دورية أكاديمية
أعرض في EDS

Any qualified provider: a qualitative case study of one community NHS Trust's response.

التفاصيل البيبلوغرافية
العنوان: Any qualified provider: a qualitative case study of one community NHS Trust's response.
المؤلفون: Walumbe J; Centre for Primary Care and Public Health, Queen Mary University of London, London, UK., Swinglehurst D; Centre for Primary Care and Public Health, Queen Mary University of London, London, UK., Shaw S; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
المصدر: BMJ open [BMJ Open] 2016 Feb 23; Vol. 6 (2), pp. e009789. Date of Electronic Publication: 2016 Feb 23.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
مواضيع طبية MeSH: Patient Freedom of Choice Laws*/economics , Patient Freedom of Choice Laws*/standards, Community Health Services/*organization & administration , Musculoskeletal Diseases/*therapy , State Medicine/*legislation & jurisprudence, Attitude of Health Personnel ; Community Health Services/economics ; Community Health Services/standards ; Cost-Benefit Analysis ; England ; Health Policy ; Health Services Research ; Humans ; Interviews as Topic ; Qualitative Research ; Quality of Health Care
مستخلص: Objective: To examine how those managing and providing community-based musculoskeletal (MSK) services have experienced recent policy allowing patients to choose any provider that meets certain quality standards from the National Health Service (NHS), private or voluntary sector.
Design: Intrinsic case study combining qualitative analysis of interviews and field notes.
Setting: An NHS Community Trust (the main providers of community health services in the NHS) in England, 2013-2014.
Participants: NHS Community Trust employees involved in delivering MSK services, including clinical staff and managerial staff in senior and mid-range positions.
Findings: Managers (n=4) and clinicians (n=4) working within MSK services understood and experienced the Any Qualified Provider (AQP) policy as involving: (1) a perceived trade-off between quality and cost in its implementation; (2) deskilling of MSK clinicians and erosion of professional values; and (3) a shift away from interprofessional collaboration and dialogue. These ways of making sense of AQP policy were associated with dissatisfaction with market-based health reforms.
Conclusions: AQP policy is poorly understood. Clinicians and managers perceive AQP as synonymous with competition and privatisation. From the perspective of clinicians providing MSK services, AQP, and related health policy reforms, tend, paradoxically, to drive down quality standards, supporting reconfiguration of services in which the complex, holistic nature of specialised MSK care may become marginalised by policy concerns about efficiency and cost. Our analysis indicates that the potential of AQP policy to increase quality of care is, at best, equivocal, and that any consideration of how AQP impacts on practice can only be understood by reference to a wider range of health policy reforms.
(Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)
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فهرسة مساهمة: Keywords: QUALITATIVE RESEARCH
تواريخ الأحداث: Date Created: 20160225 Date Completed: 20161024 Latest Revision: 20231111
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC4769419
DOI: 10.1136/bmjopen-2015-009789
PMID: 26908521
قاعدة البيانات: MEDLINE
الوصف
تدمد:2044-6055
DOI:10.1136/bmjopen-2015-009789