Table 2.
Barriers | Non-Professional | Professional | ||
---|---|---|---|---|
Patients | Carers | Secondary Care Specialists | General Practitioners | |
Specialist Referral | • Delay in referral from primary care | • Delay in referral from primary care | • Delay in referral from primary care • Quality of referral influences prioritisation |
• Role as gatekeepers to specialist care • Need for positive blood tests • Referral linked to personal confidence and role perception |
Routine follow up and DMARD monitoring | • Lack of time with rheumatologist • Cancellation and postponement of appointments • Perceived lack of knowledge of GPs • Poor primary/secondary care interaction |
• Waiting times in clinic • Transport difficulties • Perceived lack of knowledge of GPs • Poor primary/secondary care interaction |
• Time pressures • Paucity of follow up appointments • Lack of monitoring by GPs |
• Lack of regular review • Lack of clarity of role in monitoring |
Access to care in times of need | • Difficulty of access during a flare | • No specific comments | • Seeing patients urgently impeded by time pressures and paucity of appointments. • GPs not providing emergency care |
• Lack of knowledge of RA treatment • Preference for personal knowledge of rheumatologist to access secondary care urgently |