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Organisational and workload constraints were significant barriers to implementation, although the intervention was valued by both patients and nurses and a pilot cluster trial was successfully run.

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Suzanne H Richards 1, John L Campbell 1,*, Christopher Dickens 2, Rob Anderson 2, Manish Gandhi 3, Andy Gibson 4, David Kessler 5, Luke Knight 3, Willem Kuyken 6, David A Richards 2, Rod S Taylor 1,2, Katrina Turner 5, Obioha C Ukoumunne 7, Antoinette Davey 1, Fiona C Warren 1, Rachel E Winder 1, Christine A Wright 1

1 Primary Care Research Group, University of Exeter Medical School, Exeter, UK
2 Institute of Health Service Research, University of Exeter Medical School, Exeter, UK
3 Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
4 Department of Health and Social Sciences, University of the West of England, Bristol, UK
5 Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
6 University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
7 NIHR Collaborations for Leadership in Applied Health Research and Care South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
* Corresponding author Email:

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