Theme 4: capacity to allocate resources to care
| Factor | Description | Patients accounts | Healthcare professionals accounts |
| Financial | The ability to free up financial resources | So obviously taking an afternoon off as annual leave or whatever wouldn’t result in a disciplinary, but then in the long-run I have to think…(P5) If you're doing it once a week or something, you're spacing it out… it’s travelling there. That would be—it’s expensive to travel up here because it’s not exactly in the closest of areas, it’s in the middle of nowhere (P7) | They might have a bit more support but again they've then got to think about to do—if they're paying for it privately there’s the added cost to them (C4) When I think about some of these patients that come like 3 hours on public transport—what a waste of money that is. I think of patients that come all the way from Birmingham and Brighton. That doesn't make any sense to me, and actually at times I have said I think we should do this on the phone (C17) |
| Infrastructure | Access to material and informational resources | You could get a stand and you'd be able to see everything really. If you put it on a table, if you need to sit on a chair. You could pull it a bit away from you so they can see you. I reckon definitely it would work (P7) I would either Skype on my laptop or Skype on my thing, and if I could transfer to the TV, you know? I've got a smart TV, it could be done that way. Because if you've got a bigger picture you could see more, you could do more, whereas if you've got a little screen your vision is very limited to a little square (P8) | If you haven't got a laptop and Skype at home, then you're probably not going to be that techy, that tech savvy, and that open to learning how to use a tablet that you've never used before or something, probably (C19) They would need access to the technology… do they have the Internet, do they have a connection, do they have a smart device, do they have a way that they can use that and are they familiar with their platform… a prime example is Skype. iPhone users tend to use FaceTime so do they have a Skype account, are they able to set it up? I think it’s that accessibility, and it’s have they used it before which is a big thing…(PC2) |
| Social capacity | Support available through social network | I have a husband who does lots of stuff for me… I can't do housework because I can't lift an iron anymore (P4) Without that group, I think I would just be in bits right now to be honest.(P14) | This woman, who I was talking about just before, she lived by herself and she hasn't got any carers but the family was helping (C2) More patients are having their family members helping them with these things at home and that visit regularly. There’s no reason why that can't be—if they're turning up to help them put on TED stockings, then I'm sure they can help them turn on a tablet and watch something (C5) |
| Healthcare system | Sources of healthcare capacity | I think it’s emotional support as well. I suppose in my case because I've had so many mental issues attached to my disorder, I have found support here from an orthopaedic point of view. When I had a setback and I was told there was a potential another infection in my bone I went to pieces here, and I saw (anonymised). He was so reassuring… I know I've got security because I feel (anonymised) knows my case so well, and he knows what happened (P10) It’s difficult for me, I can’t use the underground or anything like that so I use the patient transport and they fetch me… some of those appointments have been 10 min or so and I have used the patient transport…(PP2) | But the skill then is to watch your language and rather than tell someone how easy it is, or tell someone the solution, again that’s where motivational interviewing comes in. Rather than saying but you can just pace, let’s work out how you can pace, say something like is there anything that you've been learning that you feel could give some boundaries there or anything you've tried? So again, you're getting the person to solve their own problems (C13) Sometimes the hospital transports are not quite helpful for them. They don't come on time, so they delay sometimes. She ends up missing her appointment because of a delay in the hospital transport (C2) |