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Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative study

OBJECTIVE: Exploring the views of stakeholders to the referral management systems (RMS) used by GP practices in Northumberland, UK to evaluate its perceived effectiveness. DESIGN: This was an in-depth qualitative semi-structured interview study. PARTICIPANTS AND SETTING: 32 participants (GPs, hospit...

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Autores principales: Dew, Rosie, Wilkes, Scott
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6629383/
https://www.ncbi.nlm.nih.gov/pubmed/31289080
http://dx.doi.org/10.1136/bmjopen-2018-028436
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author Dew, Rosie
Wilkes, Scott
author_facet Dew, Rosie
Wilkes, Scott
author_sort Dew, Rosie
collection PubMed
description OBJECTIVE: Exploring the views of stakeholders to the referral management systems (RMS) used by GP practices in Northumberland, UK to evaluate its perceived effectiveness. DESIGN: This was an in-depth qualitative semi-structured interview study. PARTICIPANTS AND SETTING: 32 participants (GPs, hospital consultants, referral support, hospital managers, Clinical Commissioning Group manager) in the North East of England, UK. METHOD: Interviews using a grounded theory approach and thematic analysis. RESULTS: The main benefit of RMS mentioned by participants was that it allowed for unnecessary referrals to be vetted by consultants, and helps ensure patients are sent to the correct clinic. Generally, the consultants in our study felt that RMS did not significantly help them reject referrals. Some GPs experienced that RMS undermined GP autonomy and did not help when they had exhausted their abilities to manage a patient in primary care, and it was suggested that in some cases RMS may delay rather than prevent a referral. The main perceived disadvantage of RMS was the additional workload for GPs and consultants, and RMS was felt to be a barrier to commutation between GPs and consultants. Frustration with the system design and lack of knowledge of its cost-effectiveness were articulated. CONCLUSION: Although RMS was reported to reduce some unnecessary referrals, the effect of referral delay and rejection is unknown. Although there were some positive attributes described, RMS was mostly received negatively by the stakeholders.
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spelling pubmed-66293832019-07-30 Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative study Dew, Rosie Wilkes, Scott BMJ Open Qualitative Research OBJECTIVE: Exploring the views of stakeholders to the referral management systems (RMS) used by GP practices in Northumberland, UK to evaluate its perceived effectiveness. DESIGN: This was an in-depth qualitative semi-structured interview study. PARTICIPANTS AND SETTING: 32 participants (GPs, hospital consultants, referral support, hospital managers, Clinical Commissioning Group manager) in the North East of England, UK. METHOD: Interviews using a grounded theory approach and thematic analysis. RESULTS: The main benefit of RMS mentioned by participants was that it allowed for unnecessary referrals to be vetted by consultants, and helps ensure patients are sent to the correct clinic. Generally, the consultants in our study felt that RMS did not significantly help them reject referrals. Some GPs experienced that RMS undermined GP autonomy and did not help when they had exhausted their abilities to manage a patient in primary care, and it was suggested that in some cases RMS may delay rather than prevent a referral. The main perceived disadvantage of RMS was the additional workload for GPs and consultants, and RMS was felt to be a barrier to commutation between GPs and consultants. Frustration with the system design and lack of knowledge of its cost-effectiveness were articulated. CONCLUSION: Although RMS was reported to reduce some unnecessary referrals, the effect of referral delay and rejection is unknown. Although there were some positive attributes described, RMS was mostly received negatively by the stakeholders. BMJ Publishing Group 2019-07-09 /pmc/articles/PMC6629383/ /pubmed/31289080 http://dx.doi.org/10.1136/bmjopen-2018-028436 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Qualitative Research
Dew, Rosie
Wilkes, Scott
Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative study
title Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative study
title_full Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative study
title_fullStr Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative study
title_full_unstemmed Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative study
title_short Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative study
title_sort evaluation of the referral management systems (rms) used by gp practices in northumberland: a qualitative study
topic Qualitative Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6629383/
https://www.ncbi.nlm.nih.gov/pubmed/31289080
http://dx.doi.org/10.1136/bmjopen-2018-028436
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