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Understanding patient experience of out-of-hours general practitioner services in South Wales: a qualitative study
  1. J N Egbunike1,
  2. C Shaw2,
  3. S Bale3,
  4. G Elwyn1,
  5. A Edwards1
  1. 1
    Department of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK
  2. 2
    Department of Care Sciences, Faculty of Health, Sports and Science, University of Glamorgan, Pontypridd, UK
  3. 3
    Gwent Healthcare NHS Trust, Llanfrechfa Grange Hospital, Cwmbran, Torfaen, UK
  1. 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

Abstract

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.

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Footnotes

  • ( The interview structure is published online only at http://emj.bmj.com/content/vol25/issue10.

  • Funding: This study was part of a larger project funded by the Gwent Healthcare NHS Trust and Blaenau Gwent, Caerphilly, Monmouthshire, Newport and Torfaen Local Health Boards.

  • Competing interests: None.

  • Ethics approval: UK Multi-centre Research Ethics Committee application and approval was gained for the study in June 2005 (05/MRE09/35).

  • Patient consent: Obtained.

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