Developing recommendations to improve the quality of diabetes care in Ireland: a policy analysis.

Hdl Handle:
http://hdl.handle.net/10147/331824
Title:
Developing recommendations to improve the quality of diabetes care in Ireland: a policy analysis.
Authors:
Mc Hugh, Sheena M; Perry, Ivan J; Bradley, Colin; Brugha, Ruairí
Affiliation:
Department of Epidemiology & Public Health, 4th Floor, Western Gateway Building, Western Rd,, University College Cork, Cork, Ireland. s.mchugh@ucc.ie.
Citation:
McHugh SM et al. Developing recommendations to improve the quality of diabetes care in Ireland: a policy analysis. Health Res Policy Syst. 2014, 12 (1):53
Publisher:
Health research policy and systems / BioMed Central
Journal:
Health research policy and systems / BioMed Central
Issue Date:
Sep-2014
URI:
http://hdl.handle.net/10147/331824
DOI:
10.1186/1478-4505-12-53
PubMed ID:
25231603
Abstract:
In 2006, the Health Service Executive (HSE) in Ireland established an Expert Advisory Group (EAG) for Diabetes, to act as its main source of operational policy and strategic advice for this chronic condition. The process was heralded as the starting point for the development of formal chronic disease management programmes. Although recommendations were published in 2008, implementation did not proceed as expected. Our aim was to examine the development of recommendations by the EAG as an instrumental case study of the policy formulation process, in the context of a health system undergoing organisational and financial upheaval.; This study uses Kingdon's Multiple Streams Theory to examine the evolution of the EAG recommendations. Semi-structured interviews were conducted with a purposive sample of 15 stakeholders from the advisory group. Interview data were supplemented with documentary analysis of published and unpublished documents. Thematic analysis was guided by the propositions of the Kingdon model.; In the problem stream, the prioritisation of diabetes within the policy arena was a gradual process resulting from an accumulation of evidence, international comparison, and experience. The policy stream was bolstered by group consensus rather than complete agreement on the best way to manage the condition. The EAG assumed the politics stream was also on course to converge with the other streams, as the group was established by the HSE, which had the remit for policy implementation. However, the politics stream did not converge due to waning support from health service management and changes to the organisational structure and financial capacity of the health system. These changes trumped the EAG process and the policy window remained closed, stalling implementation.; Our results reflect the dynamic nature of the policy process and the importance of timing. The results highlight the limits of rational policy making in the face of organisational and fiscal upheaval. Diabetes care is coming on to the agenda again in Ireland under the National Clinical Care Programme. This may represent the opening of a new policy window for diabetes services, the challenge will be maintaining momentum and interest in the absence of dedicated resources.
Item Type:
Article
Language:
en
Description:
In 2006, the Health Service Executive (HSE) in Ireland established an Expert Advisory Group (EAG) for Diabetes, to act as its main source of operational policy and strategic advice for this chronic condition. The process was heralded as the starting point for the development of formal chronic disease management programmes. Although recommendations were published in 2008, implementation did not proceed as expected. Our aim was to examine the development of recommendations by the EAG as an instrumental case study of the policy formulation process, in the context of a health system undergoing organisational and financial upheaval.
Keywords:
DIABETES MELLITUS
ISSN:
1478-4505

Full metadata record

DC FieldValue Language
dc.contributor.authorMc Hugh, Sheena Men_GB
dc.contributor.authorPerry, Ivan Jen_GB
dc.contributor.authorBradley, Colinen_GB
dc.contributor.authorBrugha, Ruairíen_GB
dc.date.accessioned2014-09-24T11:18:22Z-
dc.date.available2014-09-24T11:18:22Z-
dc.date.issued2014-09-
dc.identifier.citationMcHugh SM et al. Developing recommendations to improve the quality of diabetes care in Ireland: a policy analysis. Health Res Policy Syst. 2014, 12 (1):53en_GB
dc.identifier.issn1478-4505-
dc.identifier.pmid25231603-
dc.identifier.doi10.1186/1478-4505-12-53-
dc.identifier.urihttp://hdl.handle.net/10147/331824-
dc.descriptionIn 2006, the Health Service Executive (HSE) in Ireland established an Expert Advisory Group (EAG) for Diabetes, to act as its main source of operational policy and strategic advice for this chronic condition. The process was heralded as the starting point for the development of formal chronic disease management programmes. Although recommendations were published in 2008, implementation did not proceed as expected. Our aim was to examine the development of recommendations by the EAG as an instrumental case study of the policy formulation process, in the context of a health system undergoing organisational and financial upheaval.en_GB
dc.description.abstractIn 2006, the Health Service Executive (HSE) in Ireland established an Expert Advisory Group (EAG) for Diabetes, to act as its main source of operational policy and strategic advice for this chronic condition. The process was heralded as the starting point for the development of formal chronic disease management programmes. Although recommendations were published in 2008, implementation did not proceed as expected. Our aim was to examine the development of recommendations by the EAG as an instrumental case study of the policy formulation process, in the context of a health system undergoing organisational and financial upheaval.-
dc.description.abstractThis study uses Kingdon's Multiple Streams Theory to examine the evolution of the EAG recommendations. Semi-structured interviews were conducted with a purposive sample of 15 stakeholders from the advisory group. Interview data were supplemented with documentary analysis of published and unpublished documents. Thematic analysis was guided by the propositions of the Kingdon model.-
dc.description.abstractIn the problem stream, the prioritisation of diabetes within the policy arena was a gradual process resulting from an accumulation of evidence, international comparison, and experience. The policy stream was bolstered by group consensus rather than complete agreement on the best way to manage the condition. The EAG assumed the politics stream was also on course to converge with the other streams, as the group was established by the HSE, which had the remit for policy implementation. However, the politics stream did not converge due to waning support from health service management and changes to the organisational structure and financial capacity of the health system. These changes trumped the EAG process and the policy window remained closed, stalling implementation.-
dc.description.abstractOur results reflect the dynamic nature of the policy process and the importance of timing. The results highlight the limits of rational policy making in the face of organisational and fiscal upheaval. Diabetes care is coming on to the agenda again in Ireland under the National Clinical Care Programme. This may represent the opening of a new policy window for diabetes services, the challenge will be maintaining momentum and interest in the absence of dedicated resources.-
dc.languageENG-
dc.language.isoenen
dc.publisherHealth research policy and systems / BioMed Centralen_GB
dc.rightsArchived with thanks to Health research policy and systems / BioMed Centralen_GB
dc.subjectDIABETES MELLITUSen_GB
dc.titleDeveloping recommendations to improve the quality of diabetes care in Ireland: a policy analysis.en_GB
dc.typeArticleen
dc.contributor.departmentDepartment of Epidemiology & Public Health, 4th Floor, Western Gateway Building, Western Rd,, University College Cork, Cork, Ireland. s.mchugh@ucc.ie.en_GB
dc.identifier.journalHealth research policy and systems / BioMed Centralen_GB

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