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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( 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.