How do clinical nurse specialists influence primary care management of asthma? A qualitative study.

Methods: We carried out a qualitative interview study alongside a randomised controlled trial which tested the effectiveness of asthma nurse specialists in east London. We carried out face-to-face interviews with five asthma nurse specialists, eight general practitioners (GPs) and six practice nurses, and also held a focus group session with six people who had attended hospital with acute asthma.

Results: Four factors were associated with effective specialist nurse liaison: (1) primary care practices which prioritised asthma care; (2) GPs who trusted practice nurses to manage chronic disease autonomously; (3) GPs who recognised specialist nurse expertise and acted on their advice; and (4) practices which had simple systems in place to deal with recommendations.

Brief encounters of aggression and violence in primary care: a team approach to coping strategies.

Objectives: Our aim was to investigate the extended primary care team's experience of aggression and violence from patients, in order to promote the formulation of multiprofessional team procedures for critical incident management and organizational development.

Methods: A qualitative study based on in-depth interviews and focus groups with primary health care teams and community staff was carried out in one inner London and one outer London health authority area. Key issues and themes were derived from transcripts of 30 individual interviews and five focus group discussions.

The CeMENT project: a case study in change management.

The Community Based Medical Education in North Thames (CeMENT) Project case study is a useful approach to analysing complex change facing the medical profession and all medical teachers. The project was a collaboration involving five North London medical schools to develop the community-based aspects of the undergraduate medical curriculum. The project management team was drawn from academic general practitioners, hospital specialists with expertise in medical education, and education.

Influences on hospital admission for asthma in south Asian and white adults: qualitative interview study.

Objective: To explore reasons for increased risk of hospital admission among south Asian patients with asthma.

Design: Qualitative interview study using modified critical incident technique and framework analysis.

Setting: Newham, east London, a deprived area with a large mixed south Asian population.