Evaluating community health services: conflict and controversy

Authors

  • Pam Dawson (MCSP),

    Corresponding author
    1. Division of Physiotherapy and Applied Life Sciences, Faculty of Health, Social Work and Education, University of Northumbria at Newcastle
      Pam Dawson Senior Lecturer Division of Physiotherapy and Applied Life Sciences Faculty of Health, Social Work and Education University of Northumbria at Newcastle Coach Lane Campus Newcastle upon Tyne NE7 7XA UK
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      PD was formerly Superintendent Physiotherapist at Newcastle Domiciliary Physiotherapy Service, Newcastle upon Tyne City Health Trust.

  • Bob Heyman (PhD)

    1. Division of Behavioural and Contextual Studies, Faculty of Health, Social Work and Education, University of Northumbria at Newcastle
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Pam Dawson Senior Lecturer Division of Physiotherapy and Applied Life Sciences Faculty of Health, Social Work and Education University of Northumbria at Newcastle Coach Lane Campus Newcastle upon Tyne NE7 7XA UK

Abstract

The best way to evaluate community health services remains the subject of much argument and debate. This paper explores difficulties encountered in the management of a randomized controlled trial of physiotherapy in a primary health care setting, and discusses conflicts which arose when carrying out a time limited commissioned evaluation of a carer support scheme. Although randomized controlled trials are still regarded as the gold standard in medical research, they can be difficult to coordinate, and often cannot be applied when patient problems are chronic or incurable and require multidisciplinary intervention. There are many cultural and organizational barriers that have to be overcome for evaluation to be successful and meaningful. If these barriers are underestimated or ignored, the quality of evaluation is compromised.

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