Examining the impact of a novel integrated care pathway for faecal incontinence on patients and within a National Health Service organisation

Rimmer, Craig John (2019). Examining the impact of a novel integrated care pathway for faecal incontinence on patients and within a National Health Service organisation. University of Birmingham. M.D.

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Faecal incontinence (FI) is a common healthcare problem. The management of FI patients is widely reported as being disjointed. In response to this and governmental guidance, an integrated care pathway (ICP) was implemented at a local NHS trust.


To assess how the implementation of a community-based ICP affects the key stakeholders and to observe the process of organisational change within the trust using normalization process theory (NPT).


Mixed methodology combining semi-structured interviews of key stakeholders, narrative interviews with patients, focus group discussion, observational work and clinical quantitative data. Qualitative data was analysed using thematic analysis and the Framework Method, with NPT being used to structure the qualitative findings.


Key facilitators to the implementation of the ICP included clinical leadership, staff commitment, teamwork, adequate clinical capacity and good clinical outcomes.

There was a delay in the implementation due to lack of organisational management input and key stakeholder time

From a patient perspective, benefits were identified such as improved access to the service and symptom improvement.


An ICP for FI could provide an answer to the long-standing issues that have blighted continence services. Patients report satisfaction based on improved access to the service alongside good clinical outcomes.

Type of Work: Thesis (Doctorates > M.D.)
Award Type: Doctorates > M.D.
Lavis, Annaa.lavis@bham.ac.ukUNSPECIFIED
Licence: All rights reserved
College/Faculty: Colleges (2008 onwards) > College of Medical & Dental Sciences
School or Department: School of Health and Population Sciences
Funders: National Institute for Health Research
Subjects: H Social Sciences > HV Social pathology. Social and public welfare
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RD Surgery
URI: http://etheses.bham.ac.uk/id/eprint/9241


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