The University of Southampton
University of Southampton Institutional Repository

Patients as healthcare consumers in the public and private sectors: a qualitative study of acupuncture in the UK

Bishop, Felicity L., Barlow, Fiona, Coghlan, Beverly, Lee, Phillipa and Lewith, George T. (2011) Patients as healthcare consumers in the public and private sectors: a qualitative study of acupuncture in the UK BMC Health Services Research, 11, (129), pp. 1-11. (doi:10.1186/1472-6963-11-129). (PMID:21619572).

Record type: Article


The aim of this study was to compare patients' experiences of public and private sector healthcare, using acupuncture as an example. In the UK, acupuncture is popular with patients, is recommended in official guidelines for low back pain, and is available in both the private sector and the public sector (NHS). Consumerism was used as a theoretical framework to explore patients' experiences.

Semi-structured face-to-face interviews were conducted in 2007-8 with a purposive sample of 27 patients who had recently used acupuncture for painful conditions in the private sector and/or in the NHS. Inductive thematic analysis was used to develop themes that summarised the bulk of the data and provided insights into consumerism in NHS- and private practice-based acupuncture.

Five main themes were identified: value for money and willingness to pay; free and fair access; individualised holistic care: feeling cared for; consequences of choice: empowerment and vulnerability; and "just added extras": physical environment. Patients who had received acupuncture in the private sector constructed detailed accounts of the benefits of private care. Patients who had not received acupuncture in the private sector expected minimal differences from NHS care, and those differences were seen as not integral to treatment. The private sector facilitated consumerist behaviour to a greater extent than did the NHS, but private consumers appeared to base their decisions on unreliable and incomplete information.

Patients used and experienced acupuncture differently in the NHS compared to the private sector. Eight different faces of consumerist behaviour were identified, but six were dominant: consumer as chooser, consumer as pragmatist, consumer as patient, consumer as earnest explorer, consumer as victim, and consumer as citizen. The decision to use acupuncture in either the private sector or the NHS was rarely well-informed: NHS and private patients both had misconceptions about acupuncture in the other sector. Future research should evaluate whether the differences we identified in patients' experiences across private and public healthcare are common, whether they translate into significant differences in clinical outcomes, and whether similar faces of consumerism characterise patients' experiences of other interventions in the private and public sectors.

PDF 1472-6963-11-129.pdf - Version of Record
Available under License Other.
Download (245kB)

More information

Published date: 27 May 2011
Organisations: Primary Care & Population Sciences


Local EPrints ID: 190983
ISSN: 1472-6963
PURE UUID: 22312b8e-fd41-449d-9056-a3fd1634ffdd
ORCID for Felicity L. Bishop: ORCID iD

Catalogue record

Date deposited: 15 Jun 2011 15:34
Last modified: 18 Jul 2017 11:36

Export record



Author: Fiona Barlow
Author: Beverly Coghlan
Author: Phillipa Lee
Author: George T. Lewith

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton:

ePrints Soton supports OAI 2.0 with a base URL of

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.