TY - JOUR
T1 - Relationship continuity
T2 - When and why do primary care patients think it is safer?
AU - Rhodes, Penny
AU - Sanders, Caroline
AU - Campbell, Stephen
PY - 2014/12
Y1 - 2014/12
N2 - Background: Doctor–patient continuity is popular with patients and practitioners, and is associated with better outcomes; however, changes in policy and practice organisation have diminished its scope. Although there has been some discussion of safety implications from professionals’ perspective, patients’ views remain largely unexplored. Aim: To explore patients’ understanding of safety in primary care. Design and setting An interview-based study with patients from general practices in the northwest of England. Method: Patients were recruited from five general practices through patient participation groups and posters in waiting rooms, with further participants recruited through snowballing techniques until no new themes emerged. In-depth interviews were digitally recorded and transcribed. Anonymised transcripts were coded and analysed inductively. Emergent themes were discussed by the team. Results: For patients, relationship continuity was not simply a matter of service quality but an important safety concern that offered greater psychosocial security than consultations with unfamiliar GPs. Relationship continuity enabled the GP to become a repository of information; acquire specialist knowledge of a patient’s condition; become familiar with the patient’s consulting behaviour; provide holistic care; and foster the development of trust. Patients were also aware of the risks: a false sense of security and lack of a fresh perspective. Their desire for continuity varied with the nature of their concerns, psychological vulnerability, and perception of GPs’ qualities and skills. No one supported a return to imposed continuity. Conclusion: Relationship continuity and choice of GP were important safety strategies, neither of which is adequately supported by recent policy changes.
AB - Background: Doctor–patient continuity is popular with patients and practitioners, and is associated with better outcomes; however, changes in policy and practice organisation have diminished its scope. Although there has been some discussion of safety implications from professionals’ perspective, patients’ views remain largely unexplored. Aim: To explore patients’ understanding of safety in primary care. Design and setting An interview-based study with patients from general practices in the northwest of England. Method: Patients were recruited from five general practices through patient participation groups and posters in waiting rooms, with further participants recruited through snowballing techniques until no new themes emerged. In-depth interviews were digitally recorded and transcribed. Anonymised transcripts were coded and analysed inductively. Emergent themes were discussed by the team. Results: For patients, relationship continuity was not simply a matter of service quality but an important safety concern that offered greater psychosocial security than consultations with unfamiliar GPs. Relationship continuity enabled the GP to become a repository of information; acquire specialist knowledge of a patient’s condition; become familiar with the patient’s consulting behaviour; provide holistic care; and foster the development of trust. Patients were also aware of the risks: a false sense of security and lack of a fresh perspective. Their desire for continuity varied with the nature of their concerns, psychological vulnerability, and perception of GPs’ qualities and skills. No one supported a return to imposed continuity. Conclusion: Relationship continuity and choice of GP were important safety strategies, neither of which is adequately supported by recent policy changes.
KW - General practice
KW - Patient safety
KW - Patients' perceptions
KW - Primary care
KW - Systems
KW - Trust
UR - http://www.scopus.com/inward/record.url?scp=84919334393&partnerID=8YFLogxK
UR - http://www.mendeley.com/research/relationship-continuity-primary-care-patients-think-it-safer
U2 - 10.3399/bjgp14X682825
DO - 10.3399/bjgp14X682825
M3 - Article
VL - 64
SP - 758
EP - 764
JO - Journal of the Royal College of General Practitioners
JF - Journal of the Royal College of General Practitioners
SN - 0960-1643
IS - 629
ER -