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Bringing genetics into primary care : findings from a national evaluation of pilots in England
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Martin, Graham P., Currie, Graeme and Finn, R. (2009) Bringing genetics into primary care : findings from a national evaluation of pilots in England. Journal of Health Services Research & Policy, Vol.14 (No.4). pp. 204-211. doi:10.1258/jhsrp.2009.008158 ISSN 1355-8196.
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Official URL: http://dx.doi.org/10.1258/jhsrp.2009.008158
Abstract
Objectives Developments in genetic knowledge and clinical applications are seen as rendering traditional modes of organizing genetics provision increasingly inappropriate. In common with a number of developed world countries the UK has sought to increase the role of primary care in delivering such services. However, efforts to reconfigure service delivery face multiple challenges associated with divergent policy objectives, organizational boundaries and professional cultures. This paper presents findings from an evaluation of an English initiative to integrate genetics into ‘mainstream’ clinical provision in the National Health Service.
Methods Qualitative research in 11 case-study sites focusing on attempts by pilots funded by the initiative to embed knowledge and provision within primary care illustrating barriers faced and the ways in which these were surmounted.
Results Lack of intrinsic interest in clinical genetics among primary care staff was compounded by national targets that focused their attention elsewhere and by service structures that rendered genetics a peripheral concern demanding minimal engagement. Established divisions between the commissioning of mainstream and specialist services, along with the pressures of shorter-term targets, impeded ongoing funding.
Conclusions More wide-ranging policy and organizational support is required if the aim of entrenching genetics knowledge and practice across the Health Service is to be realized.
| Item Type: | Journal Article | ||||
|---|---|---|---|---|---|
| Subjects: | H Social Sciences > HD Industries. Land use. Labor | ||||
| Divisions: | Faculty of Social Sciences > Warwick Business School > International Centre for Governance & Public Management Faculty of Social Sciences > Warwick Business School |
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| Journal or Publication Title: | Journal of Health Services Research & Policy | ||||
| Publisher: | Royal Society of Medicine Press Ltd. | ||||
| ISSN: | 1355-8196 | ||||
| Official Date: | October 2009 | ||||
| Dates: |
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| Volume: | Vol.14 | ||||
| Number: | No.4 | ||||
| Number of Pages: | 8 | ||||
| Page Range: | pp. 204-211 | ||||
| DOI: | 10.1258/jhsrp.2009.008158 | ||||
| Status: | Not Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access |
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