Negotiating new roles in general practice: a qualitative study of clinical pharmacists.

Background: To address general practice workforce shortages, policy in England has supported the recruitment of 'non-medical' roles through reimbursement funding. As one of the first to receive funding, the clinical pharmacist role offers insight into the process of new role negotiation at general practice level.

Aim: To identify factors influencing clinical pharmacist role negotiation at practice level, comparing the process under two different funding and employment models.

The use and impact of digital COVID-19 tracking in adult social care: a prospective cohort study of care homes in Greater Manchester.

Background: To support proactive care during the coronavirus pandemic, a digital COVID-19 symptom tracker was deployed in Greater Manchester (UK) care homes. This study aimed to understand what factors were associated with the post-uptake use of the tracker and whether the tracker had any effects in controlling the spread of COVID-19.

Methods: Daily data on COVID-19, tracker uptake and use, and other key indicators such as staffing levels, the number of staff self-isolating, availability of personal protective equipment, bed occupancy levels, and any problems in accepting new residents were analysed for 547 care homes across Greater Manchester for the period April 2020 to April 2021.

Implementation, uptake and use of a digital COVID-19 symptom tracker in English care homes in the coronavirus pandemic: a mixed-methods, multi-locality case study.

Background: COVID-19 spread rapidly in UK care homes for older people in the early pandemic. National infection control recommendations included remote resident assessment. A region in North-West England introduced a digital COVID-19 symptom tracker for homes to identify early signs of resident deterioration to facilitate care responses.

The challenges of integrating signposting into general practice: qualitative stakeholder perspectives on care navigation and social prescribing in primary care.

Background: A national policy focus in England to address general practice workforce issues has led to a commitment to employ significant numbers of non-general practitioner (GP) roles to redistribute workload. This paper focuses on two such roles: the care navigation (CN) and social prescribing link worker (SPLW) roles, which both aim to introduce 'active signposting' into primary care, to direct patients to the right professional/services at the right time and free up GP time. There is a lack of research exploring staff views of how these roles are being planned and operationalised into general practice and how signposting is being integrated into primary care.

Skill-mix change in general practice: a qualitative comparison of three 'new' non-medical roles in English primary care.

Background: General practice is currently facing a significant workforce challenge. Changing the general practice skill mix by introducing new non-medical roles is recommended as one solution; the literature highlights that organisational and/or operational difficulties are associated with skill-mix changes.

Aim: To compare how three non-medical roles were being established in general practice, understand common implementation barriers, and identify measurable impacts or unintended consequences.

Communicating Cardiovascular Disease Risk to People with Psoriasis: What Techniques do Practitioners Use?

Background: Psoriasis can be associated with unhealthy lifestyle behaviours such as smoking, excess alcohol use and insufficient physical activity, consequently increasing cardiovascular disease (CVD) risk. Health care practitioners are expected to discuss lifestyle risk factors with patients with a view to reducing health-related risk for patients. However, little is known about the techniques used to communicate information about risk to patients with psoriasis.

'I should have taken that further' - missed opportunities during cardiovascular risk assessment in patients with psoriasis in UK primary care settings: a mixed-methods study.

Background: Unhealthy lifestyle is common in psoriasis, contributing to worsening disease and increased cardiovascular disease (CVD) risk. CVD risk communication should improve patients' understanding of risk and risk-reducing behaviours; however, the effectiveness of risk screening is debated and evaluation currently limited.

Objective: To examine the process of assessing for and communicating about CVD risk in the context of psoriasis.

The role of personal models in clinical management: Exploring health care providers' beliefs about psoriasis.

Objectives: Individuals' illness representations, including beliefs about psoriasis (a complex immune-mediated condition), and their emotional responses to the condition guide self-management behaviour. It is also plausible that health care providers' illness representations guide their own management of psoriasis. Patients commonly report poor health care experiences related to psoriasis, and the role of health care providers' beliefs, emotions, as well as their knowledge, experiences and behaviours ('personal models') in this is unexplored.

Do English healthcare settings use 'Choice Architecture' principles in promoting healthy lifestyles for people with psoriasis? An observational study.

Background: The influence of environmental factors in shaping behaviour is becoming increasingly prominent in public health policy, but whether health promotion strategies use this knowledge is unknown. Health promotion is important in the management of psoriasis, a long-term inflammatory skin condition, and health centre waiting areas are ideal places to promote health information to such patients. We systematically examined patient information materials containing either general, or specific, health messages for patients with psoriasis.

'On the surface': a qualitative study of GPs' and patients' perspectives on psoriasis.

Background: Psoriasis is a chronic, inflammatory skin disease affecting approximately 2% of the UK population and is currently incurable. It produces profound effects on psychological wellbeing and social functioning and has significant associated co-morbidities. The majority of patients with psoriasis are managed in primary care, however in-depth patient and GP perspectives about psoriasis management in this setting are absent from the literature.

Parents' Perspectives of Cleft Lip and/or Palate Services: A Qualitative Interview.

The study aimed to explore in depth the perspectives of parents about their child's cleft services. Purposive and theoretical sampling produced a diverse sample of mothers and fathers with children aged 20 weeks to 21 years. Parents were recruited from a specialist cleft center in the U.

'Doing the "right" thing': how parents experience and manage decision-making for children's 'normalising' surgeries.

Using cleft lip and palate as an exemplar, this article examines parents' decision-making for children in the context of elective treatments which aim to 'normalise' a child's function, appearance, communication or identity. Using purposive and theoretical sampling, 35 parents with children from infancy to young adulthood were recruited through a specialist cleft centre in England. Parents were interviewed in-depth between 2006 and 2008 about their beliefs and motivations in relation to treatment decision-making in this context.

Parents' emotional and social experiences of caring for a child through cleft treatment.

Little is known about the experiences of parents caring for a child through long-term treatment for cleft lip and/or cleft palate. We conducted in-depth interviews with 35 parents with children between the ages of 20 weeks and 21 years to explore experiences across the treatment program. We analyzed the data using a constructivist grounded theory approach and present in detail in this article one subcategory from the analysis: managing emotions.

Qualitative approaches in craniofacial research.

This article proposes the customary use of qualitative methods as complementary research tools to enhance the evidence base in the craniofacial field. The recognition given to qualitative approaches in other healthcare areas and their value in enhancing understanding of lay and professional beliefs and behaviors is contrasted with the paucity of qualitative studies to date in the craniofacial field. Research tools from the qualitative repertoire are briefly introduced and their underpinning principles are explained.