| Bringing genetics into primary care: findings from a national evaluation of pilots in England. | |
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MedLine Citation:
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PMID: 19770118 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Developments in genetic knowledge and clinical applications are seen as rendering traditional modes of organizing genetics provision increasingly inappropriate. In common with a number of developed world countries the UK has sought to increase the role of primary care in delivering such services. However, efforts to reconfigure service delivery face multiple challenges associated with divergent policy objectives, organizational boundaries and professional cultures. This paper presents findings from an evaluation of an English initiative to integrate genetics into 'mainstream' clinical provision in the National Health Service. METHODS: Qualitative research in 11 case-study sites focusing on attempts by pilots funded by the initiative to embed knowledge and provision within primary care illustrating barriers faced and the ways in which these were surmounted. RESULTS: Lack of intrinsic interest in clinical genetics among primary care staff was compounded by national targets that focused their attention elsewhere and by service structures that rendered genetics a peripheral concern demanding minimal engagement. Established divisions between the commissioning of mainstream and specialist services, along with the pressures of shorter-term targets, impeded ongoing funding. CONCLUSIONS: More wide-ranging policy and organizational support is required if the aim of entrenching genetics knowledge and practice across the Health Service is to be realized. |
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Authors:
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Graham Martin; Graeme Currie; Rachael Finn |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of health services research & policy Volume: 14 ISSN: 1355-8196 ISO Abbreviation: J Health Serv Res Policy Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-09-22 Completed Date: 2009-12-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9604936 Medline TA: J Health Serv Res Policy Country: England |
Other Details:
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Languages: eng Pagination: 204-11 Citation Subset: H |
Affiliation:
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Business School, University of Nottingham, Nottingham, UK. graham.martin@nottingham.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Delivery of Health Care
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methods* England Genetic Predisposition to Disease Genetic Services / organization & administration* Health Services Research Humans National Health Programs / organization & administration* Neoplasms / genetics Pilot Projects Primary Health Care* |
| Grant Support | |
ID/Acronym/Agency:
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//Department of Health |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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