Evidence map›Paper›PMID 31848203›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2020

Ethics education and moral decision-making in clinical commissioning: an interview study.

Selena Knight, Benedict Wj Hayhoe, Lucy Frith, Mark Ashworth, Imran Sajid, Andrew Papanikitas

Abstract read
In one paragraph

Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Books:The British journal of general practice : the journal of the Royal College of General Practitioners · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Selena KnightKing's College London, School of Population Health Sciences, London.
Benedict Wj HayhoeImperial College London, Department of Primary Care and Public Health, London.
Lucy FrithNIHR Research Design Service NW Public Involvement Strategic Lead, University of Liverpool, Department of Health Services Research, Liverpool.
Mark AshworthKing's College London, School of Population Health Sciences, London.
Imran SajidNHS West London Clinical Commissioning Group, London.
Andrew PapanikitasUniversity of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClinical commissioning involves ethically challenging decisions about health resource allocation. However, commissioners come from a range of professional backgrounds with varying levels of training and expertise in ethical decision-making. Hence, they may lack the relevant training and resources to feel fully prepared for this increasingly demanding role.

aimThis study aims to provide insight into how prepared commissioners feel in making ethical decisions; what ethics learning needs they might have; and how these might be addressed. DESIGN AND

settingThis qualitative interview study explored the experiences of commissioners working for clinical commissioning groups (CCGs) in England.

methodEighteen participants were interviewed between December 2017 and July 2018 using a purposive sampling approach to participant selection. Transcriptions were coded and analysed using the constant comparative method of thematic analysis.

resultsMost participants had not received ethics training in preparation for, or during, their commissioning role, and reported difficulties identifying and analysing ethical issues. Participants often felt uncomfortable about decisions they were involved in, attributing this to a number of factors: a sense of moral unease; concerns that CCGs' decision-making processes were not sufficiently transparent; and that CCGs were not fully accountable to the population served.

conclusionCommissioners face complex decisions involving ethical issues, and associated moral unease is exacerbated by a lack of ethics training and lack of confidence in identifying and analysing these. This study shows a clear need for additional support and ethics training for commissioners to support them in this area of decision-making.

Indexed as

Advisory CommitteesBioethical IssuesDecision MakingDecision Making, OrganizationalDelivery of Health CareHumansInterviews as TopicMoralsPrimary Health CareProfessional RolePublic Health AdministrationQualitative ResearchResource Allocationethicshealthcare rationingresource allocation

Identifiers

PMID31848203
PMCPMC6917357

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.