Attempting to couple the problem and policy streams
Participants referred to a number of strategies used to increase the chance that proposals would be accepted and implemented by the HSE. In the first instance, the EAG was cognisant of the need to align proposals with national policy and “not (to) wander off message.” Sec- ondly, the group tried to contextualize proposals and fit with the future direction of the HSE, seizing opportun- ities to address individual aspects of their overall plan. For example, early in the process the group was asked to prepare submissions to put forward to the HSE to in- form its budget allocation process. The group prioritised community diabetes nurse specialist positions to act as a link with primary and secondary care services. Accor- ding to one interviewee, the group agreed “that if there was one thing we could get to happen it would be com- munity diabetes nurses and my recollection of the sub- mission was prioritizing that link to primary care teams and primary care networks...that was clearly the direction of travel at the HSE at that time.” Finally, the group recommended the establishment of regional Diabetes Ser- vices Implementation Groups, as proposed in previous reports [32,34], to increase the feasibility of implementing the recommendations at local level. This proposal, which had limited cost implications, is now directly linked into the national Clinical Care Programme for Diabetes. It was described by one interviewee as one of “the biggest outputs of the EAG”.
Attempting to couple the problem and policy streamsParticipants referred to a number of strategies used to increase the chance that proposals would be accepted and implemented by the HSE. In the first instance, the EAG was cognisant of the need to align proposals with national policy and “not (to) wander off message.” Sec- ondly, the group tried to contextualize proposals and fit with the future direction of the HSE, seizing opportun- ities to address individual aspects of their overall plan. For example, early in the process the group was asked to prepare submissions to put forward to the HSE to in- form its budget allocation process. The group prioritised community diabetes nurse specialist positions to act as a link with primary and secondary care services. Accor- ding to one interviewee, the group agreed “that if there was one thing we could get to happen it would be com- munity diabetes nurses and my recollection of the sub- mission was prioritizing that link to primary care teams and primary care networks...that was clearly the direction of travel at the HSE at that time.” Finally, the group recommended the establishment of regional Diabetes Ser- vices Implementation Groups, as proposed in previous reports [32,34], to increase the feasibility of implementing the recommendations at local level. This proposal, which had limited cost implications, is now directly linked into the national Clinical Care Programme for Diabetes. It was described by one interviewee as one of “the biggest outputs of the EAG”.
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