Pre-implementation Planning in UK General Practice: A Scoping Review of Reported Practice

Background: Implementing change in UK general practice is inherently challenging, contributing to persistent evidence-to-practice gaps, inefficient use of resources, and reduced quality of care. Strategies that improve efficiency and increase the likelihood of successful implementation are needed. Strengthening planning during the pre-implementation phase is one potential approach, allowing more accurate, evidence-informed predictions of implementation success and supporting value-based decisions before committing resources. Although pre-implementation planning lacks a formal definition or consensus on specific activities, it is widely recognised as a preparatory phase preceding implementation and sustainment. Empirical evidence links pre-implementation activities to improved implementation outcomes, and these activities are embedded in widely used frameworks and recommended in guidance, reflecting broad expert consensus. Despite this recognition, little is known about how pre-implementation planning is conducted in UK general practice. Objective: This scoping review aims to explore how pre-implementation planning is conducted in UK general practice, what information it generates, and how this informs implementation decision-making. Design: Major bibliographical databases and sources of grey literature will be searched to find index implementation cases in UK general practice published from 2020 to 2025. Backward and forward citation, as well as author contact, will be used to locate reports of pre-implementation planning. Data will be extracted on study, intervention, and practice context, as well as pre-implementation planning activities, their outputs, use in guiding implementation decisions, perceived value, and practical considerations. Expected outcomes and conclusions: The findings will map current pre-implementation planning practices, highlight examples of good practice, and identify gaps to guide future improvements in pre-implementation planning in UK general practice.