Abstract
Introduction: General practitioners with special interests (GPwSIs) and extended roles (GPwERs) have been developed internationally to expand access to specialist expertise and relieve secondary care pressure, but their implementation and evaluation in Aotearoa New Zealand (NZ) remain unexplored.
Aim: This scoping review mapped the roles, service models, and clinical applications of GPwSIs/GPwERs in NZ.
Methods: An online search was conducted across PubMed, Scopus, CINAHL, and Google Scholar for literature published up to July 2025. The review followed PRISMA-ScR guidelines and included peer-reviewed publications focused on GPwSI/GPwER roles in NZ.
Results: Five studies met the inclusion criteria, all of which were retrospective clinical audits conducted between 2007 and 2019. Three were comparative studies, and two were single-practitioner audits. Two studies focused on skin cancer excision, while the remaining addressed diabetes care, varicose vein treatment, and public otolaryngology services. The skin cancer studies, conducted a decade apart (2007 and 2017), reported improved malignant lesion diagnosis by GPwSIs compared to other vocational specialists (general practitioners and surgeons). The GPwSI otolaryngology model demonstrated greater efficiency and effectiveness than standard hospital outpatient clinics. Diabetes and varicose vein audits, both single-practitioner audits, found improved effectiveness and safe clinical outcomes.
Conclusion: This review identified a limited body of literature describing GPwSI /GPwER roles in NZ. The findings highlight variation in role implementation, service models, and outcome reporting. Further research is needed to examine the breadth, consistency, sustainability, and potential benefits and unintended impacts of these extended general practice roles within the NZ health system.