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Evaluation of the primary/secondary care interface in relation to a primary care rheumatology service

Critchley, S and Ball, E 2007, 'Evaluation of the primary/secondary care interface in relation to a primary care rheumatology service' , Quality in Primary Care, 15 (1) , pp. 33-36.

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    Abstract

    Objective The rheumatology department at The Royal Oldham Hospital developed a primary care service aimed at bridging the gap between primary and secondary care for patients with potential rheumatological conditions, and this was given the name rheumatology Tier 2. The objective of this study was to evaluate this primary care rheumatology service (Tier 2)in order to assess its validity, patient satisfaction and effectiveness. Design Ten patients participated in individual semi-structured interviews. Three GPs were interviewed individually, and two GPs formed a focus group. Thematic analysis was used to interpret the findings. Setting Patients were recruited from seven consecutive rheumatology Tier 2 clinics. GPs were recruited from Oldham Primary Care Trust (PCT) as this was the main source of patient referrals for the service. Results The key findings were in relation to the integration of primary healthcare and hospital services, i.e. the primary/secondary care interface. This highlighted the importance of early assessment, diagnosis and treatment of patients with suspected inflammatory arthritis. Conclusion Early diagnosis and treatment with disease-modifying anti-rheumatic drugs improves patients’ outcomes. The rheumatology Tier 2 service built on this evidence and provided a rapid assessment and referral to secondary care for those patients with suspected inflammatory arthritis.

    Item Type: Article
    Uncontrolled Keywords: primary care development, primary/ secondary care interface, rheumatology, Tier 2 service
    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 Publishing
    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 Department of Health. Supporting People with Long Term Conditions. An NHS and social care model to support local innovation and integration. London: HMSO, 2005. 2 Arthritis and Musculoskeletal Alliance. Standards of Care for People with Musculoskeletal Conditions. Available at: www.arma.uk.net (accessed 24 November 2006). 3 Quinn MA, Conaghan PG and Emery P. The therapeutic approach of early intervention for rheumatoid arthritis: what is the evidence? Rheumatology 2001;40:1211–20. 4 Hochberg MC. Early aggressive DMARD therapy: the key to slowing disease progression in rheumatoid arthritis. Scandinavian Journal of Rheumatology 1999;28:3–7. 5 Irvine S, Munro R and Porter D. Early referral, diagnosis and treatment of rheumatoid arthritis: evidence for a changing practice. Annals of Rheumatic Disease 1999;58: 510–13. 6 Hewlett S, Mitchell K, Haynes J et al. Patient-initiated hospital follow-up for rheumatoid arthritis. Rheumatology 2000;29:990–7. 7 Hetthen J and Helliwell PS. A comparison between primary care-led rheumatology services and secondary care provision. Rheumatology 1999;38:1294–5. 8 Strauss A and Corbin J. Basics of Qualitative Research: techniques and procedures for developing grounded theory (2e). Thousand Oaks: Sage, 1998. 9 Artinian BA. Qualitative modes of inquiry. Western Journal of Nursing Research 1998;10:138–49. 10 Buckley CD. Science, medicine and the future. Treatment of rheumatoid arthritis. British Medical Journal 1997;315:236–8. 11 The University of York. Cost Effectiveness Matters: The NHS Economic Evaluation Database. 2002:6(1).
    URI: http://usir.salford.ac.uk/id/eprint/9490

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