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‘The team for both sides?’ A qualitative study of change in heart failure services at three acute NHS Trusts
Author(s) -
Lord Laura,
Dowswell George,
Hewison Alistair
Publication year - 2015
Publication title -
health and social care in the community
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.984
H-Index - 68
eISSN - 1365-2524
pISSN - 0966-0410
DOI - 10.1111/hsc.12118
Subject(s) - excellence , context (archaeology) , nursing , medicine , national service framework , qualitative research , work (physics) , primary care , service (business) , national service , continuity of care , acute care , health care , public relations , family medicine , older people , political science , business , gerontology , sociology , paleontology , social science , mechanical engineering , law , biology , engineering , marketing
Heart failure ( HF ) is an increasingly prevalent long‐term condition that affects around 900,000 people in the United Kingdom (National Institute for Health and Clinical Excellence). The study examined how HF services in the English National Health Service ( NHS ) were changing, focusing particularly on the primary/secondary care interface. The maintenance of continuity in care in the face of increasing demand and financial pressures on health and social care was a key concern. Semi‐structured interviews were conducted with 22 members of staff working in HF services in three NHS acute Trusts in the West Midlands of England. Interviews were conducted between April and December 2011 with purposively selected participants and data were analysed using the Framework Method. Four main themes emerged from the analysis: service context, capacity, the primary/secondary interface and communication across boundaries. Barriers to, and facilitators of, continuity of care for patients with HF were identified within these themes. The findings provide insights into the structure, management and work of HF services in the acute and community settings. They highlight how local systems for the management of HF patients are developing in ways which are not necessarily consistent with national policy.