Table 8 Main facilitators in all hospitals
Commissioner’s target and financial penalty scheme |
“You know and it’s always a cost issue isn’t it? No matter what, patient care is cost, that’s what it is isn’t it? And that, I think that’s wrong.” Nurse, hospital 3, February 2012 |
“I'm slightly wary of targets, that to achieve a target we could be pushing it to people who aren't happy with it.” Consultant, hospital 1, November 2011 |
Funding for additional specialist staff and dialysis machines |
“But also the commissioners, by having a bit of a stick as well as a carrot for us to achieve higher home therapy rates, [it] has been very helpful in our negotiations with our Trust [hospital] to say “look, we’ll lose this amount of money if we don’t invest to achieve it”.” Clinical lead, hospital 4, March 2012 |
Clinical leadership and wider staff support |
“I think we’re fortunate to have staff who want to do this ..... it’s been driven by enthusiastic staff wanting to provide, you know, better care for their patients.” Centre clinical lead, medicine, hospital 4, April 2012 “I’m liking the way now it’s [home dialysis] coming back in to the fore again. Because I think it is so much better for the patients than having to get on transport, taken all round the area before they come here and then waiting for transport again.” Haemodialysis unit nurse manager, hospital 2, October 2011 |
Training and support systems for home dialysis patients |
“….they’ll say some patients need 3 days [training], some patients need 7, some people need 2 weeks. So we go as quick as what you need to go. So its quite good really.” PD Patient, (9) hospital 1, November 2011 |