Evaluation of specialists' outreach clinics in general practice in England: process and acceptability to patients, specialists, and general practitioners.

Bowling, Ann; Stramer, Katia; Dickinson, E; Windsor, Joy; Bond, Michael C.

doi:10.1136/jech.51.1.52

Cited by 50 publications

(71 citation statements)

References 9 publications

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“…This is consistent with the evaluations of other specialist outreach services (Bowling et al, 1997). However, since the low-risk patients, who were not offered an appointment at the regional centre, were the least satisfied it would appear that these costs were not a major factor influencing their preference for a particular service.…”

Section: Management Of Women With a Family History Of Breast Cancer supporting

confidence: 83%

Patient satisfaction with two different models of cancer genetic services in south-east Scotland

et al. 2004

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There is a need to integrate primary-and secondary-care cancer genetic services, but the most appropriate model of service delivery remains unclear. This study reports patients' expectations of breast cancer genetic services and a comparison of their satisfaction with two service models. In the first model, risk assessment was carried out using mailed family history data. Women estimated as being at high/moderate risk were offered an appointment at the familial breast cancer clinic, and those at low risk were sent a letter of reassurance. In the second model, all women were seen by a genetic nurse specialist, who assessed risk, referred high/moderate-risk women to the above clinic and discharged those at low risk. Over 60% of all women in the study regarded access to breast screening by mammogram and regular check-ups as very important. This underlines the demand for a multidisciplinary service providing both clinical genetic and surgical services. Satisfaction was high with both models of service, although significantly lower among women not at increased cancer risk and thus not offered a clinical check-up and mammography. Increased cancer worry was associated with a greater expressed need for information and for reassurance through follow-up clinical checks and mammography. Better targeting of counselling to the expressed concerns and needs of these women is required to improve the service offered. GPs and patients expressed no clear preference for any specific service location or staffing configuration. The novel community service was less expensive in terms of both staff and patient costs. The potential to decrease health staff/patient contact time and to employ nurse practitioners with both clinical genetic and oncology training should be explored further. The rapidly rising demand for these services suggests that the evaluation of further new models needs to continue to be given priority to guide the development of cancer genetic services.

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Section: Management Of Women With a Family History Of Breast Cancer supporting

confidence: 83%

Patient satisfaction with two different models of cancer genetic services in south-east Scotland

et al. 2004

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“…[16][17][18][19][20][21][22]24,[26][27][28]31,34 They included GPs and specialists already participating in outreach (and choosing to respond to surveys). Even this selected group identi ed certain disadvantages.…”

Section: Results From Descriptive Surveysmentioning

confidence: 99%

Systematic review of outreach clinics in primary care in the UK

Powell

2002

J Health Serv Res Policy

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“…On the other hand, the initiative runs the risk of compromising the quality of care that patients receive and may lead to increased costs with less efficient use of consultants' time. Two systematic reviews of specialist outreach clinics, including adult and paediatric care (Gruen et al, 2009;Powell, 2002) and evaluations of specialist outreach clinics in General Practice (Bowling et al 1997;Bond et al, 2000 Bowling andBond, 2001) have reported an increase in patient satisfaction and improved processes of care, but negligible effects on health outcomes and service costs. Studies specifically evaluating the shift of children's specialist outpatient services into community settings are rare.…”

Section: Introductionmentioning

confidence: 97%

“…Many of the Care Closer to Home (CCTH) evaluations carried out to date have focused on adult outpatient services (Bowling et al 1997;Bond et al, 2000;Bowling and Bond, 2001;Sibbald et al, 2007Sibbald et al, , 2008, or on preventing inpatient admission and reducing length of stay (Parker et al, 2011a(Parker et al, , 2011b. Thus despite a policy drive for paediatric CCTH, there remain gaps in existing evidence about the appropriateness of this model for specialist paediatric outpatient services, namely the acceptability of the model by parents, patients and healthcare professionals, and the extent to which any of the proposed benefits have been achieved (McLellan, 1995).…”

Section: Introductionmentioning

confidence: 99%

Paediatric ‘care closer to home’: Stake-holder views and barriers to implementation

et al. 2012

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Evaluation of specialists' outreach clinics in general practice in England: process and acceptability to patients, specialists, and general practitioners.

Cited by 50 publications

References 9 publications

Patient satisfaction with two different models of cancer genetic services in south-east Scotland

Patient satisfaction with two different models of cancer genetic services in south-east Scotland

Systematic review of outreach clinics in primary care in the UK

Paediatric ‘care closer to home’: Stake-holder views and barriers to implementation

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