ArticleBMJ open2020
Integrating care between an NHS hospital, a community provider and the role of commissioning: the experience of developing an integrated respiratory service.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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.
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Who cites it
2 citing papers in PubMed.
- Integrated care for chronic respiratory disease: a narrative review.European respiratory review : an official journal of the European Respiratory Society · 2026Review
- Mediators implementation and delivery: the falls management exercise programme (FaME).BMC health services research · 2025Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
objectivesAn integrated respiratory service was commissioned in 2016 in a UK region to support patients with chronic obstructive pulmonary disease. The service brought together the respiratory department of a National Health Service hospital and a not-for-profit community provider. This paper evaluates: (1) the perceived efficacy of integrated working between the organisations from the perspective of staff and (2) the relationship between commissioning and integration of the services.
designSemistructured interviews with staff from the three organisations involved in the integrated respiratory service. Staff were purposefully sampled. The interviews were audio recorded, transcribed and analysed thematically.
settingSecondary care respiratory unit; community provider of respiratory care; and a clinical commissioning group.
participantsNineteen interview participants: nine from the community provider; eight from the hospital and two from the clinical commissioning group.
resultsStaff identified lack of integration between the organisations characterised by: poor communication, lack of trust, absence of shared information technology and ineffective integrative initiatives. The commissioning process created barriers to integration including: contractual limitations which prevented pathway development, absence of agreed clinical governance arrangements and lack of recognition of community work undertaken by hospital staff. Positive working relationships were established over time as staff recognised the skills that each had to offer.
conclusionsThe commissioning process underpinned the relationship between the organisations and contributed to distrust and negative perceptions of the 'other'. Commissioning an integrated service should incorporate dialogue with stakeholders as early as possible and before the contract is finalised to develop a bedrock of trust.
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Registered trials
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