Table 5 Summary of planning and embedding phase contextual facilitators and barriers

Facilitators

Organisational form, size and culture

…it’s also a smaller organisation, so … relationships with people are easier to form… that those that are employed with the PHN are passionate about primary health care… so that makes a real difference in terms of the culture. SITE LEAD

Relevance to organisational function

You know, obviously people in health planning and, you know, other teams, probably that’s a very direct correlation between what the embedded Economist does, and their work. PHN PARTICIPANT 1

Acknowledgment of the need to upskill in economic evaluation

…it's a clear gap in our skillset, and we need to be in a position to improve our decision-making particularly around economic factors. PHN PARTICIPANT 2

Highly motivated staff

The staff are really keen to extend their own knowledge and they see this as a great opportunity SITE LEAD

Stage of organisational evolution

I think to some extent we’ve been in a very rigorous establishment process as the PHN for a few years now, attempting to commission services and support, improvement in a range of services [but] we haven’t necessarily had the capacity and capability to demonstrate our impact sufficiently. …it’s part of our evolution and maturity. PHN PARTICIPANT 4

Modest expectations and an openness to learning

We'd like some clarity around some of our processes and procedures, certainly in the commissioning space… as well as our health planning processes, we're really keen on that… Improving, we want improvement. We're willing to sort of put our hand up and say "We're not doing this very well." …So we want to be able to improve our processes and our evaluation and our commissioning area… So we want the economist to come up with some ways - or at least do some research - around how we can do that, or how we can capitalise on what we're already doing. SITE LEAD

Barriers

Limited staff time

…barriers are around your own priorities and what you’ve got going on at the time …I just wish I’d tapped into it more. I wish I’d had more involvement…but I think that’s just how it’s unfolded PHN PARTICIPANT 10

Geography

I think Newcastle staff have potentially gained more from it because of the, you know, bums on seats approach. That always works that way, that there’s – if there’s somebody in passing who you’re having a chat to in the kitchen, who might say what are you doing this week, and have those sorts of even unplanned interactions.

PHN PARTICIPANT 9