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Secondary and tertiary care is provided by obstetric nurses, secondary care (hospital) midwives, residents and obstetricians, working together in teams.
Data on inputs were available on staffing numbers by type (doctors, secondary nurses, primary nurses, secondary midwives, primary midwives and other staff) and the non-staffing recurrent expenditure (Table 3).
Using a qualitative design, GPs, nurses, secondary care doctors, nurse specialists, physiotherapists, a healthcare manager and patients with respiratory disease took part in focus groups and in-depth interviews.
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A multi-disciplinary team was involved in the design of the system and the implementation of the project: this included primary care physicians, respiratory nurses, a secondary care respiratory physician, a psychiatrist, and engineers.
Patients were recruited via general practitioner (GP) practices (sampled for a range of practice level social deprivation scores and rurality) specialist nurses and secondary care-based services, including two teaching hospitals, across three study sites.
Preschool children with a history of wheezing were recruited by a small team of children's research nurses and secondary care paediatricians following hospital attendance for wheeze or after receiving information from their primary care physician.
Referrals to primary (i.e. social workers, primary care psychologists, social psychiatric nurses) and secondary mental health care (i.e. psychiatrists, psychotherapists, ambulatory mental health care organisations, and organisations for addiction treatment) were included in this study.
However, carers of patients being discharged early may feel less burdened in anticipation of surgery and our model of care also enhanced communication and teamwork between nurses in secondary and primary care.
24 It is therefore possible that similar effects might be achievable if therapy were to be delivered by GI nurses within secondary care utilising a lower intensity, guided self-help treatment approach which could be less time consuming to deliver and further increase access to evidence-based interventions for patients.
The focus of this clinical workspace is on the patient – and the procedure to be undertaken - the nurse is secondary.
The audit as well as Royal College of Paediatrician and Child Health guidance [ 18] supported development of a nurse-led secondary care service for children referred by their GP with constipation.
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