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ABSTRACT: Background
New out-of-hours healthcare services in the UK are intended to offer simple, convenient access and effective triage. They may be unsatisfactory for patients with complex needs, where continuity of care is important.Aim
To explore the experiences and perceptions of out-of-hours care of patients with advanced cancer, and with their informal and professional carers.Design of study
Qualitative, community-based study using in-depth interviews, focus groups and telephone interviews.Setting
Urban, semi-urban and rural communities in three areas of Scotland.Method
Interviews with 36 patients with advanced cancer who had recently used out-of-hours services, and/or their carers, with eight focus groups with patients and carers and 50 telephone interviews with the patient's GP and other key professionals.Results
Patients and carers had difficulty deciding whether to call out-of-hours services, due to anxiety about the legitimacy of need, reluctance to bother the doctor, and perceptions of triage as blocking access to care and out-of-hours care as impersonal. Positive experiences related to effective planning, particularly transfer of information, and empathic responses from staff. Professionals expressed concern about delivering good palliative care within the constraints of a generic acute service, and problems accessing other health and social care services.Conclusions
Service configuration and access to care is based predominantly on acute illness situations and biomedical criteria. These do not take account of the complex needs associated with palliative and end-of-life care. Specific arrangements are needed to ensure that appropriately resourced and integrated out-of-hours care is made accessible to such patient groups.
SUBMITTER: Worth A
PROVIDER: S-EPMC1821404 | biostudies-literature | 2006 Jan
REPOSITORIES: biostudies-literature
The British journal of general practice : the journal of the Royal College of General Practitioners 20060101 522
<h4>Background</h4>New out-of-hours healthcare services in the UK are intended to offer simple, convenient access and effective triage. They may be unsatisfactory for patients with complex needs, where continuity of care is important.<h4>Aim</h4>To explore the experiences and perceptions of out-of-hours care of patients with advanced cancer, and with their informal and professional carers.<h4>Design of study</h4>Qualitative, community-based study using in-depth interviews, focus groups and telep ...[more]