Our study design was explorative and the findings are not generaliseable to all contexts and settings. However, our work highlights issues likely to be relevant to many, particularly those with a similarly high proportion of rurally situated patients with low socioeconomic status; and is supported by findings that ambulatory or community-based care is feasible and effective. Analysis of participant accounts is interpretative and involves the “positioned” researcher [29]. Reflexivity about the influence of the researcher on shaping the data was ensured through awareness of potential researcher biases and analysing verbatim transcriptions word-for-word to avoid interpretation of meaning by the researcher. Coding and emergent themes were also checked by a second researcher to minimise potential bias. The principal investigator is a young white British female; the power dynamic of researcher and participant has been acknowledged throughout data collection and analysis and has been minimised by the fact that the principal investigator had no responsibility for programme management or patient care and was an outsider to routine programme activities.