Table 3

Ideal & Real Models of Care in relation to Darzi's (2008)18 three elements of good quality care

  • “Actually they're going to be safe in our hands and … the care they're going to receive is good.” (Senior nurse, Centre D)

  • “That's my patient, their safety comes first.” (Specialist nurse, Centre B)

  • “Being able to provide a service with skilled clinicians … the knowledge to be able to treat a patient safely … as an emergency service you can't ask for any more.” (Manager ambulance service, Centre C)

  • “I think when you want to get patients to theatre ... it's full ... sometimes you see a little bit of harm come to patients because they don't get to theatre in time.” (Junior doctor, Centre D)

  • “So whether or not the continual monitoring gets done is a different matter... without continual monitoring you can't say that they're going to remain fine.” (Junior nurse, Centre C)

  • “We get a phone call maybe for some pain medication … somebody's got a major life event and we don't know about it (lack of communication) ... so there are safety issues there about prescribing medication.” (GP, Centre D)

  • “Getting the patients treated at the right time with the right services ... getting them treated early picking up the people that need additional services especially psychology getting them in there quickly to … prevent future disability.” (Occupational therapist, Centre B)

  • “My role is to ensure that the patient's care pathway is efficient, timely and they have a satisfaction in the service.” (Junior nurse, Centre A)

  • “We have so many ankle fractures sitting around on the ward for a week before the operation… if you operated on them straightaway … they would be done and out the next day.” (Junior doctor, Centre D)

  • “It's a high pressure job … you don't feel like you can give high quality care … that individual's satisfaction of what you consider high quality care isn't always … what the department offers.” (Senior Nurse, Centre D)

  • “I would say…for the patients who need psychological support that's one of the main things that's lacking …in every hospital … there's no access to it for patients.” (Physiotherapist, Centre A)

Patient experience
  • “Enough information about their condition to help them not to be scared of it … they need to understand the reasons why we have asked them to do what they are doing … to understand what they are feeling and experiencing.” (Senior physiotherapist, Centre D)

  • “I suppose it's easier just getting your head down and doing the tasks ... during busy times especially just knowing that you've done this, this and this, ….It's almost like once you've done the task, then it becomes somebody else can care about the kind of emotional side of it.” (Junior nurse, Centre C)