INSÄNT AV pgazeley@aol.com DEN 13 :e OKTOBER, 1996 vid 12 - tiden
Dear Colleagues,I am a Business Manager at Airedale NHS Trust in
Yorkshire, England and I am currently researching material
for a management dissertation. This is focused on the
factors which improve the continuity of care across primary
and secondary sectors for the diabetic patient. I am
particularly interested in the extent of teamworking between
all the professionals involved, the significance of
information flows, maintenance of composite patient
records and in the allocation of resources across the
different sectors.Airedale NHS Trust provides acute and community care,
has strong clinical links with the primary sector and is
about to establish a Diabetic Resource Centre. In some
Health Centres almost all diabetic care is provided by the
GP supported by a team of specialist nurses, dieticians,
chiropodists etc. I understand that in Sweden different
councils have implemented various initiatives to integrate
care and that in Gothenburg there is a group of clinicians
who meet to discuss ways to improve the provision
of "seamless care" for the diabetic patient.I am visiting Sweden later in the year spending the first
week in Stockholm based at and around the LUCD,
Karolinska Institute interviewing a wide range of people
in the acute sector and in Primary Health Care centres.
During the second week I am based in Gottenburg and
would welcome the opportunity to meet with others who
have an interest in the above topic. I have time to spare
on Wednesday and Thursday 6 / 7th November and
would particularly like to visit a Primary Care Cantre in
the area served by Sahlgrenska University Hospital
in Gothenburg. If you are able to help please contact me -
alternatively I welcome your comments.I have now completed my research at Airedale and find that
despite integrated organisational structure, diabetic care
is still fragmented with teamworking and the degree of
shared care variable across the district. There are some
outstanding successes but national policy and funding
mechanisms provide no incentives for GPs to support
diabetics within Primary Care even though there seems to
be a great potential for this to achieve real advantages
for the patient. The total cost of diabetic care is hidden
within our pricing structure and funding for chronic
disease is not a priority despite the potential for prevention
and long term savings in both money and clinical
problems for the patient. There is a hope that the Diabetic
Centre will focus care and provide the opportunity for
staff to meet and discuss common issues. The lead
clinician aims to establish a diabetic database which
will be accessible to everyone in the district but
to date this is hampered by lack of resources.Thanks for your help. Sorry if I have not used this site
properly but I cant read Swedish! Pam
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