Stakeholder views of podiatry services in the UK for people living with arthritis: a qualitative study.

Publisher: BioMed Central Country of Publication: England NLM ID: 101471610 Publication Model: Electronic Cited Medium: Internet ISSN: 1757-1146 (Electronic) Linking ISSN: 17571146 NLM ISO Abbreviation: J Foot Ankle Res Subsets: MEDLINE

Original Publication: London : BioMed Central, 2008-

Podiatry*; Arthritis/*therapy ; Foot Diseases/*therapy ; Patient Acceptance of Health Care/*psychology ; Stakeholder Participation/*psychology; Adult ; Arthritis/complications ; Arthritis/psychology ; Female ; Focus Groups ; Foot Diseases/etiology ; Foot Diseases/psychology ; Health Knowledge, Attitudes, Practice ; Health Services Accessibility ; Health Services Needs and Demand ; Humans ; Male ; Middle Aged ; Qualitative Research ; Referral and Consultation ; State Medicine ; United Kingdom ; Young Adult

Background: The aim of this study was to explore the views of stakeholders in podiatry services, patients, commissioners and general practitioners (GP), to further understand experiences of referral, access and provision of treatment in the National Health Service (NHS) for foot problems for patients living with arthritis.
Method: To explore in-depth individual views and experiences of stakeholders in podiatry services, 19 patients who had arthritis (osteoarthritis and/or rheumatoid arthritis) participated in one of four focus groups. In addition, seven commissioners and/or GPs took part in semi structured interviews. A purposive sampling strategy was adopted for all focus groups and semi structured interviews. To account for geographical variations, the focus groups and semi structured interviews were conducted across two predetermined regions of the United Kingdom (UK), Yorkshire and Hampshire. Data was rendered anonymous and transcribed verbatim. Thematic analysis was employed to identify key meanings and report patterns within the data.
Results: Five key themes derived from the focus groups and interviews suggest a variety of factors influencing referral, access and provision of treatment for foot problems within the UK. 1. Systems working together (navigation of different care pathways, access and referral opportunities for people with OA or RA, education around foot health services for people with OA or RA); 2.Finance (financial variations, different care systems, wasting resources); 3. Understanding what podiatry services have to offer (podiatrists are leaders in foot health services, service requirements in relation to training standards and health needs); 4. Person factors of foot pain (arthritis is invisible, affects quality of life, physical and mental wellbeing); 5. Facilitators of foot care (NICE guidelines, stakeholder events, supporting self-management strategies).
Conclusion: The findings indicate that patients, commissioners and GPs have very similar experiences of referral, access and provision of treatment for foot problems, for patients living with arthritis. Essentially, commissioners and GPs interviewed called for a transformational approach in current systems to include newer models of care that meet the footcare needs of individual patient circumstances. Patients interviewed called for better signposting and information about the different services available to help them manage their foot health needs. To address this, we have formulated a signposting pack for all stakeholders to help them facilitate access to appropriate clinicians 'at the right time, in the right place' to manage foot health problems.

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CDF-2015-08-032 United Kingdom DH_ Department of Health; CDF-2015-08-032 National Institute for Health Research

Keywords: Arthritis; Foot health; Footcare; Independence; Mobility; Pain management; Podiatry; Service provision

Date Created: 20200925 Date Completed: 20210727 Latest Revision: 20211006

20221213

PMC7517686

10.1186/s13047-020-00427-7

32972443