Table 3.

Analysis process moving from categories to themes

CATEGORIES	CATEGORIES	CATEGORIES
1. Physician considers first line officer incompetent	1. Specialist reachable over phone for advice if personally known	1. Lack of trust in organizational pathways for seeking information for patient care
2. Lack of support system for clinical guidance
3. Lack of access to latest literature/research from the Health Department	2. Focus of departmental meetings on targets and not clinical guidance	2. Personal professional/social network (locally and distant) for patient care
4. Lack of functional referral system
SUBTHEME 1	SUBTHEME 2	SUBTHEME 3
Lack of confidence in available resources	Unpredictable support	Reliance on personal (rather than organizational) resources to safeguard patients’ interests
MAIN THEME
Formal organizational structures, including supervisory support and technical guidelines, not adequate