Rationale for networks General/role in Tower Hamlets |
Tell me a bit about your current role with Tower Hamlets What are the day-to-day activities that you are involved in? And what was your role at the time the networks were developed? Could you summarise your role in the development and implementation of the networks? Are there any other positions you’ve held within Tower Hamlets? From your point of view, what are the key milestones in the networks project?
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Early planning |
What were some of the challenges the family practices faced in their interactions that prompted or informed early discussions around the networks? Were you involved in the early planning of the initiative? If so, could you describe your role and the role of other key actors? Do you have any other insights or thoughts on the early planning and rationale behind the networks?
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Intended goals/Integration |
What were the intended aims of the networks from your point of view? What type of project do you feel best describes the networks? For example, quality improvement, integration What is your understanding of the term integration? What implications do you think it has for Tower Hamlets?
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Network componentsComponents |
Probing questions (if needed)
– Administrative support – Education, skills training, developing capacity – Evidence-based guidelines or care standards (packages) – Financial incentives – Information technology (IT) systems – Outcome measurement (including dashboards) – Reporting and feedback – Leadership and peer support (social) – Aligning norms and values (culture) – Patient involvement – Other
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Individual components |
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Aligning |
How did the network align with existing initiatives (such as national targets, primary care incentives, and hospital incentives) and what role do you feel this played? (For example, Quality and Outcomes Framework, hospital QIPP targets, diabetes national targets ‘Year of Care,’ national immunisation targets) Is there anything that was not included in the networks programme you feel could or should have been?
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Facilitating factors |
What factors facilitated adopting the networks? Probing questions (if needed)
– Peer support – Leadership – IT support – Financial incentives – Existing structures or relationships within Tower Hamlets? – Existing national policies or structures? (For example, priority of integration) – Other
What factors do you think were indispensable to implementing the networks?
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Barriers |
What factors hindered adopting the networks? Probing questions (if needed)
Would you identify finances or budget restrictions as a barrier?
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Flexibility and level of implementation |
How flexible or responsive did you find the development and implementation of the networks? What role do you feel the clinical effectiveness group played in developing the networks? Specifically the clinical leads? How did you approach navigating the culture change with this project?
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Effects |
Do you feel the networks achieved their intended goals? What changes in your work did you notice when the networks were implemented? Increased or decreased breadth, depth, responsibility, level of interest Other than the four specific programmes, do you feel the networks have impacted in other areas? If so, which? Follow-up: What are your thoughts on the network improved services such as for mental illness and sexual health? What do you feel the impact of the networks on patients has been? Recognising that practices may serve different patient populations, what challenges did this present and how do you feel yourself and your colleagues responded to these challenges? Potential follow-up: how do you feel setting up the networks based on geographical boundaries differed from the model applied with fundholding? Similarly, practices also vary in size — what impact do you feel this had on the process? What are three of the most important things you think have changed through the process of the networks? What are your thoughts on the sustainability of the networks? Potential probes:
What are some of the key lessons you feel have been learned through the networks?
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Other |
What do you feel is likely to happen with the networks in the future? Potential follow-up: What unfinished work or next steps would you identify with respect to the networks? Do you feel the networks could be applied to other GP practices either in the UK or in other countries? (Or do you feel what was implemented was very context-specific to Tower Hamlets?) Have you been asked or are you aware of individuals in Tower Hamlets being asked about their experience with networks in Tower Hamlets in order to learn from it or apply it to their own context? Are there any particular individuals you would identify as leaders with this project — either at a local level or with the various organisations involved? Is there anyone else you would suggest that would be helpful to interview for this project?
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Conclusion Closing |
Is there anything else you would like to add? Summarise Thank you very much for your time Ensure have contact information for any questions
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