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Table 2 Quotations illustrating the plurality of ideas about success

From: “Was that a success or not a success?”: a qualitative study of health professionals’ perspectives on support for people with long-term conditions

Quotation

Source

The ideal success is someone you have a good relationship with, who at the same time is well, is ticking all the boxes for excellence in biomedical control, and taking full responsibility, and keeping themselves well and healthy

Philip, General practitioner, northern England

I think if the person feels more in control and happier. I probably should say more that they’re getting better HbA1c and hitting more targets… to get the actual QOF with this being a GP practice. But my initial desire is to make the patient feel better and they’ve got control over things and it’s their condition, they’re managing it.

Pippa, Practice nurse, northern England

Somebody that maybe needs input from me less than they did originally… that would be a success. Success would be somebody that believes, that they can actually feel more confident to manage their diabetes, it’s important in their lives, and they can walk out of there knowing when they need to ring me… And I think from a sort of medical perspective… from a biochemical perspective, has the HbA1c been reduced, have the cholesterol and blood pressure reduced?… Because some people believe they’re doing amazingly well, but maybe they’re not… So I think that will be the three things: less contact; they’re feeling well in themselves (better in themselves), and the biochemical changes.

Shania, nurse specialist, diabetes, London

I - So in terms of what success looks like for your team, how do you tend to evaluate that?

Mixed discussion group, diabetes, London

P - That’s an interesting question. Our commissioners are very focused on HbA1c so they’re very much focused on biomedical outcomes and… because that translates into money… so that tends to be what we’re judged against in the main. But we also obviously would measure things like psychological functioning, social support and psychiatric morbidity as well, and where - we’re currently in the process of doing an evaluation of the service which would include all of those measure and we’re going to just… I guess come up with a quality of life index as well, so we’re working with our health colleagues in doing that. So we’re being forced to look at the biomedical side of things, the service use but our own focus would be to allow people to engage better with their health care that they can be independent, healthy people in the future, who don’t end up in hospital.