Penny Rhodes
Background: New models of diabetes care are emerging within primary care, re? ecting a wish to provide higher quality care, address increasing prevalence, shift services from secondary to primary care, and increase specialisation within primary care. Aim: To obtain general practitioners’ (GPs’) views about the impact of the new service on quality of care. Design: of study Self-completion questionnaire and semi-structured interviews. Methods: Questionnaires were sent to all GPs in Bradford outside the specialist diabetes clinic practices.Interviews were also undertaken with a subsample of responders and non-responders. Results: A 60% response rate was achieved; 83% of responders had made referrals to the clinics; 83% (including some non-referrers) believed the clinics were providing a valuable service. Bene???½ ts included good quality care, convenient access, su¤cient time with patients, and responsiveness to patients’ needs. Thirty- five percent of referrers nonetheless mentioned concerns or weaknesses in the new arrangements: increasing waiting-times for first appointments, uneven geographical distribution, poor communication with GPs and concern over the quality of expertise. Conclusion: GPs generally gave a positive evaluation of the clinics. Issues to be addressed when considering the development of similar models of specialist care in community settings include: variability between clinics, the need for strategic planning, the role of specialist nurses, equity of access,the need for increased skills within all primary care teams, and integration with secondary care.
