英国的独立处方:来自卫生部联合医疗专业药物项目组的见解。

IF 2.5 3区 医学 Q1 ORTHOPEDICS
Ivan Bristow, Catherine Bowen, Nicky Wilson, Alan Borthwick
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引用次数: 0

摘要

背景:英国药品立法在十年前(2013年)进行了修订,允许足病医生和物理治疗师独立开处方的权利,这是第一个这样做的联合卫生专业。非医疗处方是一个更广泛的政策议程的一部分,促进角色灵活性,以应对人口老龄化的挑战,并在劳动力订约的情况下保持有效的保健供应。目的:本研究的目的是概述卫生部AHP药物项目委员会团队在为足病和物理治疗独立开处方方面的经验,并特别关注所遇到的挑战。方法:对项目团队的八名核心成员进行了深入的开放式访谈,这些成员来自于在整个项目期间(2010-2013年)服务的个人。包括前卫生部主任和副主任专职卫生专业人员;卫生参与和传播司干事;保健及护理专业委员会的代表;药品和保健产品监管机构;卫生院长委员会;皇家足病学院和特许物理治疗协会(该小组还包括联合卫生专业联合会的代表)。然而,由于该代表也是本研究的研究人员,他已经回避了自己作为参与者的任何角色。)对数据进行转录并进行专题分析。结果:项目的复杂图景揭示了一系列障碍和挑战,包括跨专业角色边界紧张和对两个专业的负面先验假设。成功取决于采用双重策略,包括提交以患者利益为重点的强有力的需求案例,以及仔细管理专业期望。职业社会学的基础理论为理解所涉及的各种利益相关者之间的关系提供了一个支持性的解释框架。结论:最终,成功取决于通过明确关注患者利益,使项目目标与医疗保健政策保持一致。通过持续强调改善患者护理来平衡相互竞争的专业和政策需求,为其他联合卫生专业的未来项目奠定了基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Independent prescribing in the UK: insights from the Department of Health Allied Health Professions Medicines Project team.

Background: The UK medicines legislation was amended ten years ago (2013) to allow podiatrists and physiotherapists independent prescribing rights, the first of the allied health professions to do so. Non-medical prescribing formed one part of a broader policy agenda promoting role flexibility in response to the challenge of an ageing population and the need to maintain effective health provision in the face of a contracting workforce.

Aim: The aim of this study was to outline the experiences of the Department of Health AHP medicines project board team in working towards independent prescribing for podiatry and physiotherapy, with a particular focus on the challenges encountered.

Methods: In depth, open-ended interviews were conducted with eight of the core members of the project team, drawn from those individuals who served throughout the duration of the project (2010-2013). Included were the former Department of Health Chief and Deputy Chief Allied Health Professions Officers; the Department of Health Engagement and Communications Officer; representatives of the Health and Care Professions Council; the Medicines and Healthcare products Regulatory Agency; the Council of Deans of Health; the Royal College of Podiatry and the Chartered Society of Physiotherapy (The team also included the representative of the Allied Health Professions Federation. However, as that representative is also a researcher in this study, he has recused himself from any role as a participant.). Data were transcribed and subject to a thematic analysis.

Results: A complex picture of the project emerged revealing a range of obstacles and challenges, including inter-professional role boundary tensions and negative prior assumptions about the two professions. Success hinged upon the adoption of a dual strategy involving submission of a robust case of need focused on patient benefit coupled with the careful management of professional expectations. Underpinning theory from the sociology of the professions offers a supportive explanatory framework for understanding the relationships between the various stakeholders involved.

Conclusions: Ultimately, success depended upon aligning the project aims with healthcare policy through a clear focus on patient benefit. Balancing competing professional and policy demands through a continual emphasis on improved patient care laid the foundations for future projects by other allied health professions.

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来源期刊
CiteScore
4.50
自引率
10.30%
发文量
83
审稿时长
>12 weeks
期刊介绍: Journal of Foot and Ankle Research, the official journal of the Australian Podiatry Association and The College of Podiatry (UK), is an open access journal that encompasses all aspects of policy, organisation, delivery and clinical practice related to the assessment, diagnosis, prevention and management of foot and ankle disorders. Journal of Foot and Ankle Research covers a wide range of clinical subject areas, including diabetology, paediatrics, sports medicine, gerontology and geriatrics, foot surgery, physical therapy, dermatology, wound management, radiology, biomechanics and bioengineering, orthotics and prosthetics, as well the broad areas of epidemiology, policy, organisation and delivery of services related to foot and ankle care. The journal encourages submissions from all health professionals who manage lower limb conditions, including podiatrists, nurses, physical therapists and physiotherapists, orthopaedists, manual therapists, medical specialists and general medical practitioners, as well as health service researchers concerned with foot and ankle care. The Australian Podiatry Association and the College of Podiatry (UK) have reserve funds to cover the article-processing charge for manuscripts submitted by its members. Society members can email the appropriate contact at Australian Podiatry Association or The College of Podiatry to obtain the corresponding code to enter on submission.
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