Document Detail

A stakeholder analysis of developments at the primary and secondary care interface.
MedLine Citation:
PMID:  8978115     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The interface between primary and secondary care has become a major focus of health policy debate, but the differing perspectives of stakeholders on recent developments in policy and practice have seldom been researched. AIM: To examine stakeholder perspectives on the extent of developments at the primary and secondary care interface, and the barriers and opportunities for future development. METHOD: This qualitative study was based on semi-structured interviews with a purposive sample of 27 primary and secondary care stakeholders in Southampton and South West Hampshire in 1994. Respondents were asked to identify developments in seven areas: direct access, consultant outreach, shifted services, substituted services, shared care, workload shifts and communication. RESULTS: Key issues were identified relating to the cultures of primary and secondary care, communication and work-load. Most respondents described an important shift in power from consultants to GPs. Although respondents identified several useful developments at the interface, including improvements in communication and increased direct access facilities, there were relatively few reports of shifts in resources and services to primary care. Respondents identified important continuing barriers to change, including the attitudes of consultants and the individualistic culture of GPs. CONCLUSION: Policies to "shift the balance' and to further "a primary care-led NHS (National Health Service)' need to address the cultural and political factors which respondents identified as barriers to primary care development.
D Evans
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of general practice : the journal of the Royal College of General Practitioners     Volume:  46     ISSN:  0960-1643     ISO Abbreviation:  Br J Gen Pract     Publication Date:  1996 Nov 
Date Detail:
Created Date:  1997-01-14     Completed Date:  1997-01-14     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9005323     Medline TA:  Br J Gen Pract     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  675-7     Citation Subset:  IM    
Institute for Health Policy Studies, University of Southampton.
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MeSH Terms
Attitude of Health Personnel
Family Practice
Great Britain
Health Care Reform*
Hospital-Physician Relations
State Medicine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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