The University of Southampton
University of Southampton Institutional Repository
Warning ePrints Soton is experiencing an issue with some file downloads not being available. We are working hard to fix this. Please bear with us.

Provision of services in primary care for type 2 diabetes: a qualitative study with patients, GPs, and nurses in the East of England

Provision of services in primary care for type 2 diabetes: a qualitative study with patients, GPs, and nurses in the East of England
Provision of services in primary care for type 2 diabetes: a qualitative study with patients, GPs, and nurses in the East of England

BACKGROUND: There is little evidence on the impact of national pressures on primary care provision for type 2 diabetes from the perspectives of patients, 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 primary care interview study in the East of England. METHOD: Semi-structured interviews were conducted, between August 2017 and August 2018, with people who have type 2 diabetes along with their respective GPs and nurses. 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: The authors interviewed 24 patients and 15 GPs and nurses, identifying a changing landscape of diabetes provision owing to burgeoning pressures that were presented repeatedly. Patient responders 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 care provision. A reluctant acknowledgement surfaced among 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 by patients and providers, 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.

diabetes mellitus, type 2, general practitioners, health services, nurses, primary health care, provision
0960-1643
e668-e675
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Griffin, Simon J.
1f8d5095-3c10-4973-a2c4-84ce6415d118
Kinmonth, Ann Louise
eede622c-cfbd-492f-8268-dc77ce097b29
Burt, Jenni
af1903e7-2bb8-464d-8e82-ec1076fdbb2e
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Griffin, Simon J.
1f8d5095-3c10-4973-a2c4-84ce6415d118
Kinmonth, Ann Louise
eede622c-cfbd-492f-8268-dc77ce097b29
Burt, Jenni
af1903e7-2bb8-464d-8e82-ec1076fdbb2e

Dambha-Miller, Hajira, Griffin, Simon J., Kinmonth, Ann Louise and Burt, Jenni (2020) Provision of services in primary care for type 2 diabetes: a qualitative study with patients, GPs, and nurses in the East of England. British Journal of General Practice, 70 (698), e668-e675. (doi:10.3399/bjgp20X710945).

Record type: Article

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, 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 primary care interview study in the East of England. METHOD: Semi-structured interviews were conducted, between August 2017 and August 2018, with people who have type 2 diabetes along with their respective GPs and nurses. 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: The authors interviewed 24 patients and 15 GPs and nurses, identifying a changing landscape of diabetes provision owing to burgeoning pressures that were presented repeatedly. Patient responders 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 care provision. A reluctant acknowledgement surfaced among 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 by patients and providers, 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.

Text
e668.full - Version of Record
Available under License Creative Commons Attribution.
Download (107kB)

More information

Accepted/In Press date: 7 February 2020
Published date: September 2020
Keywords: diabetes mellitus, type 2, general practitioners, health services, nurses, primary health care, provision

Identifiers

Local EPrints ID: 443969
URI: http://eprints.soton.ac.uk/id/eprint/443969
ISSN: 0960-1643
PURE UUID: 45f01614-fa26-43fe-8515-44d57ec7abea
ORCID for Hajira Dambha-Miller: ORCID iD orcid.org/0000-0003-0175-443X

Catalogue record

Date deposited: 18 Sep 2020 16:31
Last modified: 10 Jan 2022 03:17

Export record

Altmetrics

Contributors

Author: Simon J. Griffin
Author: Ann Louise Kinmonth
Author: Jenni Burt

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×