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Article
Publication date: 4 February 2022

Jennifer White, Julie Byles and Tom Walley

Telehealth consultations are likely to continue while living with COVID-19 and the risk of other pandemics. Greater understanding of patient perceptions is important in order to…

Abstract

Purpose

Telehealth consultations are likely to continue while living with COVID-19 and the risk of other pandemics. Greater understanding of patient perceptions is important in order to inform future integrated care models involving telehealth.

Design/methodology/approach

An interpretative qualitative study. Fifteen, in-depth qualitative interviews were conducted with diverse range of community dwelling patients who attended outpatient clinics at The John Hunter Hospital, Newcastle. Data were analysed using an inductive thematic approach.

Findings

Key themes were identified: (1) telehealth is valuable in a pandemic; (2) telehealth accessibility can be challenging; (3) there are variations in care experiences, especially when visual feedback is lacking; (4) telehealth for acute and complex care needs may lead to gaps and (5) considerations towards the future of telehealth, beyond a pandemic.

Research limitations/implications

There is a shortfall in evidence of the patient experience of integrated care within a telehealth framework. The results provided practical insights into how telehealth services can play a greater role in integrated care.

Practical implications

Apart from the need for affordable access to high-speed data for basic Internet access, the author posit the need for patient and clinician training towards promoting communication that is underpinned by choice, trust and shared decision-making.

Originality/value

Telehealth is important towards keeping patients safe during COVID-19. Key findings extend knowledge of the practical implications need to promote integrated telehealth systems. While there is a benefit in extending telehealth to more preventative activities, there is also a need for greater service coordination and sharing of information between treating clinicians. Overall the results highlight telehealth consultations to be an effective means of treating well-known conditions and for follow-up rather than for acute conditions.

Details

Journal of Integrated Care, vol. 30 no. 4
Type: Research Article
ISSN: 1476-9018

Keywords

Content available

Abstract

Details

Clinical Governance: An International Journal, vol. 11 no. 2
Type: Research Article
ISSN: 1477-7274

Article
Publication date: 1 December 1996

Mark Pilling and Tom Walley

Points out that the Department of Health’s Executive Letter: EL(95)5 moved the finance of high technology treatment provided at home for chronically ill patients from the NHS…

446

Abstract

Points out that the Department of Health’s Executive Letter: EL(95)5 moved the finance of high technology treatment provided at home for chronically ill patients from the NHS prescribing budget onto a defined and consistent framework. The aim was to obtain better value for money by encouraging competition between potential homecare providers. Reports on a survey of prescribing advisers of purchasing health authorities, which focused on their response to these developments, and discusses the issues identified by purchasers in their implementation of EL(95)5. Notes that, although most purchasers chose to contract directly with a single commercial homecare organization in 1995‐1996, there was no consensus about where contracts should be placed in the future, and that the purchasers identified inefficiencies in contracting for such care. Discusses methods of improving the purchasers’ response to contracting.

Details

Journal of Management in Medicine, vol. 10 no. 6
Type: Research Article
ISSN: 0268-9235

Keywords

Article
Publication date: 1 June 1996

Mark Pilling and Tom Walley

High‐technology treatments such as total parenteral nutrition or intravenous antibiotics may increasingly be provided to patients at home. In the past, these services have been…

1460

Abstract

High‐technology treatments such as total parenteral nutrition or intravenous antibiotics may increasingly be provided to patients at home. In the past, these services have been funded by the NHS prescribing budget. The aim of the Department of Health’s Executive letter EL(95)5, Purchasing High Tech Healthcare for Patients at Home was to ensure that contracts placed by health authority purchasers maintain effective patient services and obtain better value for money by encouraging competition between potential homecare providers. Examines contracting for high‐tech health care for patients at home and suggests that efficiency could be improved when contracting with commercial home‐care organizations by lead purchasing arrangements. In the long‐term, contracting with NHS tertiary centres is most likely to ensure continuity of care and appropriate clinical monitoring of patients.

Details

Journal of Management in Medicine, vol. 10 no. 3
Type: Research Article
ISSN: 0268-9235

Keywords

Article
Publication date: 27 March 2007

Helen Prosser and Tom Walley

This qualitative study aims to examine key stakeholders' perspectives of primary care group/trust prescribing strategies. Within the context of general practice prescribing, the…

Abstract

Purpose

This qualitative study aims to examine key stakeholders' perspectives of primary care group/trust prescribing strategies. Within the context of general practice prescribing, the paper also debates the wider issue of whether GPs' prescribing autonomy is under threat from managerial expansion following recent organisational changes in primary care.

Design/methodology/approach

Data were obtained from focus groups and a series of individual semi‐structured interviews with GPs and key primary care organisation stakeholders.

Findings

The data underlie a tension between the managerial objective of cost‐restraint and GPs' commitment to quality improvement and individual clinical patient management. In presenting both managerial and medical narratives, two divergent and often conflicting discourses emerge, which leads to speculation that managerial attempts to constrain prescribing autonomy will achieve only limited success. The contention is that GPs' discourse features as a challenge to a managerial discourse that reflects attempts to regulate, standardise and curtail clinical discretion. This is due not only to GPs' expressed hegemonic ideals that clinical practice centres on the interests of the individual patient, but also to the fact that the managerial discourse of evidence‐based medicine encapsulates only a limited share of the knowledge that GPs draw on in decision making. However, while managers' discourse presented them as unwilling to impose change or directly challenge clinical practice, evidence also emerged to suggest that is not yet possible to be sufficiently convinced of the future retention of prescribing autonomy. On the other hand, the use of peer scrutiny posed an indirect managerial influence on prescribing, whilst the emergence of prescribing advisors as analysts of cost‐effectiveness may threaten doctors' dominance of medical knowledge.

Research limitations/implications

There is a continuing need to analyse the impact of the new managerial reforms on primary care prescribing.

Originality/value

This study provides a snapshot of managerial and GP relations at a time of primary care transition.

Details

Journal of Health Organization and Management, vol. 21 no. 1
Type: Research Article
ISSN: 1477-7266

Keywords

Abstract

Details

Clinical Governance: An International Journal, vol. 14 no. 2
Type: Research Article
ISSN: 1477-7274

Content available
Article
Publication date: 30 January 2007

30

Abstract

Details

Clinical Governance: An International Journal, vol. 12 no. 1
Type: Research Article
ISSN: 1477-7274

Content available
Article
Publication date: 17 October 2008

30

Abstract

Details

Clinical Governance: An International Journal, vol. 13 no. 4
Type: Research Article
ISSN: 1477-7274

Content available
Article
Publication date: 25 January 2008

82

Abstract

Details

Clinical Governance: An International Journal, vol. 13 no. 1
Type: Research Article
ISSN: 1477-7274

Abstract

Details

Clinical Governance: An International Journal, vol. 13 no. 2
Type: Research Article
ISSN: 1477-7274

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