Providing XXXX services to remote and rural areas: consensus study.

@entity5 @entity1
There is controversy about how @entity5 care should be provided to @entity1 in remote and rural areas. The aim of this project was to measure consensus among health professionals who treat rural @entity1 with @entity5 about priorities for @entity5 care. A modified Delphi process was used. Of 78 health professionals in Grampian, 62 responded (79%). Of 49 items suggested, there was agreement on 26 (53%), encompassing fast access to diagnosis, high-quality specialist treatment, and well-coordinated delivery of care with good and fast communication and effective team working between all health professionals involved. Specialist oncology nurses in local hospitals were considered a priority along with good facilities, accommodation, and transport for @entity1 . There was no agreement on the best location for chemotherapy (local or central). The only large difference of opinion between @entity1 based in primary and secondary care concerned chemotherapy provision at local community hospitals (primary care was in favour, hospital practitioners against, P_<0.001). In making their decisions, @entity1 took problems of access into account, but were also concerned with quality of care and feasibility in the current health service. Our findings show that more evidence is needed regarding the balance of risks and benefits of local chemotherapy provision. Overall, however, there is agreement on many principles for @entity5 care that could be translated into practice.
