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Clinical nurse specialists in palliative care (2): explaining diversity in the organisation and costs of Macmillan nursing services.

Research output: Contribution to Journal/MagazineJournal articlepeer-review

<mark>Journal publication date</mark>07/2002
<mark>Journal</mark>Palliative Medicine
Issue number5
Number of pages11
Pages (from-to)375-385
Publication StatusPublished
<mark>Original language</mark>English


In the UK, the work of Macmillan clinical nurse specialists in palliative care is now well established. There has been little research, however, into the organizational context in which these nurses operate and the implications for the services they deliver. We report on a major evaluation of the service delivery, costs, and outcomes of Macmillan nursing services in hospital and community settings. The study was based on eight weeks of fieldwork in each of 12 selected services. Data are presented from semi-structured interviews, clinical records, and cost analysis. We demonstrate wide variation across several dimensions: location and context of the services; activity levels; management patterns; work organization and content; links with other colleagues; and resource use. We suggest that such variation is likely to indicate the existence of both excellent practice and suboptimal practice. In particular, our study highlights problems in how teamwork is conceptualized and delivered. We draw on recent organizational theories to make sense of the heterogeneous nature of Macmillan nursing services.

Bibliographic note

This is one of a series of publications resulting from a major study commissioned by Macmillan Cancer Support. RAE_import_type : Journal article RAE_uoa_type : Social Work and Social Policy & Administration