Infrastructure influences (COM-B: physical opportunity, social opportunity, automatic motivation)
SECONDARY, RECRUITMENT
As well as the broad environmental challenges and opportunities outlined, participants also referred to organisational practices that impacted on opportunities to accrue patients. Differences between organisations and institutions could create difficulties during the conduct of pre-hospital trials, namely in relation to the allocation of recruitment accruals, and associated financial reward provided through clinical research networks. For example, patients may have been recruited through an ambulance service but the accrual recognition (and any associated resource reward) would be awarded to the secondary care hospital which they were transported to.… some of the big pre-hospital trials, all of the credit went to the hospitals that took patients afterwards, even though all the work was done in pre-hospital care, and that’s still an ongoing problem… Pre-hospital trial researcher 1.Furthermore, the fact that Air Ambulances are independent charities rather than NHS organisations was also described as creating barriers to the set-up and conduct of pre-hospital trials. Air ambulances were described as having different priorities towards pre-hospital research, motivated largely by future funding to deliver innovative care.… if you’re considering any trial involving air ambulances, you have to be so, so cognisant of in all of your negotiations that they are not NHS organisations, they are … independent charities whose sole job is to raise money to allow the pre-hospital teams to provide an enhanced level of care … Pre-hospital trial researcher 2.