Personal continuity and access in UK general practice: A qualitative study of general practitioners' and patients' perceptions of when and how they matter

Guthrie, B. and Wyke, S. (2006) Personal continuity and access in UK general practice: A qualitative study of general practitioners' and patients' perceptions of when and how they matter. BMC Family Practice, 7(11), (doi:10.1186/1471-2296-7-11)

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Abstract

Background Personal continuity is a core value for family practice, but policy and performance targets emphasise other aspects of care, particularly waiting times for consultation. This study examined patient and general practitioner (GP) perceptions of the value of personal continuity and rapid access, and the relationship between them. Methods Qualitative analysis of semi-structured interviews with a purposive sample of 16 GPs and 32 patients in the Lothian region of Scotland, to identify whether, how, why and in which circumstances personal continuity and rapid access were valued. Results From the patients' perspective, what mattered was 'access to appropriate care' depending on the problem to be dealt with. For a few patients, rapid access was the only priority. For most, rapid access was balanced against greater involvement in the consultation when seeing 'their' trusted doctor, which was particularly valued for chronic, complex and emotional problems. GPs focused on the value of personal continuity in the consultation for improving the diagnosis and management of the same kinds of problem. GPs did not perceive enabling access to be a core part of their work. There was little evidence that GPs routinely discussed with patients when or how personal continuity and access should be balanced. Conclusion 'Access to appropriate care' from the patients' perspective is not fully addressed by GPs' focus on personal continuity, nor by performance targets focused only on speed of access. GPs need to make enabling access as much a part of their core values as personal continuity, and access targets need to be based on less simplistic measures that account for the appropriateness of care as well as speed of access

Item Type:Articles
Additional Information:The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-2296/7/11/prepub
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wyke, Professor Sally
Authors: Guthrie, B., and Wyke, S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Social Scientists working in Health and Wellbeing
College of Social Sciences
Journal Name:BMC Family Practice
Publisher:BioMed Central
ISSN (Online):1471-2296
Published Online:24 February 2006

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