Ingram Simon, Gill Jonathon, Stathers Isadora, Jenkins Samantha, Neville Eleanor, Berry Alice
Physiotherapy Department, Somerset NHS Foundation Trust, Taunton, UK.
School of Health and Social Wellbeing, University of the West of England, Bristol, UK.
Musculoskeletal Care. 2025 Sep;23(3):e70152. doi: 10.1002/msc.70152.
Musculoskeletal (MSK) conditions represent an increasing challenge within the NHS. Rising demand has driven a national shift towards more community-based care and supported self-management. Community Appointment Days (CAD) are community-based, full-day events providing access to clinical expertise, community partners and voluntary sector services. The collaborative ethos facilitates a personalised and holistic approach to musculoskeletal health. This evaluation aimed to explore the acceptability of the CAD model.
Following a CAD in the Southwest of England, patient experience was collected using the Friends and Family test and CollaboRATE measure for level of shared decision-making. Interviews were conducted with patients, and a focus group was held with staff. The Theoretical Framework of Acceptability (TFA) informed the interview and focus group guides, and data analysis. Thematic analysis employed a hybrid deductive/inductive approach.
The CAD was attended by 130/160 (81%) patients. Experience measures were completed by 97/130 (75%) patients. The Friends and Family test demonstrated that most patients were 'extremely likely' (n = 63, 65%) or 'likely' (n = 32, 33%) to recommend a CAD. The average CollaboRATE score was 10.8/12. One-to-one interviews were completed with 13 patients, and a focus group with 10 staff. Four themes were identified: (1) a positive response to the CAD ethos; (2) the importance of effective planning and communication; (3) effective implementation of the CAD; and (4) potential impact and integration with existing musculoskeletal pathways.
The CAD was perceived as an acceptable, personalised, and holistic model of care that supports self-management and cross-sector collaboration for supporting MSK health.
肌肉骨骼疾病在英国国民医疗服务体系(NHS)中构成了日益严峻的挑战。需求的不断增加推动了全国范围内向更多基于社区的护理和支持自我管理的转变。社区预约日(CAD)是基于社区的全天活动,提供临床专业知识、社区合作伙伴和志愿部门服务。协作精神促进了针对肌肉骨骼健康的个性化和整体方法。本评估旨在探讨CAD模式的可接受性。
在英格兰西南部进行一次CAD后,使用朋友和家人测试以及协作率测量法收集患者体验,以评估共同决策水平。对患者进行了访谈,并与工作人员举行了焦点小组讨论。可接受性理论框架(TFA)为访谈和焦点小组指南以及数据分析提供了指导。主题分析采用了混合演绎/归纳方法。
160名患者中有130名(81%)参加了CAD。130名患者中的97名(75%)完成了体验测量。朋友和家人测试表明,大多数患者“极有可能”(n = 63,65%)或“有可能”(n = 32,33%)推荐CAD。协作率平均得分为10.8/12。对13名患者进行了一对一访谈,对10名工作人员进行了焦点小组讨论。确定了四个主题:(1)对CAD精神的积极回应;(2)有效规划和沟通的重要性;(3)CAD的有效实施;(4)对现有肌肉骨骼疾病诊疗路径的潜在影响和整合。
CAD被视为一种可接受的、个性化的和整体的护理模式,支持自我管理和跨部门协作以促进肌肉骨骼健康。