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OBJECTIVES To understand the effects of a large scale 'payment for performance' scheme (the Quality and Outcomes Framework [QOF]) on professional roles and the delivery of primary care in the English National Health Service. METHODS Qualitative semi-structured interview study. Twenty-four clinicians were interviewed during 2006: one general practitioner(More)
OBJECTIVE To test whether a drug review and symptom self management and lifestyle advice intervention by community pharmacists could reduce hospital admissions or mortality in heart failure patients. DESIGN Randomised controlled trial. SETTING Home based intervention in heart failure patients. PARTICIPANTS 293 patients diagnosed with heart failure(More)
BACKGROUND The advent of general practice co-operatives represented a fundamental change in the delivery and organization of out-of-hours services. Concerns have been voiced that co-operatives might impact adversely on workload in accident and emergency (A&E) departments. OBJECTIVE The purpose of this study was to assess the impact of establishing a(More)
BACKGROUND Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) or chronic fatigue syndrome (CFS) has been used to name a range of chronic conditions characterized by extreme fatigue and other disabling symptoms. Attempts to estimate the burden of disease have been limited by selection bias, and by lack of diagnostic biomarkers and of agreed(More)
INTRODUCTION A cross over comparison between 'traditional' continuing medical education (CME) activities and portfolio-based learning in general practice is described. METHOD Thirty-two volunteer general practitioners (GPs) were divided into two cohorts; each cohort spent six months following a 'traditional' route to postgraduate educational accreditation(More)
BACKGROUND The Clinical Standards Advisory Group (CSAG) was asked by UK health ministers to advise on the standards of clinical care attainable for people with depression. The GP survey reported here is one part of a multicomponent UK-wide study of services for depression that also included visits to a sample of services and structured patient telephone(More)
OBJECTIVE To gain understanding of general practitioners' and patients' opinions of the routine introduction of standardised measures of severity of depression through the UK general practice quality and outcomes framework. DESIGN Semistructured qualitative interview study, with purposive sampling and constant comparative analysis. PARTICIPANTS 34(More)
BACKGROUND We sought to investigate the formal and informal ways preregistration students from medicine, nursing, pharmacy and the allied healthcare professions learn about patient safety. METHODS We drew on Eraut's framework on formal and informal acquisition of professional knowledge to undertake a series of phased theoretically informed, in-depth(More)
BACKGROUND Patients at risk of severe exacerbations contribute disproportionally to asthma mortality, morbidity and costs. We evaluated the effectiveness and costs of using 'asthma risk registers' for these patients in primary care. METHODS In a cluster-randomised trial, 29 primary care practices identified 911 at-risk asthma patients using British asthma(More)