ABSTRACT
Access to information in medical records provided the advice worker with a multi-dimensional view of patients’ circumstances, allowing the advice worker to triangulate three sources of information. These include: patient input, general practice (GP) perspective and medical histories. Access to such information was a fundamental factor in creating a parity of professionalism between (G) and the advice worker, whose preparation of draft medical statements could only be achieved in this way. This approach reduces the workload of general practitioners, but requires their expert medical knowledge, as they ultimately sign off any supporting evidence before final submission. The practical research challenge is usually to deliver a pre-specified protocol in a particular setting. The contrast in service development work is that the nature of the changes to be made are often unknowable at the outset and only emerge slowly by trial and error as changes are customised to the local setting.
