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Barriers to Accessing Radiotherapy rupert.suckling@doncasterpct.nhs.uk. 1. Access and Health Care 2. Access and Radiotherapy 3. Barriers to Access 4. From Description to Action. Access and Health Care (Gulliford 2001). Access is about…
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Barriers to Accessing Radiotherapy rupert.suckling@doncasterpct.nhs.uk
1. Access and Health Care 2. Access and Radiotherapy 3. Barriers to Access 4. From Description to Action
Access and Health Care (Gulliford 2001) Access is about… helping people to command appropriate health care resources in order to preserve or improve their health • Availability (supply) • Financial, organisational, social or cultural barriers (acceptability, accessibility) • Relevant and effective (outcomes) • Perspectives
Access and Radiotherapy Tumour group (Williams 2009) Geography and Deprivation (Williams 2009) late presentation Co-morbidity Performance status On site radiotherapy (Gulliford 2003) Distance (Szumacher 2007) Transport (Goddard 2008) patient transport hospital transport Breast cancer (Bickell 2008, Kinkler 2009) age and co morbidities physician factors patient factors (fear, risks, practical, side effects)
Barriers to Access (Bickell 2008) Candidacy describes the ways in which people's eligibility for medical attention and intervention is jointly negotiated between individuals and health services (Dixon Woods)
From Description to Action Reassess the Assumptions –Malthus Define patterns of cancer patients not attending for radiotherapy Assess local barriers and mobilising factors Assess process of clinical decision making Assess public and staff expectations of radiotherapy Assess service responsiveness