The introduction of new interventional procedures in the British National Health Service : A qualitative study

Abstract

Objectives: To investigate how interventional procedures (IPs) are introduced into the British National Health Services and identify areas for improvement in the current process. Methods: Qualitative study using one to one semi-structured interviews. Using the framework approach, the data generated from 14 participants were analysed with coding of emergent themes. Data were analysed separately for providers and commissioner organisations. Results: Variations were observed in how IPs are introduced from both the provider and commissioner perspectives. Patterns of approaches allowed the development of models reflecting practice at each type of organisation: very structured in some places to, unstructured or almost non-existent in others. Factors affecting the decision to introduce a procedure include: immediate costs and benefits, numbers of people affected, training requirements, NICE guidance, nature of procedure, support from colleagues, incentives, public or policy-maker pressure, and aims of the institution. Monitoring was seen as a key area for improvement by many. Conclusions: These variations indicate that the process of introducing new IPs in the NHS can be improved. Factors affecting decision-making and problems have been identified. The results of our study could inform and help shape future processes of managing and the introduction of new procedures into the NHS. (C) 2010 Elsevier Ireland Ltd. All rights reserved.