The conflict between specialist diabetes services and acute-general internal medicine for consultant diabetologists in the UK in 2006

Autor:	Dinesh Nagi, Richard I. G. Holt, Peter H. Winocour, C. Walton, C. Gosden, B. Turner
Rok vydání:	2008
Předmět:	Service (business) medicine.medical_specialty Opting out business.industry Project commissioning Public health education MEDLINE General Medicine Primary care medicine.disease Nursing Internal medicine Diabetes mellitus Medicine business Service development
Zdroj:	Clinical Medicine. 8:377-380
ISSN:	1473-4893 1470-2118
DOI:	10.7861/clinmedicine.8-4-377
Popis:	An online survey of consultant diabetologists in the UK examined the interface between specialist services and acute-general internal medicine (acute-GIM). Out of 592 consultants, 289 (49%) responded. Of these, 94% contributed to acute-GIM, devoting equivalent time to acute-GIM and specialist diabetes services. Of the respondents, 10% provided a single-handed specialist service and 78% provided endocrine services. The survey found the input to acute-GIM was increasing, partly because other specialties were opting out. The increased commitment to acute-GIM compromised specialist diabetes activity through reduced consultant and training-grade time for outpatient activity and service development. The shift to primary care of chronic disease led to further conflict between acute-GIM and delivery of a specialist service, given the current systems for provision of consultant-led care. The large number of specialist trainees in diabetes and endocrinology will require innovative commissioning mechanisms that reflect the need to sustain and develop specialist diabetes and endocrine care in the appropriate settings as well as the continued input in acute trusts for acute-GIM.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::1c81a765664bf91c16bfbef3afb9fbd6 https://doi.org/10.7861/clinmedicine.8-4-377 Zobrazit plný text záznamu