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Influence of commissioning arrangements on implementing and sustaining a complex healthcare intervention (ESCAPE-pain) for osteoarthritis: a qualitative case study by Andrew Walker; Annette Boaz; Michael V. Hurley is a Medicine article available to read on EtoBox.

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## Objectives: Funding in health care has a critical impact on the implementation and sustainability of evidence-based interventions. this study explored the perspectives of physiotherapists on the influence of commissioning arrangements on the implementation and sustainability of a group rehabilitation programme for osteoarthritis (escape-pain). ## Design: A qualitative case study approach using in-depth interviews. ## Setting: National health service (nhs) musculoskeletal (msk) outpatient departments in england. ## Participants: Thirty physiotherapists in clinical and senior management roles from 11 nhs msk providers. ## Results: Five themes were identified: (1) clinical perspectives of escape-pain - msk services wanted to implement and sustain escape-pain because it provided evidence-based, quality care; (2) focusing on clinical activity over outcomes - commissioners were perceived as prioritising activity-based performance over delivering clinical outcomes; (3) rationing availability - patient access to escape-pain could be limited due to rationing resources; (4) absorbing costs - contracts did not always cover the activities associated with delivering escape-pain meaning that

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Author

Andrew Walker; Annette Boaz; Michael V. Hurley

Publisher

Elsevier BV

Published

2021

Language

EN

Field

Medicine (Health Sciences)