Professionals' perceptions of type 2 diabetes in primary care during a service redesign

Abstract

The purpose of this study was to survey primary health care professionals' perceptions of type 2 diabetes, an evaluation during a service redesign. Management of people with type 2 diabetes has been led by hospital based secondary care. The objective of the service redesign was to transfer the management of the majority of people with type 2 diabetes from secondary care to general practitioner (GP) led, multidisciplinary primary care (comprising the GP, practice nurses, dietitians and podiatrists) delivered closer to the patients. Prior to implementation, all primary health care professionals undertook accredited educational preparation and there was infrastructure development by the creation of new posts and streamlining of IT systems to support the planned change.

The study aim was to examine health care professionals' perspectives of diabetes, its management, the value of clinical guidelines and the impact of practice organisation.

A cross-sectional survey design was used. Primary health care professionals in one geographical area were sent the validated Perceptions of Diabetes Questionnaire (n=112).

The response rate was 34% (n=38). Professionals attached great importance to ongoing education of people with type 2 diabetes in essential areas of care. Type 2 diabetes was perceived as more difficult to treat than other chronic conditions. There was a high level of satisfaction with the workload associated with the service redesign and a team approach is valued. There is an association between diabetes-specific education and confidence in diabetes management. Professionals identified some barriers to using clinical guidelines.

Overall, professionals were satisfied with the new model of multidisciplinary, GP led care management and their workload with the support of additional education in diabetes. Copyright © 2012 FEND. Published by John Wiley & Sons, Ltd.