Specialist services in the community: a qualitative study of consultants holding novel types of employment contracts in England
Future Hospital Journal
Royal College of Physicians
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Pitchforth, E., & Roland, M. (2015). Specialist services in the community: a qualitative study of consultants holding novel types of employment contracts in England. Future Hospital Journal, 2 173-179. https://doi.org/10.7861/futurehosp.2-3-173
Objectives To understand, from consultants’ experiences, the potential benefits and limitations of specialists being employed by a community organisation. Methods A qualitative study using semi-structured interviews with consultants holding novel contracts across three specialties: geriatric medicine, respiratory medicine and palliative medicine. Results Consultants in our study reported that community based roles offered a number of potential benefits. They felt better able to take a population perspective, to treat patients in a holistic sense and to form good working relationships with community based colleagues. A number of challenges were also evident, including a lack of clarity about their role, professional isolation and, for those in geriatric and respiratory medicine, a lack of training and career development opportunities. Conclusions Our study suggests that community based consultant posts are often taken up by highly motivated individuals who report the benefits in terms of being able to provide more appropriate care for patients but that the long term development of these posts may be constrained by a number of factors. Their idiosyncratic nature, the lack of clarity around the role, challenges to professional identity and lack of training opportunities or professional development suggest that current approaches to their development may not be sustainable.
specialist services, consultants, community based care, qualitative
This work was supported by the National Institute for Health Research (NIHR) Health Services and Delivery Research (HS&DR) programme [ref:12/135/02]. This paper presents independent research funded by the NIHR. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
External DOI: https://doi.org/10.7861/futurehosp.2-3-173
This record's URL: https://www.repository.cam.ac.uk/handle/1810/248983