Provision of services in primary care for type 2 diabetes: a qualitative study with patients, GPs, and nurses in the East of England.
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Publication Date
2020-09Journal Title
The British journal of general practice : the journal of the Royal College of General Practitioners
ISSN
0960-1643
Publisher
Royal College of General Practitioners
Volume
70
Issue
698
Pages
e668-e675
Language
eng
Type
Article
This Version
AM
Physical Medium
Electronic-Print
Metadata
Show full item recordCitation
Dambha-Miller, H., Griffin, S., Kinmonth, A., & Burt, J. (2020). Provision of services in primary care for type 2 diabetes: a qualitative study with patients, GPs, and nurses in the East of England.. The British journal of general practice : the journal of the Royal College of General Practitioners, 70 (698), e668-e675. https://doi.org/10.3399/bjgp20x710945
Abstract
Background: There is little evidence on the impact of national pressures on primary care provision for type 2 diabetes from the perspectives of patients and their GPs and nurses.
Aim: To explore experiences of primary care provision for people with type 2 diabetes and their respective GPs and nurses.
Design and setting: A qualitative interview study in the East of England
Methods: Semi-structured interviews with people who have type 2 diabetes (n=24) along with their respective GPs and nurses (n=15). Purposive sampling was used to select for heterogeneity in glycaemic control and previous healthcare experiences. Interviews were audio-recorded and analysed thematically. The consolidated criteria for reporting qualitative research were followed.
Results: We identified a changing landscape of diabetes provision owing to burgeoning pressures that were presented repeatedly. Patient participants wanted GP-delivered care with continuity. They saw GPs as experts best placed to support them in managing diabetes, but were increasingly receiving nurse-led care. Nurses reported providing most of the in-person care, while GPs remained accountable but increasingly distanced from face-to-face diabetes provision. A reluctant acknowledgement surfaced amongst GPs, nurses and their patients that only minimum care standards could be maintained, with aspirations for high quality provision unlikely to be met.
Conclusion: Type 2 diabetes is a tracer condition that reflects many aspects of primary care. Efforts to manage pressures have not been perceived favourably, despite some benefits. Reframing expectations of care, by communicating solutions to both patients and providers so that they are understood, managed and realistic, may be one way forward.
Sponsorship
MRC (G0001164)
MRC (MC_UU_12015/4)
NIHR Central Commissioning Facility (NIHRDH-RP-PG-0606-1259)
Wellcome Trust (061895/Z/00/Z)
Embargo Lift Date
2021-07-27
Identifiers
External DOI: https://doi.org/10.3399/bjgp20x710945
This record's URL: https://www.repository.cam.ac.uk/handle/1810/302866
Rights
All rights reserved