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Table 4 Views regarding a specialist nurse model for providing CHD screening in SMI

From: Prevention of coronary heart disease in people with severe mental illnesses: a qualitative study of patient and professionals' preferences for care

  View expressed by *
Perceived advantages CMHT GP SU N
• There would be greater accessibility to screening for patients 5
• It would introduce more flexibility into a system which otherwise only suits certain patient profiles   4
• The nurse would provide specialist cross-disciplinary knowledge in a complex area that few CMHT staff or GPs feel wholly confident in.   4
• This model has worked successfully in other areas e.g. offering HIV testing in a drug dependency unit; a hepatitis nurse attached to a community drug team   3
• A nurse could bridge the existing gaps between primary and secondary care   3
• It would prevent the burden falling on already overworked CMHT workers and allow them to concentrate on their "traditional [mental health] work".   3
• Mobile services are also successful e.g. breast screening, needle exchanges   3
• It would facilitate communication, allow monitoring of the service and improve liaison between different parts of the service. 3
• It would allow a trusting ongoing clinical relationship to be established with the specialist nurse who knows about physical health issues    2
• The nurse could take on additional roles e.g. running interventions, groups, prescribing     1
• Someone needs to take specific responsibility to ensure that screening does happen     1
• One specialist nurse could be employed across whole Primary Care Trusts    1
Perceived disadvantages     
• There might be too much or (in the view of a different participant) too little work for the specialist nurse to provide   7
• It would be an expensive option and thus is unlikely to be prioritised or commissioned – non-attendance rates may be too high to justify the cost 6
• It adds another person into the health service equation and complicates it    2
• It might encourage further dependence on the service by people with SMI, rather than them accessing their GP like everybody else    1
• It may make patients link physical side effects to their antipsychotic medication, encouraging cessation of treatment    1
• It may create suspicion when SMI patients feel "singled out" for a special service    1
  1. * Note: Tick-boxes indicate which group(s) of participants expressed the view: CMHT = staff from community mental health team; GP = staff from general practice; SU = service users. Numbers (N) indicate the prevalence of each view within the total sample.