scholarly journals Integrating sport and exercise medicine clinics into the National Health Service: a qualitative study

2020 ◽  
Vol 6 (1) ◽  
pp. e000888
Author(s):  
Dane Vishnubala ◽  
Katherine Rose Marino ◽  
Margaret Kathryn Pratten ◽  
Andy Pringle ◽  
Steffan Arthur Griffin ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Thematic Analysis ◽  
Heavy Exercise ◽  
Structured Interviews ◽  
Ultrasound Education ◽  
Exercise Medicine ◽  
Sport And Exercise ◽  
Inductive Thematic Analysis

ObjectivesTo explore the services National Health Service (NHS)-based sport and exercise medicine (SEM) clinics can offer, and the barriers to creating and integrating SEM services into the NHS.MethodsSemi-structured interviews were undertaken to collect data from identified ‘stakeholders’. Stakeholders were identified as individuals who had experience and knowledge of the speciality of SEM and the NHS. An inductive thematic analysis approach was taken to analyse the data.ResultsN=15 stakeholder interviews. The management of musculoskeletal (MSK) injuries (both acute and chronic) and concussion were highlighted as the two key services that SEM clinics can offer that would most benefit the NHS. MSK ultrasound was also mentioned by all stakeholders as a critical service that SEM clinics should provide. While exercise medicine is an integral part of SEM, SEM clinics should perhaps not have a heavy exercise medicine focus. The key barriers to setting up SEM clinics were stated to be convincing NHS management, conflict with other specialities and a lack of awareness of the speciality.ConclusionThe management of acute MSK injuries and concussion should be the cornerstone of SEM services, ideally with the ability to provide MSK ultrasound. Education of others on the speciality of SEM, confirming consistent ‘unique selling points’ of SEM clinics and promoting how SEM can add value to the NHS is vital. If the successful integration of SEM into the NHS is not widely achieved, we risk the NHS not receiving all the benefits that SEM can provide to the healthcare system.

scholarly journals Uncovering, creating or constructing problems? Enacting a new role to support staff who raise concerns about quality and safety in the English National Health Service

2020 ◽  
pp. 136345931990129
Author(s):  
Graham P Martin ◽  
Sarah Chew ◽  
Mary Dixon-Woods
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Employee Voice ◽  
Potential Contribution ◽  
Quality And Safety ◽  
Structured Interviews ◽  
Speak Up ◽  
English National Health ◽  
English National Health Service

Employee voice is an important source of organizational intelligence about possible problems in quality and patient safety, but effective systems for encouraging and supporting those who seek to speak up have remained elusive. In the English National Health Service, a novel role known as the ‘Freedom to Speak Up Guardian’ has been introduced to address this problem. We critically examine the role and its realization in practice, drawing on semi-structured interviews with 51 key individuals, including Guardians, clinicians, managers, policymakers, regulators and others. Operationalizing the new role in organizations was not straightforward, since it had to sit in a complex set of existing systems and processes. One response was to seek to bound the scope of Guardians, casting them in a signposting or coordinating role in relation to quality and safety concerns. However, the role proved hard to delimit, not least because the concerns most frequently voiced in practice differed in character from those anticipated in the role’s development. Guardians were tasked with making sense of and dealing with issues that could not always straightforwardly be classified, deflected to the right system or escalated to the appropriate authority. Our analysis suggests that the role’s potential contribution might be understood less as supporting whistleblowers who bear witness to clear-cut wrongdoing, and more as helping those with lower-level worries to construct their concerns and what to do with them. These findings have implications for how voice is understood, imagined and addressed in healthcare organizations.

Co-designing interventions for communicating positive newborn bloodspot screening results: use of online Experience-based Co-design (Preprint)

2021 ◽  
Author(s):  
Jane Chudleigh ◽  
Lynette Shakespeare ◽  
Pru Holder ◽  
Holly Chinnery ◽  
Gemma Hack ◽  
...  
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Care Professionals ◽  
Specific Information ◽  
Structured Interviews ◽  
Working Groups ◽  
Newborn Bloodspot Screening ◽  
Heath Care

BACKGROUND Each year in England, almost 10,000 parents are informed of their child’s positive newborn bloodspot screening result around 2-8 weeks after birth, depending on the condition. Communication of positive newborn bloodspot screening results is a subtle and skilful task, which demands thought, preparation and evidence to minimise potentially harmful negative sequelae. Evidence exists of variability in the content and the way the result is currently communicated which has the potential to lead to increased parental anxiety and distress. OBJECTIVE The main objective was to co-design interventions to improve delivery of positive newborn bloodspot screening results to families. METHODS The principles of Experience-based Co-design were used with seventeen health care professionals employed in three National Health Service Trusts in England and 21 parents; 13 mothers and 8 fathers of 14 children recruited from the same three National Health Service Trusts. Staff experiences were gathered via semi-structured interviews. Filmed, narrative interviews with parents were developed into a composite film. These data were used to identify priorities for improving communication of positive newborn bloodspot screening results to parents during firstly, separate parent and heath care professionals feedback events followed by joint parent and heath care professionals feedback events. Following this, parents and heath care professionals worked together via online co-design working groups to develop co-designed solutions and additions to existing processes. RESULTS Themes identified from the parent’s interviews included: impact of initial communication; parental reactions; attending the first clinic appointment; impact of staff communication strategies and skills; impact of diagnosis on family and friends; improvements to the communication of positive NBS results; and parents views of NBS. Themes identified from the staff interviews included: communication between health care professionals; process of communicating with the family; parent and family- centred care; availability of resources and challenges to effective communication. Three online co-design working groups were developed, each attended by 12-18 participants who had taken part in the parental or health care professionals’ interviews. The priorities included: changes to the NBS card; standardised laboratory proformas; standardised communication checklists; and an email / letter for providing reliable up to date condition specific information for parents following communication of the positive NBS result. CONCLUSIONS Variation in communication practices for positive NBS results continues to exist. This was influenced by many factors and has the potential to lead to negative sequelae from a parental perspective. Parents and health care professionals were able to successfully work together to identify priorities and develop potential solutions to improve communication of positive NBS results to parents. The adaptation of EBCD to include virtual methods could reduce costs associated with this methodology while also enabling the approach to be more responsive to health care professionals’ and patients’/parents’ busy schedules. CLINICALTRIAL ISRCTN 15330120 INTERNATIONAL REGISTERED REPORT RR2-10.1186/s40814-019-0487-5

Transition from higher education to National Health Service for visually impaired physiotherapists: An interpretative phenomenological exploration

2013 ◽  
Vol 31 (1) ◽  
pp. 32-46 ◽  
Author(s):  
Karen Atkinson ◽  
Jane Owen Hutchinson
Keyword(s):  
Higher Education ◽  
National Health Service ◽  
Health Service ◽  
Lived Experience ◽  
National Health ◽  
Health Care Professionals ◽  
Visually Impaired ◽  
Phenomenological Approach ◽  
Structured Interviews ◽  
Wide Range

This idiographic study aims to hear the voices of a small group of visually impaired physiotherapists to explore their lived experience 1 of transition from higher education (HE) into employment. The findings are based on six semi-structured interviews analysed using an interpretative phenomenological approach. Participants were visually impaired physiotherapists who are either working, or have worked, in the National Health Service (NHS). A number of interrelated themes emerged concerning the work of the disabled self, compensation, stigma and passing, disclosure, barriers, disempowerment, and positive experiences. These appear to be linked to a reluctance by participants to engage with their disability identity. The experiences and perceptions of participants do not provide evidence of a commitment to disability-related support for disabled health-care professionals. The results of this study indicate that a wide range of both personal and institutional barriers still exist in the NHS.

The role of the sports and exercise medicine physician in the national health service

2011 ◽  
Vol 45 (2) ◽  
pp. e1-e1
Author(s):  
P. O'Halloran ◽  
V. T. Brown ◽  
K. Morgan ◽  
N. Maffulli ◽  
M. Perry ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Exercise Medicine ◽  
Medicine Physician ◽  
Sports And Exercise

scholarly journals The role of the sports and exercise medicine physician in the National Health Service: a questionnaire-based survey

2009 ◽  
Vol 43 (14) ◽  
pp. 1143-1148 ◽  
Author(s):  
P O'Halloran ◽  
V T. Brown ◽  
K Morgan ◽  
N Maffulli ◽  
M Perry ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Exercise Medicine ◽  
Medicine Physician ◽  
Sports And Exercise

scholarly journals One Size DOES NOT Fit All: Black British-Born Mental Health Nurses and Factors Influencing their ‘National’ Health Service Career Progression

2020 ◽  
Vol 7 (3) ◽  
pp. 88
Author(s):  
Deborah Isaac
Keyword(s):  
Ethnic Identity ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Career Progression ◽  
Structured Interviews ◽  
Senior Managers ◽  
Predominantly Black ◽  
Black British ◽  
Factors Influencing

Evidence suggests that Black and Minority Ethnic nurses in England’s National Health Service significantly lag behind their White counterparts in Bands 8a, 8b, 8c, 8d & 9 and ‘Very Senior Managers’ positions. Some attribute unequal positions of these nurses to discrimination, racism, exclusion, classism and other forms of disadvantage. Other factors however, are obscured through the accounts of predominantly Black overseas nurses. National Health Service Trusts’ workforce data tends to be gathered using the acronyms BME or BAME. Narrow ascriptions of skin colour or ethnicity to signify experiences of nurses as BME or BAME overlook complexed factors influencing their career. The aim of this study is to understand the career progression of Black British-born nurses as current literature fail to meaningfully account for their experiences. To understand the issues influencing the apparent lag, this study utilised a qualitative approach. Data collection was supported by semi-structured interviews. Unlike other studies, participants revealed very little to suggest discrimination as a hindering factor of career progression. Such a finding indicated that socialised ‘British cultural capital’ constitutes a strong ‘helping factor’ to override the ‘hindering factor’ of their ‘Black ethnic identity’. This implies that National Health Service Trusts equal opportunities policy drivers should apply more robust ethnic monitoring and reporting systems. Consequently, its grading structures would be best placed to represent and compare intergroup nuances between ethnic minority nurses. It will become inescapable for the UKs National Health Service not to address intersectional factors of ethnic identity, due to historical and persistent exposure of workforce inequities.

scholarly journals Switching roles: a qualitative study of staff experiences of being dialectical behaviour therapists within the National Health Service in England

2017 ◽  
Vol 10 ◽  
Author(s):  
Rebecca Hutton ◽  
Suzanne Hodge ◽  
Martin Tighe
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Positive Impact ◽  
Behavioural Therapy ◽  
Future Research ◽  
Structured Interviews ◽  
Job Role ◽  
The Impact

AbstractMany National Health Service (NHS) Trusts in England have invested in dialectical behavioural therapy (DBT) for mental health service users. The experiences of NHS staff delivering DBT were explored using semi-structured interviews with six dialectical behaviour therapists working in secondary mental health services within the NHS. The aim was to consider the impact on staff of adding the DBT therapist role onto their existing job role. Interview data were analysed using thematic analysis. Six themes were inductively generated from the data: DBT as a useful framework; DBT as the most satisfying part of the job; ‘Worzel Gummidge heads’– conflicts in roles; ‘DBT buddies’– the importance of informal support; uncertainty about the future; and recursivity – using DBT skills personally. Interactions between themes, implications for the service and future research directions are discussed. Key findings suggest that the addition of the DBT therapist role, as well as the recursive nature of DBT, has a positive impact professionally and personally. However, the service context within which participants were working can lead this additional role to cause increased demands and therefore stress, reducing that positive impact.

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