI, and collaborative decision-making. These activities should have explicit learning objectives and opportunities for participants to question assumptions, explore uncertainty, and reflect on the important consideration of how their contributions influence patient care.

Why general practice is an important setting for IPL

Irish general practice offers distinctive opportunities for interprofessional learning, but its diversity must be acknowledged. Practices operate in urban and rural settings, within and outside primary care centres, and in partnership with community-based services. An IPL model suitable for a large urban centre may not be feasible in a small rural practice. A sustainable approach must therefore accommodate differences in workforce composition, service availability, geography, and local educational infrastructure. Several characteristics of general practice make it particularly valuable for IPL.

Continuity of care: Patients may be known to a practice over many years. This enables GPs, general practice nurses (GPNs), and HSCPs to consider how communication, shared decision-making, and coordinated management influence care over time, rather than focusing solely on an individual consultation.

Undifferentiated clinical presentations: Patients frequently present with symptoms that do not initially fit a clear diagnostic category. Sharing observations and perspectives within the general practice and CHN team can help all clinicians consider medical, functional, psychological, and social factors, while maintaining clear professional responsibilities and appropriate escalation pathways.

Community-based care: Health and wellbeing are influenced by housing, employment, social isolation, transport, health literacy, and family circumstances, as well as clinical conditions. IPL can help professionals understand these wider determinants of health and consider how services can better respond to their patients’ circumstances.

Small organisational structures: Close working relationships may make shared learning easier, but limited staffing, administrative capacity, and protected educational time can restrict formal supervision and the ability to accommodate students from several professional programmes simultaneously.

These characteristics suggest that IPL in general practice should be practical, flexible, and closely connected to the needs of patients, professionals, and local communities.

IPL in action in a general practice setting: Translating shared learning into practice

IPL can be developed through multidisciplinary case discussions, joint reviews of clinical guidelines, journal clubs, practice meetings, shared audit and QI projects, and education sessions involving specialist community teams. The value lies not simply in bringing key professionals together, but in creating opportunities to exchange knowledge, examine assumptions, and apply learning to practice.¹¹

For example, a GP and GPN reviewing a patient with a complex chronic condition may use a structured discussion to explore clinical reasoning, professional responsibilities, monitoring requirements, and opportunities for coordinated care. Subsequent reflection can help both professionals clarify their respective contributions, identify learning needs, and agree an approach to ongoing management.

Where relevant to their roles and professional requirements, practitioners can document their participation, learning, and reflection. For GPN and GP midwives, such activities may contribute to CPD, subject to the applicable NMBI requirements.¹²

Effective IPL requires an environment in which questions can be asked, uncertainty acknowledged, and professional perspectives respectfully challenged. An open learning culture supports accountability by enabling teams to identify knowledge gaps, inconsistent practices, and weaknesses in systems before these contribute to patient harm. This approach is consistent with the principles of clinical governance, including patient-centred care, safety, clear accountability, leadership, interdisciplinary working, and continuous QI.

However, learning discussions must not replace formal governance procedures. Findings from research, audit, patient feedback, incidents, near misses, or variation in practice may identify concerns that require further investigation and appropriate action through established clinical-governance, QI, patient-safety, or risk-management processes.¹¹

IMPROVING CHRONIC DISEASE MANAGEMENT
IPL is already possible within routine general practice, although its educational value may not always be recognised. Multimorbidity, frailty, mental health difficulties, polypharmacy, disability, and complex social circumstances frequently require coordinated contributions from several professional groups.¹³

A multidisciplinary review of chronic obstructive pulmonary disease (COPD) care, for example, might identify inconsistent inhaler-technique assessment, incomplete vaccination, uncertainty about referral pathways, or variation in follow-up. A structured learning discussion involving the GP, GPN, relevant community professionals, and crucially, the patient could explore the evidence, clarify responsibilities, identify gaps, and agree improvements.

Similarly, a patient living with diabetes may require medical review, medication optimisation, dietary support, podiatry, psychological care, and assistance with mobility or social circumstances. All of these relevant professionals can learn from one another’s specialist knowledge and develop a more coordinated approach to self-management and follow-up.

The potential benefits include improved consistency of care, clearer referral pathways, and more coordinated support for patients. However, any claim that IPL directly reduces complications, waiting lists, or hospital admissions should be supported by appropriate evaluation rather than assumed from the learning activity alone.

Shared learning can also take place between two professionals. A joint clinical review may help a GP and GPN better understand one another’s competencies and identify appropriate opportunities for delegation, provided these remain within each professional’s scope of practice, competence, and relevant governance arrangements.

SUPPORTING OLDER PEOPLE IN THE COMMUNITY
Collaborative learning can also support community-based care for older people living with frailty. A facilitated case discussion or simulation involving GP staff, public health nurses, occupational therapists, physiotherapists, social prescribing link workers, and other relevant professionals could explore how different perspectives contribute to assessment, prevention, and coordinated support.

For example, an occupational therapist may explain how a home assessment identifies environmental barriers to independence, while a physiotherapist may contribute expertise in mobility, strength, and falls prevention. A social prescribing link worker may identify opportunities to address loneliness or social isolation through community resources.

By learning about one another’s roles and discussing shared cases, professionals can develop a clearer understanding of when and how to involve colleagues. This may support more coordinated care planning and help older people to remain safely at home where appropriate. Any effect on hospital admissions, discharge outcomes, or service utilisation should be assessed through local evaluation.

RESEARCH, AUDIT, AND QI
Research, audit, and QI provide valuable vehicles for IPL because they create a shared focus on improving practice.¹² A review of COPD or diabetes management might bring together the GP, GPN, pharmacist, and relevant community teams to examine evidence, prescribing, inhaler technique, vaccination, smoking cessation, pulmonary rehabilitation, self-management, and referral pathways.

Each profession may see a different part of the patient journey. Bringing these perspectives together can reveal gaps that might otherwise remain unnoticed. The team can agree actions, identify responsibilities, and review whether the changes improve care. Recording the learning and reviewing outcomes also helps establish whether the intervention has achieved its intended purpose.

IPL should extend beyond clinical staff. Administrative and coordination staff have valuable insights into patients, referral pathways, appointment systems, information transfer, and the practical organisation of care. Patients and carers should also be recognised as contributors to learning, as their experiences can reveal gaps between professional assumptions and the realities of navigating healthcare services.

Nevertheless, IPL should remain focused. Bringing together a large number of disciplines without a clearly defined clinical or educational objective is unlikely to make the best use of limited time. The composition of each learning group should reflect the patient population, the learning needs identified, and the expertise required.

Overcoming key system barriers

For IPL to become a sustainable feature of Irish general practice and CHNs, the system barriers that restrict participation must be addressed.

PROTECTED TIME AND FUNDING
GPs frequently work under independent-contractor arrangements, while other professionals may be employed by the HSE or different organisations. Releasing staff for shared learning can therefore have different financial and operational implications for each group. Where IPL is unfunded, participation may compete with clinical appointments, waiting lists, and other service demands.

A sustainable model should provide protected learning time and appropriate funding mechanisms, including consideration of how existing general practice and community service arrangements could support participation. Accredited or formally recognised CPD activities may provide an additional incentive, but accreditation alone will not resolve the underlying resource constraints.

SERVICE PLANNING AND PERFORMANCE MEASUREMENT
Service indicators often focus on individual activities, such as consultations delivered, appointments completed, or investigations undertaken. These measures remain important, but they do not necessarily capture the contribution of collaborative learning to communication, continuity, care coordination, or care and service improvement.

Evaluation should therefore include both learning outcomes and relevant service outcomes. Measures might include improvements in referral quality, adherence to agreed care pathways, completion of clinical reviews, patient experience, communication between services, and identified changes in professional practice.

Where appropriate and feasible, longer-term indicators could include avoidable hospital presentations or disease-specific complications. Such outcomes should be selected according to the intervention and interpreted carefully, as they are influenced by factors beyond IPL alone.

LEADERSHIP AND ORGANISATIONAL SUPPORT
General practice and service leaders have an essential role in establishing a culture that values shared learning. This includes agreeing learning priorities, facilitating respectful discussion, supporting reflection, and ensuring that actions arising from learning are followed through. In CHNs, local coordination between general practice and community services can help identify shared priorities and overcome organisational separation. However, IPL arrangements should be flexible enough to accommodate practices with limited staffing, small teams, or substantial travel distances.

EDUCATIONAL INFRASTRUCTURE AND EVALUATION
A practical implementation model could combine short, regular case discussions with periodic joint learning sessions, audit, or QI projects, and access to relevant specialist expertise. Shared objectives, a named facilitator, or rotation of this responsibility, where feasible, brief documentation, and follow-up on agreed actions can help ensure that learning leads to changes in practice. Initial implementation should be evaluated to identify what works, for whom, and in which settings. Evaluation should consider participation, professional experience, changes in knowledge and collaborative behaviour, and relevant patient or service outcomes. Findings can then inform the development of models that are proportionate, transferable, and sustainable across different Irish general practice settings.

Conclusion

IPL offers an opportunity to strengthen the collaborative foundations of Irish general practice at a time when primary care is increasingly expected to provide integrated, person-centred care. It can help professionals understand one another’s roles, share expertise, reflect on clinical practice, and identify opportunities to improve the coordination, quality, and safety of care.^14,11

However, IPL should not be regarded as an automatic consequence of multidisciplinary working. Its educational value depends on purposeful and agreed learning objectives, meaningful participation, supportive leadership, protected time, and a culture in which professionals can reflect openly while maintaining clear accountability. The evidence also highlights the need to evaluate interventions, rather than assume that shared learning alone will produce measurable improvements in patient outcomes.

Introducing IPL into Irish general practice therefore requires coordinated action across education, practice, and policy. Undergraduate programmes should prepare future professionals for collaborative practice. General practices and community teams should be supported to embed shared learning into routine clinical activity, and health service planners, professional bodies, and policymakers should consider the funding, governance, and evaluation structures needed to sustain it.

A proportionate approach, adapted to the realities of individual practices and CHNs, could begin with shared case discussions, joint audit and QI, reflective learning, and collaboration around clearly identified patient-care priorities. Learning should be documented, actions followed through, and outcomes reviewed.

Ultimately, IPL should be recognised not as an additional task competing with clinical care, but as a way of learning from the care already being delivered. By creating the conditions for professionals to learn with, from, and about one another, Irish general practice can strengthen collaborative working, an understanding of roles and responsibilities, and support the development of safer, more coordinated, and more responsive primary care for patients and communities.

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Authors

Kathy Taaffe, Professional Development Coordinator, General Practice Nursing