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Specialist diabetes clinics in primary care: the views of GPs about the impact on quality of care

Background: New models of diabetes care are emerging within primary care, re? ecting a wish to provide higher quality care, address increasing prevalence, shift services from secondary to primary care, and increase specialisation within primary care. Aim: To obtain general practitioners’ (GPs’) views about the impact of the new service on quality of care. Design: of study Self-completion questionnaire and semi-structured interviews. Methods: Questionnaires were sent to all GPs in Bradford outside the specialist diabetes clinic practices.Interviews were also undertaken with a subsample of responders and non-responders. Results: A 60% response rate was achieved; 83% of responders had made referrals to the clinics; 83% (including some non-referrers) believed the clinics were providing a valuable service. BeneŽ ts included good quality care, convenient access, su¤cient time with patients, and responsiveness to patients’ needs. Thirty- five percent of referrers nonetheless mentioned concerns or weaknesses in the new arrangements: increasing waiting-times for first appointments, uneven geographical distribution, poor communication with GPs and concern over the quality of expertise. Conclusion: GPs generally gave a positive evaluation of the clinics. Issues to be addressed when considering the development of similar models of specialist care in community settings include: variability between clinics, the need for strategic planning, the role of specialist nurses, equity of access,the need for increased skills within all primary care teams, and integration with secondary care.


Penny Rhodes

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