Implementing the National Service Framework for long-term (neurological) conditions: service user and service provider experiences. (April 2014)

• Record Type: Journal Article
• Authors: Sixsmith, Judith; Callender, Matthew; Hobbs, Georgina; Corr, Susan; Huber, Jörg W.
• Is Part Of: Disability and rehabilitation. Volume 36:Number 7(2014:Apr.)
• Page Start: 563
• Page End: 572
• Publication Date: 2014-04
• Subjects: People with disabilities -- Periodicals; Rehabilitation -- Periodicals; 617.03
• DOI: 10.3109/09638288.2013.804594
• Languages: English
• ISSNs: 0963-8288

Abstract

<abstract> <title>Abstract</title> <p> <italic>Purpose</italic>: This research explored the experiences of service users and providers during the implementation of the National Service Framework (NSF) for Long-Term (Neurological) Conditions (LTNCs). <italic>Method</italic>: A participatory qualitative research design was employed. Data were collected using 50 semi-structured interviews with service users, 25 of whom were re-interviewed on three occasions. Forty-five semi-structured interviews were also conducted with service providers who worked with individuals with LTNCs. Interviews focused on health, well-being and quality of life in relation to service provision, access and delivery. Data were thematically analysed individually and collaboratively during two data analysis workshops. <italic>Results</italic>: Three major themes were identified that related to the implementation of the NSF: "Diagnosis and treatment", "Better connected services" and "On-going rehabilitation". Service users reported that effective care was provided when in hospital settings but such treatments often terminated on return to their communities despite on-going need. In hospital and community settings, service providers indicated that they lacked the support and resources to provide continuous care, with patients reaching a crisis point before referral to specialist care. <italic>Conclusion</italic>: This research highlighted a range of issues concerning the recent UK-drive towards patient-centred approaches within healthcare, as service users were disempowered within the LTNC care pathway. Moreover, service providers indicated that resource constraints limited their ability to provide long-term, intensive and integrated service provision.<list list-type="bullet"><title>Implications for Rehabilitation</title><list-item><p>Our research suggests that many service users with long-term neurological conditions experienced disconnections between services within their National Service Framework care pathway.</p></list-item><list-item><p>For health and social care practitioners, a lack of continuity within a care pathway was suggested to be most pertinent following immediate care and moving to rehabilitative care.</p></list-item><list-item><p>Our findings also indicate that service providers lack the necessary financial resources and staffing capacity to provide on-going and comprehensive rehabilitation.</p></list-item><list-item><p>This article aims to help practitioners better understand particular issues during the implementation of the National Service Framework for long-term neurological conditions from the perspectives of service users and service providers.</p></list-item></list></p> </abstract>