scholarly journals PP14  Improving access to, and experience of, ambulance care for eastern european migrants: a paramedic interview study

2020 ◽  
Vol 37 (10) ◽  
pp. e8.1-e8
Author(s):  
Viet-Hai Phung ◽  
Zahid Asghar ◽  
Milika Matiti ◽  
Niro Siriwardena
Keyword(s):  
Service Providers ◽  
Ambulance Service ◽  
Eastern European ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Quality Healthcare ◽  
European Languages ◽  
East Midlands ◽  
The Uk ◽  
Key Terms

BackgroundThe UK has experienced significant immigration from Eastern Europe following European Union (EU) expansion in 2004. Lincolnshire is a predominantly rural county in the East Midlands region of the UK with a large Eastern European migrant population requiring healthcare, including urgent ambulance care. The Equality Act 2010 requires public bodies such as health services to provide access to high quality healthcare, while the Equality Delivery System seeks to ensure that NHS organisations comply with the legislation. This study aimed to explore the perceptions and experiences of ambulance staff attending Eastern European migrants in Lincolnshire.MethodsQualitative semi-structured interviews were conducted with 15 ambulance staff at locations across Lincolnshire. Purposive and maximum variation sampling ensured that participants were knowledgeable about Eastern European migrants’ use of ambulance care and covered a range of demographic characteristics. The data were analysed using framework analysis.ResultsDifficulty in accessing professional interpreters meant that some patients relied instead on family members. Some Eastern European migrants brought back foreign language medication, which ambulance staff could not understand. It was common for patients to not be registered with GPs because they were temporarily resident, did not understand how the UK healthcare system worked or preferred to go to their home country for treatment. By not registering with GPs, patients were sometimes transported to the Emergency Department for primary care conditions.ConclusionsThe practical recommendations for service delivery improvements may be valuable for service providers and could be incorporated into future protocols. These include: having a glossary of key terms in Eastern European languages; simple packs explaining how and when to use the ambulance service translated into different languages where necessary; encouraging patients to register with GPs; and face-to-face meetings where the ambulance service inform the Eastern European communities about how to use their services.

PP10 ‘The ones that don’t say’; challenges in managers identifying potentially traumatised ambulance staff

2019 ◽  
Vol 36 (1) ◽  
pp. e4.3-e5
Author(s):  
Joshua Miller ◽  
Keyword(s):  
Emergency Services ◽  
Small Sample Size ◽  
Small Sample ◽  
Ambulance Service ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Face To Face ◽  
Ethical Approval ◽  
Changing Roles ◽  
The Uk

BackgroundStress and psychological illness among emergency services personnel is reported at higher prevalence than the general population, with one UK ambulance service ascribing it to 15% of staff sickness. Research in this field has focused on ambulance crew views, while manager experiences are limited to EMS systems outside the UK. This qualitative study explored how UK ambulance service managers try to identify staff at risk of becoming traumatised by their work.MethodsFace-to-face, semi-structured interviews were audio-recorded with a purposive sample of six paramedic managers working for an NHS ambulance service. The author transcribed these interviews and analysed them using framework analysis. Ethical approval and informed consent were obtained.ResultsAll participants claimed to see the identification of potentially traumatised staff as a vital part of their role. They outlined the use of case factors such as visceral elements and child involvement, and staff factors such as home life and resilience. Interviewees talked about their changing roles as managers, peers, parent figures, clinicians, and adjudicators.Factors found as enabling the identification of potentially traumatised staff included: knowing the staff, formalising handover to other managers, and manager presence – both at incidents and on station. Disabling factors included: atypical cases, hierarchical culture, and isolated remote staff. All participants reported concerns about staff being reluctant to report distress.ConclusionsLimitations of this study include the small sample size, possible response bias, and respondents conforming to social norms, as their practice was self-reported, rather than observed. Manager presence was highlighted as very important by participants; services should consider this in their structures and policies. Further studies could examine staff reluctance to report psychological distress, as well as staff resilience, which participants saw as beneficial, yet difficult to define or predict.

scholarly journals Transforming community nursing services in the UK; lessons from a participatory evaluation of the implementation of a new community nursing model in East London based on the principles of the Dutch Buurtzorg model

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mirza Lalani ◽  
Jane Fernandes ◽  
Richard Fradgley ◽  
Caroline Ogunsola ◽  
Martin Marshall
Keyword(s):  
The Netherlands ◽  
Patient Experience ◽  
Social Care ◽  
Professional Autonomy ◽  
Community Nursing ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Model Based ◽  
Health And Social Care ◽  
The Uk

Abstract Background Buurtzorg, a model of community nursing conceived in the Netherlands, is widely cited as a promising and evidence-based approach to improving the delivery of integrated nursing and social care in community settings. The model is characterised by high levels of patient and staff satisfaction, professional autonomy exercised through self-managing nursing teams, client empowerment and holistic, patient centred care. This study aimed to examine the extent to which some of the principles of the Buurtzorg model could be adapted for community nursing in the United Kingdom. Methods A community nursing model based on the Buurtzorg approach was piloted from June 2017–August 2018 with a team of nurses co-located in a single general practice in the Borough of Tower Hamlets, East London, UK. The initiative was evaluated using a participatory methodology known as the Researcher-in-Residence model. Qualitative data were collected using participant observation of meetings and semi-structured interviews with nurse team members, senior managers, patients/carers and other local stakeholders such as General Practitioners (GP) and social workers. A thematic framework analysis of the data was carried out. Results Implementation of a community nursing model based on the Buurtzorg approach in East London had mixed success when assessed against its key principles. Patient experience of the service was positive because of the better access, improved continuity of care and longer appointment times in comparison with traditional community nursing provision. The model also provided important learning for developing service integration in community care, in particular, how to form effective collaborations across the care system with other health and social care professionals. However, some of the core features of the Buurtzorg model were difficult to put into practice in the National Health Service (NHS) because of significant cultural and regulatory differences between The Netherlands and the UK, especially the nurses’ ability to exercise professional autonomy. Conclusions Whilst many of the principles of the Buurtzorg model are applicable and transferable to the UK, in particular promoting independence among patients, improving patient experience and empowering frontline staff, the successful embedding of these aims as normalised ways of working will require a significant cultural shift at all levels of the NHS.

“Is this restaurant halal?” Surrogate indicators and Muslim behaviour

2019 ◽  
Vol 11 (5) ◽  
pp. 1105-1123
Author(s):  
Ghazala Khan ◽  
Faiza Khan
Keyword(s):  
Service Providers ◽  
Small Sample ◽  
Muslim Country ◽  
Structured Interviews ◽  
Content Type ◽  
Service Personnel ◽  
Customer Base ◽  
Additional Information ◽  
Muslim Countries ◽  
The Uk

Purpose The purpose of this study is to investigate what cues or surrogate indicators Muslims use to determine whether restaurants are suitable for dining purposes in the absence of the halal logo and to examine if the cues used are different among Muslims from non-Muslim countries as opposed to Muslims from Muslim countries. Design/methodology/approach Data were collected via semi-structured interviews in one Muslim majority (Malaysia) and one non-Muslim country (the UK). A total of 16 adults participated in the study with an equal representation from both countries. Findings In the absence of the halal logo, participants relied on extrinsic cues such as the presence of other Muslim-looking customers and service personnel to determine whether a restaurant was deemed safe for dining in. The location of a restaurant was a strong indicator for Muslims in both Muslim and non-Muslim countries. In the absence of the halal logo, participants read the menus carefully, queried the service personnel for additional information and selected safer options, such as vegetarian and seafood. Research limitations/implications The study used a small sample, and therefore, the findings are tentative. Practical implications Given the growth of Muslim population in many non-Muslim countries, it is important for restaurants in non-Muslim countries not to marginalize this customer base. Trust is a key issue and service providers without the halal logo should gain the trust of Muslim customers by training service personnel and equipping them with knowledge of what halal means, developing menus with vegetarian and seafood options, providing detailed information on ingredients and communicating this on their websites and social media sites. They could also consider working with Muslim food and travel bloggers to promote themselves to a Muslim audience. They can develop a more Muslim sympathetic marketing approach and consider using separate cooking and serving utensils to gain trust and patronage of Muslim customers as well as to appeal to a larger market (vegans/vegetarians). Originality/value The present study is one of the first studies that concentrates on gaining an insight into how Muslims make decision pertaining to the selection and dining at a restaurant in the absence of the halal logo. A major contribution of the study is the identification of cues that assist Muslims when evaluating and selecting alternative food options in the absence of a halal logo.

scholarly journals Experiences of the Pharmacy-Led Weight Management Service: Views of Service Providers in England

Pharmacy ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 82
Author(s):  
Aliki Peletidi ◽  
Reem Kayyali
Keyword(s):  
Weight Management ◽  
Service Providers ◽  
Adult Population ◽  
Community Pharmacists ◽  
Management Service ◽  
Structured Interviews ◽  
Pharmacy Staff ◽  
Work Pressure ◽  
The Uk ◽  
Training And Support

Obesity constitutes one of the main modifiable risks of developing cardiovascular disease. In the UK, in 2016, 30% of the adult population were obese (30% of females and 29% of males). Community pharmacies are ideally situated to offer weight management (WM) services, enabling individuals to control and lose their excess weight. This study aimed at exploring the views of the pharmacy-led WM service providers in England. Semi-structured interviews were conducted with 15 trained community pharmacists and pharmacy staff—11 (73.3%) from Kent, three (20%) from Kingston and Richmond and one (6.7%) from Hackney and City—offering the WM service, either owning or working in independent pharmacies or for pharmacy chains. All interviews were audio-recorded, transcribed and anonymised. The analysis was conducted using thematic analysis. Three themes emerged: training and support, barriers and approach. Interestingly, service providers (SP) stated that obesity is a tough topic to talk about: they found it difficult to start a conversation about it, even if they had received training to facilitate this role. Additionally, several barriers for running such a service were identified, such as lack of time, too much work pressure and too little advertising, which could potentially lead to poor sustainability of the service. SPs can effectively intervene in an individual’s weight through the WM service that they offer. It is clear that further training should be provided in order for SPs to feel more comfortable in approaching and communicating with people and to increase the public’s awareness of the pharmacy-led WM service, so as to ensure the service’s sustainability.

scholarly journals Living life in limbo: experiences of healthcare professionals during the HCPC fitness to practice investigation process in the UK

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jill Maben ◽  
Linda Hoinville ◽  
Dawn Querstret ◽  
Cath Taylor ◽  
Magdalena Zasada ◽  
...  
Keyword(s):  
Healthcare Professionals ◽  
Psychological Impact ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Individual Level ◽  
Healthcare Settings ◽  
Lack Of Information ◽  
The Uk ◽  
The Impact ◽  
Investigation Process

Abstract Background It is the responsibility of healthcare regulators to ensure healthcare professionals remain fit for practice in healthcare settings. If there are concerns about an individual healthcare professional they may undergo a fitness to practice investigation. This process is known to be hugely stressful for doctors and social workers, but little is known about the impact of this experience on other professions. This study explores the experiences of registrants going through the process of being reported to the UK’s Health and Care Professions Council (HCPC) and attending fitness to practice (FTP) hearings. We discuss the implications of this process on registrants’ wellbeing and, from our findings, present recommendations based on registrants experiences. In doing so we articulate the structural processes of the HCPC FTP process and the impact this has on individuals. Methods This study uses semi-structured interviews and framework analysis to explore the experiences of 15 registrants who had completed the FTP process. Participants were sampled for maximum variation and were selected to reflect the range of possible processes and outcomes through the FTP process. Results The psychological impact of undergoing a FTP process was significant for the majority of participants. Their stories described influences on their wellbeing at both a macro (institutional/organisational) and micro (individual) level. A lack of information, long length of time for the process and poor support avenues were macro factors impacting on the ability of registrants to cope with their experiences (theme 1). These macro factors led to feelings of powerlessness, vulnerability and threat of ruin for many registrants (theme 2). Suggested improvements (theme 3) included better psychological support (e.g. signposting or provision); proportional processes to the incident (e.g. mediation instead of hearings); and taking context into account. Conclusions Findings suggest that improvements to both the structure and conduct of the FTP process are warranted. Implementation of better signposting for support both during and after a FTP process may improve psychological wellbeing. There may also be value in considering alternative ways of organising the FTP process to enable greater consideration of and flexibility for registrants’ context and how they are investigated.

Viking and Laval: An Introduction

2008 ◽  
Vol 10 ◽  
pp. 463-492 ◽  
Author(s):  
Catherine Barnard
Keyword(s):  
Service Providers ◽  
Political Elite ◽  
Eastern European ◽  
The West ◽  
Member States ◽  
Trade Union Movement ◽  
Union Movement ◽  
To Come ◽  
The Uk ◽  
The Right

While the accession of the 10 former Communist states was generally greeted with enthusiasm by much of the European political elite, the trade union movement in the West was concerned that cheap Eastern European workers would flood Western European labour markets, thereby undercutting Western wage rates. As a result, a number of the old Member States (but not the UK, Ireland and Sweden) imposed transitional restrictions on the right of individuals to come to the West to work. However, these restrictions did not extend to employers—in particular service providers—coming from the new Member States, bringing with them lower paid Eastern European labour to fulfil a contract.

scholarly journals Barriers to home bowel screening test in South Asians in the UK

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Smith ◽  
S Howcutt ◽  
P Saini ◽  
J Brett ◽  
C Henshall ◽  
...  
Keyword(s):  
Screening Test ◽  
South Asians ◽  
Theoretical Domains Framework ◽  
Target Population ◽  
Bowel Cancer ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Home Test ◽  
Early Results ◽  
The Uk

Abstract Background Bowel cancer is common and accounts for 10% of all cancer mortality. Early detection significantly reduces mortality. In the UK, the NHS Bowel Cancer Screening Programme invites adults aged 60-74 years to carry out a home screening test biennially. The national target for test completion is 60%; completion is substantially lower (∼30%) amongst South Asian populations. Our aim was to develop a community-based intervention to increase completion of the home bowel screening test in South Asians. Methods Multi-methods comprising two stages: 1) group and individual interviews with South Asians aged 50-74 years purposively sampled from community groups for maximum variation. Semi-structured interviews based on the Theoretical Domains Framework (TDF) investigated determinants of bowel screening completion. Interviews were recorded, transcribed, and analysed using framework analysis and findings mapped onto the COM-B Behaviour Change Wheel; 2) Co-production of intervention during two workshops with key stakeholders and target population. Results To-date 25 adults recruited of Indian, Pakistani and Bangladeshi ethnicity with variation in age, gender, first language, faith, and compliance with bowel screening. Key barriers and TDF domains that they mapped to were: - lack of knowledge about bowel cancer and screening; lack of language, literacy and physical ability (skills) to carry out the home test; confidence to carry it out correctly (belief about capabilities); appropriate space and time to carry out the test (environmental context and resources); putting off undertaking the test (memory attention and decision processes); risk perception and fear of cancer (emotions). Enablers were: social influences from peers; goals and motivations. Conclusions Early results suggest an intervention comprising education, persuasion, modelling and enablement functions could increase completion of the home test. Key messages Community engagement and working with community leaders enhanced the success of recruitment. The TDF was a useful framework for identifying barriers to home bowel screening test by South Asians in the South East of England.

Public Policy

2018 ◽  
pp. 126-146
Author(s):  
Chi Maher
Keyword(s):  
Public Policy ◽  
Chief Executive Officers ◽  
Third Sector ◽  
Chief Executive ◽  
Social Enterprises ◽  
Policy Framework ◽  
Structured Interviews ◽  
South Wales ◽  
East Midlands ◽  
The Uk

This chapter explores the influence of public policy on small third sector social enterprises in four UK regions. The importance and contribution of small social enterprises contribution to the economy is well established. They are regarded as an integral part of the delivery of public services in the UK. Public policy, in turn, shapes the environment in which these organisations are developed. Due to limited research on how public policy are impacting on small regional small social enterprises. Semi-structured interviews were conducted with the Chief Executive Officers (CEOs) in the: East Midlands, South East, South Wales and Yorkshire and Humber regions to understand how public policy framework poses challenges and/or support small third sector social enterprises. The research finding contributes to the empirical research investigating the insinuation of these regional variations on their development and survival.

Exploring the experiences of birth mothers whose children have been diagnosed with fetal alcohol spectrum disorders: a qualitative study

2019 ◽  
Vol 12 (1/2) ◽  
pp. 27-35
Author(s):  
Robyn Thomas ◽  
Raja Mukherjee
Keyword(s):  
Fetal Alcohol Spectrum Disorders ◽  
Service Providers ◽  
Adoptive Parents ◽  
Structured Interviews ◽  
Fetal Alcohol ◽  
Birth Mothers ◽  
Content Type ◽  
Sense Of Purpose ◽  
The Uk ◽  
Fetal Alcohol Spectrum

Purpose Fetal alcohol spectrum disorder (FASD) is an umbrella term for a range of conditions that may occur in an individual whose mother drank alcohol during pregnancy. There has been little research into the experience of birth mothers of children with FASD and no published work of this kind in the UK. This is in contrast to a number of studies that have been conducted on foster/adoptive parents. In light of the recent publication in the UK of a mixed methods study on adoptive carers, it is timely to conduct research on birth mothers in the UK. The purpose of this paper is to explore the experiences of birth mothers following a diagnosis of FASD in their children. Design/methodology/approach An interpretive phenomenological analytical approach was used to generate themes from individual semi-structured interviews of five women who are birth mothers of children with FASD. Findings Four superordinate main themes and various subthemes were identified. To blame or not to blame captures the tension the mothers experience when considering the cause of their child’s condition. Life is a series of battles which describes the struggles the women experience on a crusade with a renewed sense of purpose that captures the process of transformation that occurs, which helps describe the internal and external factors that help the mothers cope. Originality/value FASD is often described in the literature as being completely preventable with the implication that it is the mother’s fault because they drank alcohol during pregnancy. However, a statement like this fails to portray the complexities of the phenomenon of women drinking during pregnancy. Life is difficult for the women for a number of different reasons, yet a sense of hope is present. The mothers have a renewed sense of purpose to do the best they can for their child and to raise awareness of FASD. Understanding their experiences can help service providers better meet the needs of parents and children affected by FASD.

scholarly journals Requirements and Incentives for Implementation of Pharmaceutical Strategic Purchasing in Iranian Health System: A Qualitative Study

2016 ◽  
Vol 9 (1) ◽  
pp. 163 ◽  
Author(s):  
Peivand Bastani ◽  
Leila Doshmangir ◽  
Mahnaz Samadbeik ◽  
Rassoul Dinarvand
Keyword(s):  
Qualitative Study ◽  
Service Providers ◽  
Analysis Data ◽  
Health Coverage ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Reimbursement Mechanisms ◽  
Strategic Purchasing ◽  
System A ◽  
Insurance Reimbursement

PURPOSE: According to the importance of strategic purchasing as a prerequisite for overall access and universal health coverage, this study was conducted to explore requirements and incentives for implementation of pharmaceutical strategic purchasing in the Iranian health system.METHODS: This was a qualitative study conducted through content analysis with an inductive approach applying a five-stage framework analysis. Data analysis was started right after transcribing each interview applying MAXQDA10. Data was saturated after 32 semi-structured interviews with experts. These key informants were selected purposefully and through snowball sampling.RESULTS: The findings are categorized under three main themes: “Payment Mechanisms to Service Providers”, “Insurance Reimbursement Mechanisms” and “Rules and Regulations”, and eight related subthemes.CONCLUSIONS: According to the importance of incentive interventions in pharmaceutical strategic purchasing, it is necessary to pay close attention to pharmaceutical price, realistic and fair premiums and appropriate contracts with suppliers, along with estimation a reasonable profit margin for pharmaceutical suppliers and the appropriate reimbursement mechanisms as the most significant incentives for increasing access to pharmaceuticals and implementing strategic purchasing.

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