Conceptualising Winter pressures in UK general practice: a protocol for a systematic evidence synthesis (Preprint)

<sec> <title>BACKGROUND</title> <p>Winter pressures (WP) describe predictable seasonal surges in healthcare demand during colder months, driven by increased illness, adverse weather, and constrained system capacity. Understanding how WP are conceptualised, and how general practice responds, is essential for strengthening service resilience and equity during winter.</p> </sec> <sec> <title>OBJECTIVE</title> <p>To examine how the term WP has been used in relation to UK general practice, and to explore the reported impacts of WP on general practice services and patient inequalities.</p> </sec> <sec> <title>METHODS</title> <p>We plan to conduct a UK-based systematic evidence synthesis of studies published in English. An initial scoping search on MEDLINE will identify key terms and MeSH headings strategy, followed by comprehensive searches across major academic and grey-literature databases, including CINAHL, Cochrane Library, Embase, MEDLINE, and NEXIS.LEXIS. Additional sources will include Scopus and Google Scholar. Searches will include English-language sources from 2013 onwards. Patient Public Involvement (PPI) will guide and validate search coverage throughout the review. Framework Analysis will be applied in a structured manner to support systematic data extraction, thematic coding and synthesis of findings to support conclusions.</p> </sec> <sec> <title>RESULTS</title> <p>Findings will be presented using a source summary table (capturing study/document characteristics) and a data extraction table (capturing themes relating to WP characterisation, stakeholder perspectives, proposed solutions, and intended/unintended outcomes), both structured according to the review's framework analysis.</p> </sec> <sec> <title>CONCLUSIONS</title> <p>This analysis of a diverse range of literature aims to explore how winter pressures are characterised, what responses are considered appropriate, and how this impacts health inequalities. Findings will inform future interventions, workforce planning, and policy strategies aimed at improving general practice resilience and equity during winter.</p> </sec> <sec> <title>CLINICALTRIAL</title> <p>This protocol has been registered on PROSPERO (ID 1072102)</p> </sec>