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The lack of well-defined organizational structure for the CEC Mobiliser Programme from community level to the central MoEs or Regional Education Umbrellas level contributed to a certain degree of ambiguity vis-à-vis roles and responsiblities across all levels and negatively impacted on implementation, supervisory and monitoring activities.
40 43 More recently, major organisational change in the NHS in 2013, when PCTs became Clinical Commissioning Groups and responsibility for the programme was transferred to local authorities at a time of reduced budgets, have also been reported to have impacted on implementation.
Hence, from the doctors' perspective, unrealistic parental expectations for cure were considered to be the biggest barrier that impacted on implementation of best-practice guidance.
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Because injury surveillance is optional in community sport, personal factors impacting on implementation of the surveillance system were common.
In this regard, there is no consensus on the most basic issues of CKD management, which negatively impacts on implementation.
However, comments made by participants identified a number of key issues and concerns that may impact on implementation of the recommendations.
This, in turn, was perceived to impact on implementation timelines, as users found it difficult to get used to new software that radically changed the way they were used to working.
In particular, we explored the reasons for the varying opinions around the choice of a screening test, and the broader contextual background to interviewees' opinions, as a way of identifying external factors that might be anticipated to impact on implementation.
Whilst the majority of interviewees did not express concerns about symptoms either being masked or exaggerated, this concern may impact on implementation of a screening programme and therefore was included in the list of master themes.
The paper shows how discoveries made during the project impacted on the implementation of the tutorials while discussing some of the perceived benefits of this approach.
Policy Outcomes : What factors impacted on the implementation of the health reform effort?
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