ORIGINAL ARTICLES

Understanding patient experience of out-of-hours general practitioner services in South Wales: a qualitative study

J N Egbunike¹, C Shaw², S Bale³, G Elwyn¹, A Edwards¹

¹ Department of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK
² Department of Care Sciences, Faculty of Health, Sports and Science, University of Glamorgan, Pontypridd, UK
³ Gwent Healthcare NHS Trust, Llanfrechfa Grange Hospital, Cwmbran, Torfaen, UK

Correspondence to:
Professor A Edwards, Department of Primary Care and Public Health, School of Medicine, Cardiff University, 2nd floor, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK; edwardsag{at}cardiff.ac.uk

Background: In the light of recent changes in the structure and provision of out-of-hours service in the UK, there is a need to re-assess the quality of care. One way to assess the quality of care is through patient experience.

Objectives: This study aimed to explore patient expectations and help-seeking behaviour, in order to understand their relationship with satisfaction and experience of out-of-hours care.

Methods: 30 semistructured telephone interviews were carried out with users of the general practitioner out-of-hours service in Gwent, South Wales. The interviews explored users’ experiences of using the service. A thematic analysis of transcripts was carried out using NUD*IST software. Comparison of data within and across codes facilitated the identification of explanatory constructs. Double coding of a sample of transcripts and discussion of emerging themes by members of the research team ensured the reliability of findings.

Results: Most (n = 25, 83%) respondents reported satisfaction with the overall service received but a few (n = 5, 17%) were dissatisfied. Patients generally had specific expectations of their consultation and there was a mismatch between patients’ expectations of the service and what the service actually provides in some specific user groups. Unmet expectations resulted in subsequent, and in some cases, multiple consultations.

Conclusions: Users’ views and expectations may be used to inform service design and improve services, but the data also indicated a need to address user expectations of services, for example by enhanced information provision. Any such interventions to improve patient experience of out-of-hours care will need to be evaluated.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?