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Patient and practitioner views of a new rheumatology (Tier 2) primary care service

Ball, E and Critchley, S 2007, 'Patient and practitioner views of a new rheumatology (Tier 2) primary care service' , Quality in Primary Care, 15 (2) , pp. 101-106.

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    Abstract

    The rheumatology Tier 2 service in Oldham was implemented to see patients in a primary care setting for their initial assessment. They were treated and discharged within the service, or referred on to secondary care in order to limit inappropriate attendance in secondary care and fast-track patients with inflammatory disease to the rheumatology consultant. The aim of this study was to evaluate patients’ and general practitioners’ (GPs’) views about the transfer of rheumatological services from secondary to primary care. Patients and GPs were from a single primary care trust in Oldham, north west England. A thematic analysis of interview data was taken, and findings showed high patient satisfaction with the service, favouring the primary care environment to a hospital setting. GPs reported on cost-effectiveness of the service and better management of the disease. The Tier 2 service has the potential to set a new direction for multiagency care within a primary care setting.

    Item Type: Article
    Uncontrolled Keywords: patient perspective, primary/secondary care interface, rheumatology care, waiting times
    Themes: Subjects / Themes > R Medicine > RT Nursing
    Health and Wellbeing
    Schools: Colleges and Schools > College of Health & Social Care
    Colleges and Schools > College of Health & Social Care > School of Nursing, Midwifery, Social Work & Social Sciences
    Journal or Publication Title: Quality in Primary Care
    Publisher: Radcliffe Medical Press Ltd
    Refereed: Yes
    ISSN: 1479-1072
    Depositing User: Dr Elaine Ball
    Date Deposited: 21 Jul 2010 14:44
    Last Modified: 20 Aug 2013 17:19
    References: 1 Arthritis and Musculoskeletal Alliance. Standards of Care for People with Inflammatory Arthritis. London: Arthritis and Musculoskeletal Alliance. 2 Chamberlain-Webber J. Tackling chronic disease. Professional Nurse 2004;20:14–18. 3 Department of Health. Health Reform in England: update, next steps. London: HMSO, 2005. 4 Department of Health. Supporting People with Long Term Conditions. London: HMSO, 2005. 5 Department of Health. The New NHS: modern and dependable. London: HMSO, 1997. 6 Department of Health. NHS Improvement Plan: putting people at the heart of public service. London: HMSO, 2004. 7 Department of Health. Spending Review 2004 Public Service Agreement. London: HMSO, 2004. 8 Department of Health. The National Service Framework for Long-term Conditions. London: HMSO, 2005. 9 Department of Health. Liberating the Talents: helping primary care trusts and nurses to deliver the NHS Plan. London: HMSO, 2002, p. 9. 10 Fyrand L, Moum T, Wichstrøm L, Finset A and Glenna˚s A. Social network size of female patients with rheumatoid arthritis compared to healthy controls. Scandinavian Journal of Rheumatology 2000;29:1, 14, 38–43. 11 Miles MB and Huberman AM. Qualitative Data Analysis: an expanded sourcebook (2e). Thousand Oaks: Sage, 1994. 12 Glaser BG and Strauss AL. The Discovery of Grounded Theory: strategies for qualitative research. Chicago: Aldine, 1967. 13 Artinian BA. Qualitative modes of inquiry. Western Journal of Nursing Research 1998;10:138–49. 14 Glaser BG and Strauss AL. Status Passage. London: Keegan Paul, 1971. 15 Chalmers I. What do I want from health research and researchers when I ama patient? BMJ 1995;310:1315–18. 16 Cheng YT and Van de Ven AH. Learning the innovation journey: order out of chaos? Organization Science 1996;7:593–614. 17 Leininger MM.Qualitative Research Methods in Nursing. Columbus OH: Greyden Press, 1998. 18 Eraut M. Non-formal learning and tacit knowledge in professional work. Brititsh Journal of Educational Psychology 2000;70:113–36. 19 Chew-Graham C, Rogers A, May C, Sheaff R and E Ball. A new role for the general practitioner? Reframing ‘inappropriate attenders’ to inappropriate services. Primary Health Care Research and Development 2004; 5:60–7. 20 Guba EG and Lincoln YS. Competing paradigms in educational research. In: Denzin NK and Lincoln YS (eds) Handbook of Qualitative Research. Beverly Hills: Sage Publications, 1994. 21 Johnson P. Analytical induction. In: Symon G and Cassell C (eds) Qualitative Methods and Analysis in Organizational Research: a practical guide. Thousand Oaks, CA: Sage Publications, 1998. 22 Steyaert C, Bouwen R and Van Looy B. Conversational construction of new meaning: configurations in organizational innovation – a generative approach. European Journal of Work and Organizational Psychology 1996; 5:67–89. 23 Kirwan JR and Snow SM. Which patients see a Rheumatologist? British Journal of Rheumatology 1991; 30:285–7. 24 Harrison MJ, Morley KD and Symmons DPM. Developments in rheumatology consultant manpower provision: the BSR/arc Workforce Register 2003–05. Rheumatology 2006;45:1416–21. 25 Speed CA and Crisp AJ. Referrals to hospital-based rheumatology and orthopaedic services: seeking direction. Rheumatology 2005;44:469–71. 26 Hewlett S, Kirwan JR, Pollock J et al. Patient initiated outpatient follow up in rheumatoid arthritis: six year randomised controlled trial. BMJ 2005;330:171–7. 27 Hewlett S, Mitchell K, Haynes J et al. Patient-initiated hospital follow-up for rheumatoid arthritis. Rheumatology 2000;29:990–7. 28 Duxbury J. National directives on managing ‘violent’ patients: a critique. Nursing Times 2003;99:11–17, 30–2. 29 Shildrick M. The disabled body, genealogy and undecidability. Cultural Studies 2005;19:755–70. 106 E Ball and SCritchley 30 Foucault M. The Birth of the Clinic: archaeology of medical perception. Translated by Sheridan A. London: Tavistock, 1973. 31 Department of Health. Our Health, Our Care, Our Say: a new direction for community services. London: HMSO, 2006, p. 25. 32 Kirwan JR, Mitchell K, Hewlett S et al. Clinical and psychological outcome from a randomised controlled trial of patient initiated direct access hospital follow-up for rheumatoid arthritis extended to 4 years. Rheumatology 2003;42:422–6. 33 Department of Health. Our Health, Our Care, Our Say: a new direction for community services. London: HMSO, 2006, p. 137. 34 Almeida C, Clarke B, O’Brien A et al. Current provision of rheumatology education for undergraduate nursing, occupational therapy and physiotherapy students in the UK. Rheumatology 2006;45:868–73
    URI: http://usir.salford.ac.uk/id/eprint/9489

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