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Abstract

Understanding issues involved in the transfer of diabetes care to general practice: the patient perspective

Background A service innovation was introduced in six Sheffield general practices with patient populations ranging from 2981 to 8511 to deliver a new model of integrated diabetes care in a primary care setting.Within the model, practices collaborated with specialist services, which provided training and advice to general practitioners and practice nurses, so that patients with type 2 diabetes could receive diabetes monitoring, treatment and self-management support from their general practice team rather than a hospital-based team.Aim To explore the views and experiences of patients with type 2 diabetes whose diabetes care, with consent, had been transferred from the hospital clinic to the patient’s general practice. Setting and participants Four of the participating practices agreed to take part in the study.A total of 49 patients with type 2 diabetes, diagnosed between 3 and 16 years previously, whose diabetes support had moved to primary care, were approached by practice staff to take part in the interviews.Method Twelve volunteer patients with type 2 diabetes took part in face-to-face semi-structured interviews in their own homes.The interviews were audiotaped, and data were analysed using the ‘framework’ method.Results The patients interviewed seemed unaware of policy initiatives that preceded the changes in their care delivery.Most respondents were positive about the changes in terms of access, waiting times, and satisfaction with consultations.Howeve r, provision of associated services such as chiropody and out-of-hours support was often fragmented, creating a potential risk for some users.Conclusions General practice-based diabetes care is acceptable to patients provided that support is continuous and addresses all aspects of patient need.Prov ision of services can vary across practices creating a potential risk for some patients.


Author(s):

Maxine Johnson , Wendy Baird , Elizabeth Goyder



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