A comprehensive service re-evaluation of the UK's first NHS generic fatigue clinic four years following its inception: a mixed methods study

Objective: To identify if the Newcastle CRESTA (Clinics for Research in Themed Assessment) fatigue clinic continues to meet patient expectations, two years since an initial evaluation in 2015, following changes to the original service model. Background: The CRESTA fatigue clinic was established in 2013 to fulfil the unmet needs of patients with long-term conditions and the symptom of chronic fatigue who did not have access to fatigue management support. The service was previously evaluated using a group concept mapping (GCM) approach and found to successfully meet patients' expectations. To ensure these needs continued to be met following change to the original service model, we re-evaluated the service using a similar approach. GCM is a mixed method approach. Statements are generated from stakeholders, sorted into themed clusters, and then rated. Method: 146 assessment tools were posted to consecutive clinic patients containing statements generated during the original study. Patients rated each statement for 'current success' on a 1-5 Likert scale and provided for free-text feedback. Unpaired t-tests were used to compare cluster success scores from both the previous evaluation and the current cohort of patients. Thematic analysis was used to evaluate the qualitative comments.