Relocating patients from a specialist homeless healthcare centre to general practices

a multi-perspective study

Kathrine Gibson Smith, Vibhu Paudyal (Corresponding Author), Katie MacLure, Katrina Forbes-McKay, Carole Buchanan, Liz Wilson, Joan MacLeod, Ann Smith, Derek Stewart

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background The relocation of formerly homeless patients eligible to transfer from a specialist homeless healthcare centre (SHHC) to mainstream general practices is key to patient integration in the local community. Failure to transition patients conferring eligibility for relocation may also negatively impact on SHHC service delivery.

Aim To explore barriers and facilitators of relocation from the perspectives of formerly homeless patients and healthcare staff involved in their care.

Design and setting Qualitative semi-structured face-to-face and telephone interviews conducted in the north east of Scotland.

Method Participants were patients and healthcare staff including GPs, nurses, substance misuse workers, administrative, and local community pharmacy staff recruited from one SHHC, two mainstream general practices, and four community pharmacies. Interview schedules based on the 14 domains of the Theoretical Domains Framework (TDF) were drafted. Transcripts of the interviews were analysed by two independent researchers using a framework approach.

Results Seventeen patients and 19 staff participated. Key barriers and facilitators aligned to TDF domains included: beliefs about consequences regarding relocation; patient intention to relocate; environmental context and resources in relation to the care of the patients and assessing patient eligibility; patient skills in relation to integration; social and professional role and identity of staff and patients; and emotional attachment to the SHHC.

Conclusion Implementation of services, which promote relocation and integration, may optimise patient relocation from SHHCs to mainstream general practices. These include peer support networks for patients, better information provision on the relocation process, and supporting patients in the journey of identifying and adjusting to mainstream practices.
Original languageEnglish
Pages (from-to)e105-e113
Number of pages9
JournalBritish Journal of General Practice
Volume68
Issue number667
Early online date25 Jan 2018
DOIs
Publication statusPublished - 28 Feb 2018

Fingerprint

General Practice
Delivery of Health Care
Pharmacies
Interviews
Patient Transfer
Professional Role
Scotland
Patient Care
Appointments and Schedules
Nurses
Research Personnel

Keywords

  • delivery of health care
  • general practice
  • homeless persons
  • primary health care
  • Theoretical Domains Framework

Cite this

Relocating patients from a specialist homeless healthcare centre to general practices : a multi-perspective study. / Gibson Smith, Kathrine; Paudyal, Vibhu (Corresponding Author); MacLure, Katie; Forbes-McKay, Katrina; Buchanan, Carole ; Wilson, Liz; MacLeod, Joan; Smith, Ann; Stewart, Derek.

In: British Journal of General Practice, Vol. 68, No. 667, 28.02.2018, p. e105-e113.

Research output: Contribution to journalArticle

Gibson Smith, K, Paudyal, V, MacLure, K, Forbes-McKay, K, Buchanan, C, Wilson, L, MacLeod, J, Smith, A & Stewart, D 2018, 'Relocating patients from a specialist homeless healthcare centre to general practices: a multi-perspective study', British Journal of General Practice, vol. 68, no. 667, pp. e105-e113. https://doi.org/10.3399/bjgp18X694577
Gibson Smith, Kathrine ; Paudyal, Vibhu ; MacLure, Katie ; Forbes-McKay, Katrina ; Buchanan, Carole ; Wilson, Liz ; MacLeod, Joan ; Smith, Ann ; Stewart, Derek. / Relocating patients from a specialist homeless healthcare centre to general practices : a multi-perspective study. In: British Journal of General Practice. 2018 ; Vol. 68, No. 667. pp. e105-e113.
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title = "Relocating patients from a specialist homeless healthcare centre to general practices: a multi-perspective study",
abstract = "Background The relocation of formerly homeless patients eligible to transfer from a specialist homeless healthcare centre (SHHC) to mainstream general practices is key to patient integration in the local community. Failure to transition patients conferring eligibility for relocation may also negatively impact on SHHC service delivery.Aim To explore barriers and facilitators of relocation from the perspectives of formerly homeless patients and healthcare staff involved in their care.Design and setting Qualitative semi-structured face-to-face and telephone interviews conducted in the north east of Scotland.Method Participants were patients and healthcare staff including GPs, nurses, substance misuse workers, administrative, and local community pharmacy staff recruited from one SHHC, two mainstream general practices, and four community pharmacies. Interview schedules based on the 14 domains of the Theoretical Domains Framework (TDF) were drafted. Transcripts of the interviews were analysed by two independent researchers using a framework approach.Results Seventeen patients and 19 staff participated. Key barriers and facilitators aligned to TDF domains included: beliefs about consequences regarding relocation; patient intention to relocate; environmental context and resources in relation to the care of the patients and assessing patient eligibility; patient skills in relation to integration; social and professional role and identity of staff and patients; and emotional attachment to the SHHC.Conclusion Implementation of services, which promote relocation and integration, may optimise patient relocation from SHHCs to mainstream general practices. These include peer support networks for patients, better information provision on the relocation process, and supporting patients in the journey of identifying and adjusting to mainstream practices.",
keywords = "delivery of health care, general practice, homeless persons, primary health care, Theoretical Domains Framework",
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note = "Acknowledgments Thanks to NHS Grampian, the general practices and community pharmacies that were involved in the research, study participants, Caroline McNiff for her part in data collection, and Jeanette Lowe for transcription of audiorecordings. Funding This study was funded by the Health Improvement Fund, NHS Grampian, 2015.",
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T1 - Relocating patients from a specialist homeless healthcare centre to general practices

T2 - a multi-perspective study

AU - Gibson Smith, Kathrine

AU - Paudyal, Vibhu

AU - MacLure, Katie

AU - Forbes-McKay, Katrina

AU - Buchanan, Carole

AU - Wilson, Liz

AU - MacLeod, Joan

AU - Smith, Ann

AU - Stewart, Derek

N1 - Acknowledgments Thanks to NHS Grampian, the general practices and community pharmacies that were involved in the research, study participants, Caroline McNiff for her part in data collection, and Jeanette Lowe for transcription of audiorecordings. Funding This study was funded by the Health Improvement Fund, NHS Grampian, 2015.

PY - 2018/2/28

Y1 - 2018/2/28

N2 - Background The relocation of formerly homeless patients eligible to transfer from a specialist homeless healthcare centre (SHHC) to mainstream general practices is key to patient integration in the local community. Failure to transition patients conferring eligibility for relocation may also negatively impact on SHHC service delivery.Aim To explore barriers and facilitators of relocation from the perspectives of formerly homeless patients and healthcare staff involved in their care.Design and setting Qualitative semi-structured face-to-face and telephone interviews conducted in the north east of Scotland.Method Participants were patients and healthcare staff including GPs, nurses, substance misuse workers, administrative, and local community pharmacy staff recruited from one SHHC, two mainstream general practices, and four community pharmacies. Interview schedules based on the 14 domains of the Theoretical Domains Framework (TDF) were drafted. Transcripts of the interviews were analysed by two independent researchers using a framework approach.Results Seventeen patients and 19 staff participated. Key barriers and facilitators aligned to TDF domains included: beliefs about consequences regarding relocation; patient intention to relocate; environmental context and resources in relation to the care of the patients and assessing patient eligibility; patient skills in relation to integration; social and professional role and identity of staff and patients; and emotional attachment to the SHHC.Conclusion Implementation of services, which promote relocation and integration, may optimise patient relocation from SHHCs to mainstream general practices. These include peer support networks for patients, better information provision on the relocation process, and supporting patients in the journey of identifying and adjusting to mainstream practices.

AB - Background The relocation of formerly homeless patients eligible to transfer from a specialist homeless healthcare centre (SHHC) to mainstream general practices is key to patient integration in the local community. Failure to transition patients conferring eligibility for relocation may also negatively impact on SHHC service delivery.Aim To explore barriers and facilitators of relocation from the perspectives of formerly homeless patients and healthcare staff involved in their care.Design and setting Qualitative semi-structured face-to-face and telephone interviews conducted in the north east of Scotland.Method Participants were patients and healthcare staff including GPs, nurses, substance misuse workers, administrative, and local community pharmacy staff recruited from one SHHC, two mainstream general practices, and four community pharmacies. Interview schedules based on the 14 domains of the Theoretical Domains Framework (TDF) were drafted. Transcripts of the interviews were analysed by two independent researchers using a framework approach.Results Seventeen patients and 19 staff participated. Key barriers and facilitators aligned to TDF domains included: beliefs about consequences regarding relocation; patient intention to relocate; environmental context and resources in relation to the care of the patients and assessing patient eligibility; patient skills in relation to integration; social and professional role and identity of staff and patients; and emotional attachment to the SHHC.Conclusion Implementation of services, which promote relocation and integration, may optimise patient relocation from SHHCs to mainstream general practices. These include peer support networks for patients, better information provision on the relocation process, and supporting patients in the journey of identifying and adjusting to mainstream practices.

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KW - general practice

KW - homeless persons

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KW - Theoretical Domains Framework

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DO - 10.3399/bjgp18X694577

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SP - e105-e113

JO - The British Journal of General Practice

JF - The British Journal of General Practice

SN - 0960-1643

IS - 667

ER -