Article Text

Staff perceptions on patient motives for attending GP-led urgent care centres in London: a qualitative study
  1. Geva Greenfield1,
  2. Agnieszka Ignatowicz1,2,
  3. Shamini Gnani1,
  4. Medhavi Bucktowonsing3,
  5. Tim Ladbrooke3,
  6. Hugh Millington4,
  7. Josip Car5,6,
  8. Azeem Majeed1
  1. 1Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
  2. 2Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK
  3. 3London Central and West Unscheduled Care Collaborative, London, UK
  4. 4Charing Cross Hospital Emergency Department, Imperial College Healthcare NHS Trust, London, UK
  5. 5Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
  6. 6Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
  1. Correspondence to Dr Geva Greenfield; g.greenfield{at}imperial.ac.uk

Abstract

Objectives General practitioner (GP)-led urgent care centres were established to meet the growing demand for urgent care. Staff members working in such centres are central in influencing patients’ choices about which services they use, but little is known about staff perceptions of patients’ motives for attending urgent care. We hence aimed to explore their perceptions of patients’ motives for attending such centres.

Design A phenomenological, qualitative study, including semistructured interviews. The interviews were analysed using thematic content analysis.

Setting 2 GP-led urgent care centres in 2 academic hospitals in London.

Participants 15 staff members working at the centres including 8 GPs, 5 emergency nurse practitioners and 2 receptionists.

Results We identified 4 main themes: ‘Confusion about choices’, ‘As if increase of appetite had grown; By what it fed on’, ‘Overt reasons, covert motives’ and ‘A question of legitimacy’. The participants thought that the centres introduce convenient and fast access for patients. So convenient, that an increasing number of patients use them as a regular alternative to their community GP. The participants perceived that patients attend the centres because they are anxious about their symptoms and view them as serious, cannot get an appointment with their GP quickly and conveniently, are dissatisfied with the GP, or lack self-care skills. Staff members perceived some motives as legitimate (an acute health need and difficulties in getting an appointment), and others as less legitimate (convenience, minor illness, and seeking quicker access to hospital facilities).

Conclusions The participants perceived that patients attend urgent care centres because of the convenience of access relative to primary care, as well as sense of acuity and anxiety, lack self-care skills and other reasons. They perceived some motives as more legitimate than others. Attention to unmet needs in primary care can help in promoting balanced access to urgent care.

  • ACCIDENT & EMERGENCY MEDICINE
  • QUALITATIVE RESEARCH
  • PRIMARY CARE

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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