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Table 9 Illustrative data extracts from theme E2: Efficiency versus long waiting times—‘On the case straight away’

From: “Is this the GVHD?” A qualitative exploration of quality of life issues in individuals with graft-versus-host disease following allogeneic stem cell transplant and their experiences of a specialist multidisciplinary bone marrow transplant service

Rapid care Every time I have been, and they’ve discovered I’ve got graft versus host somewhere else, or whatever, or even from the first time when I went with my tendon, they’ve been on it very quickly…I can call them, I can send in photos of bits of me that I think are affected, and they're on the case straight away.”—P1
  “I've had regular outpatients follow-up and very attentive care from the consultants and their colleagues. They're always very keen and helpful in terms of prescriptions that they're… have prompted, you know, my need for things and pre-empted my need for prescriptions.”—P3
Efficient clinics “The bone marrow transplant clinics in the… at the Churchill… I tend to go and get seen quite quickly.”—P1
  “I've been impressed basically in terms of, you know, efficiency… it all seems to be, you know, well organised, efficient, or reasonably efficient when I go, you know, you're never seen exactly on time but, you know, you do get seen… people do spend time with you, you know, the nurses are very helpful, you know, always willing to, you know, answer your questions, respond, help where they can. Yeh, and it seems to… well, from my point of view it seems to work quite well; very well, not just quite well; very well.”—P2
Dermatologist available “I think that the [hospital] has been good in terms of having, you know, a dermatologist on the team.”—P2
  “The once that I asked to see a dermatologist I was able to see her that same day, so that was reassuring.”—P3
  “I've seen a dermatologist here who was able to treat me there because I got it in my scalp; on my scalp as well, so she was able to prescribe lotions for that, rather than, you know, like the Eumovate and things like that, and also recommend shampoos that were a good source, sort of keep them down and things like that. And she was excellent.”—P5
Lack of efficiency “I think the only thing I would have said is that, that maybe … maybe at that stage where I did contact the triage, maybe could have… we were proactive; we did a blood test, but I didn’t feel that the follow-up was that proactive, it was just a case of well, come to clinic, they didn’t… they had the results already; they knew there was something wrong with the liver enzyme rising, but it wasn’t something they wanted to action straight away.”—P6
  “And we're usually out of those, pending on how long the queue is for blood tests, and then if I have to get any medications from the little pharmacy ‘cos that can be a long wait as well sometimes. I would say on average about two and a half/three hours altogether.”—P1
  You know, the pharmacy always takes… seems to take forever.”—P2
  “It's all around the things like IT, you know, like there doesn’t seem to be any system for recording, you know, what drugs you're on, and you know, therefore, you know, when I want a repeat of drugs, you know, I have to… you know, we have to have a discussion and it’s hard to find, you know, certain ones on the system because like I’m having liquid Cyclosporine cos I can use… so, I have it as a mouthwash as well, so that’s unusual, you know, and that’s… you know, always causes a bit of a… problem both for the prescriber and the pharmacy. So, it’s sort of, you know, little niggly things like that that are the issues.”—P2
  Got to wait quite a long time, and then even after seeing the doctor got to wait for pharmacy and things like that. So, it’s the clinic appointment time, it's late, like at twelve or something. It's really waste XXX all day because it's the middle of the part of the day is in the hospital, so it’s really you can't do anything on that day. So, that was a bit difficult, but if the appointment is early morning then well, sort of just after lunchtime it might finish. In that case afternoon we can do whatever we want.”—P7