Background: Extended stays and adverse events mean that hospital admissions are costly for people

This article describes two approaches to obtaining the views of users of health services: the self‐completion questionnaire and the focus group. The theoretical framework of each method will be given along with implications for their use in clinical audit. Practical examples of both are provided, in relation to the work of a district general hospital. The advantages and disadvantages of questionnaires and focus groups are set out as well as some suggested steps for the successful application of the two methods. In conclusion, it is argued that when used together, focus groups and questionnaires complement one another and allow users' views to be heard within the audit process.

Background Joint pain adversely impacts the physical, mental, socioeconomic and emotional wellbeing of many millions of people. Enabling Self‐management and Coping with Arthritic Pain using Exercise, ESCAPE‐pain, is a rehabilitation programme that reduces joint pain and its impact. The programme is usually delivered in clinical settings by physiotherapists but delivering it in community venues would improve access greatly. Aim To explore the feasibility of delivering ESCAPE‐pain in community venues, and the experiences of organisations and facilitators delivering it. Methods Semi‐structured interviews were conducted with managers of 17 community organisations and 10 facilitators. Results People were happy to attend ESCAPE‐pain delivered by exercise professionals at community venues, which they found convenient and valuable. It expanded community organisation's offer to older people, utilised their facilities off‐peak and advanced facilitator's personal and professional development. Recruitment onto the programme was easiest where there were good links with local clinical providers. Although collecting outcome data was burdensome it demonstrated the programme's effectiveness to commissioners. Some clinical commissioners contracted community organisations to deliver ESCAPE‐pain reducing their costs and freeing up clinical facilities. Organisations also financed ESCAPE‐pain by charging participants a nominal fee for the programme, post‐programme classes to support participants remain active and/or a membership fee. Conclusions ESCAPE‐pain delivered in community venues facilitated access to better care and on‐going support. Partnerships between healthcare commissioners and community providers maximised efficient use of their facilities and resources and fulfilled national policy of encouraging self‐management of long‐term conditions in the community.

Background Modern treat-to-target approaches to rheumatoid arthritis (RA) involve frequent monitoring of disease activity with the goal of disease remission or a low disease activity. The Rheumatoid Arthritis Impact of Disease (RAID) is a multidimensional, validated patient-reported outcome measure that covers seven domains, which has been found to discriminate between active and non-active disease. Applying smartphone apps to monitoring of RA is described as an innovation which has been implemented in the UK and USA. The proposed study will evaluate the feasibility of scaled implementation of a remote monitoring service based on RAID for eligible patients with RA at three NHS organisations (trusts) in south east London, UK. Methods Pragmatic formative service evaluation study informed by implementation theory and incorporating the perspectives of RA service users throughout. The study will follow a multi-method approach. Rapid evidence review will be carried out to identify implementation approaches used in similar services. Quantitative data will be collected from a cross-sectional sample of service users through a web-based questionnaire assessing patient satisfaction, as well as service-level data routinely collected by trusts and from the remote monitoring system and documentation produced in developing and implementing the remote monitoring service. Qualitative data will be collected from approximately 30 clinical and non-clinical staff and 20-30 patients purposively sampled to conduct semi-structured interviews to explore their perspectives on remote monitoring in RA. The evaluation will be supported by established implementation frameworks, including EPIS (Exploration, Preparation, Implementation and Sustainment) and COM-B (Capability-Opportunity-Motivation-Behaviour), which will be used to guide data generation and to inform the framework analysis of qualitative data. Discussion This pragmatic study will enhance the understanding of implementation process and outcomes and will explore the potential to scale up the remote monitoring system in RA. A larger scale hybrid study can be designed based on the dataset the current study will produce to offer definitive clinical and implementation evaluation.

No abstract