Table 3 Summarising themes from qualitative analysis
Sense making | Theme | Description |
ITP valued by health care professionals | Meeting needs of the individual part of professional identity | |
ITP valuable to NHS | Professionals recognised the value of ITP to the NHS | |
Clarity on ITP | Prioritising the patient/person as the essence of ITP | |
Value of ITP not shared | Organisation values and processes don’t support ITP; some patients don’t understand value of ITP | |
Engagement | Theme | Description |
Leadership (individual and collective) | Key individual leaders, and collective engagement with ITP | |
Levels of engagement | Variable levels of engagement, with desire for more | |
Patient engagement | Mobilisation of patient engagement through the media | |
Barriers to engagement | Included workload, fragmentation of services, fear, patient resistance | |
Action | Theme | Description |
Formal training | In generalist practice; within specialist | |
Experiential learning – phronesis | Learning from experience, including working with patients and colleagues | |
Collective action | Value of peer discussion | |
Other supports for action | Including the media | |
Partial action | Easier to tailor stopping medicines than starting them | |
Barriers | Governance (fear), time, ‘head space’ and practical support | |
Monitoring | Theme | Description |
Mixed feedback | Both supportive and negative feedback on ITP | |
Challenge of feeding back | Hard to quantify benefit | |
Challenging the status quo | Hard to ‘go against’ the guideline | |
Potential power of feedback | Should be a Key Performance Indicator |