Table 1.
Quotes on coherence and cognitive participation
| Coherence | Cognitive participation |
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Staff enthusiasm and concerns It all sounded quite exciting and I was quite, not excited, but it was like, this is really good, the first one in the UK and, you know, this will be excellent, so I was quite open minded about it… lowering the use of antibiotics and fewer invasive procedures for women. (Nurse 17, T3) It’s an exciting opportunity, um, but also there’s a bit of, um, er, you know, nerves I suppose about how it will actually be, actually run from day one, really, and how it would go (Public Health 14, T2) |
Disengaged staff It was very much the higher-up staff that kind of organised it all and they’re not really the ones that are going to be doing the actual work, so I think it’s really important to include clinical staff of all levels, kind of when it’s getting near to it and you know, really explain, and have their opinions and thoughts on, you know, how it’s gonna work (Nurse 16, T2) |
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Reduced patient anxiety Results on the same day would be amazing, yeah, no doubt about that yeah, because there’s always quite an—well, for me, it’s like an anxious wait otherwise. Yeah, that sense of not knowing and actually “how do I manage my sex life in case anything comes back positive?” Yeah, quick results can definitely make a big difference (Mike, didn’t use rapid STI service) The thing that would encourage me to test more regularly, [is] if the whole thing [time spent in clinic] could be done in a shorter time slot for me (Ben, used rapid STI service) |
Barriers to engagement (Clinic managers need to] canvass people’s feelings about it because I don’t know that we do that very well. I think we just crack on. We don’t say 'how was it for you that first week did you cope? Did you keep your head above water?' (Nurse 10, T1) |
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Avoiding inappropriate antibiotics prescriptions With antibiotics I’m really—they really mess with my stomach. I really feel really sick whenever I do take them. So, I’m just pro not taking them for that reason alone. Yeah, like—I try to think about the bigger picture of the world and stuff…but I think about my own stomach more than the wider world. So, yeah, I’d—I’m always pleased to like not have to do any unnecessary drugs (Andy, results by text) I just think I’d hate to kind of like take something that I didn’t have and then if I ever got it again it doesn’t work—so it’s kind of like half society view half personal view (Harry, follow-up appointment) |
Inadequate preparation We were told on the Wednesday that it was supposed to be starting on the Monday and we were like all a bit shocked thinking ‘well hang on a minute what about the training? We’ll look really, really stupid in front of patients’ (Administrative staff 6, T1) There was always talk about what it [Panther] could do, never talk about how it’s going to function. Even at the last minute, the week before it was meant to start [Lead Consultant] came to me and goes, ‘This is what I think the pathway is. Can you make notes on it?’ Nobody was really clear about what happened. [Project manager] had sent a PowerPoint around and it was embedded in a way that… some staff who aren’t maybe familiar with how embedded links and things work(- couldn’t open it). When the meeting came around, they said, ‘Has everyone read the email about the Pathways?’ half of the people went, ‘What email?’ …, it just wasn’t presented to us in a clearest way. (Health Adviser 1, T2) |