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Discontinuity of care at end of life: a qualitative exploration of OOH end of life care

Discontinuity of care at end of life: a qualitative exploration of OOH end of life care
Discontinuity of care at end of life: a qualitative exploration of OOH end of life care
Objective This study aimed to understand the experiences of palliative care patients when accessing or making decisions about out of hours (OOH) services. It also aimed to illuminate barriers and enablers to accessing appropriate and timely care following the introduction of the 2004 New General Medical Services Contract.

Method Longitudinal prospective qualitative study using semi-structured interviews and telephone interviews over 6 months and analysed for thematic content. 32 patients defined as receiving palliative care in six General Practices and three hospices selected on the basis of size and rural/urban location in Southern England were recruited.

Results Continuity of care was highly valued. Participants described the importance of being known by the healthcare team, and the perceived positive implications continuity could have for the quality of care they received and the trust they had in their care. Various factors prevented participants from seeking help or advice from OOH services, despite having health concerns that may have benefitted from medical assistance. Prior poor experience, limited knowledge of services and knowing who to call and, indeed, when to call were all factors that reportedly shaped participants’ use of OOH services.

Conclusions Interpersonal or relationship continuity and management continuity are vital to the process of optimising the patient experience of OOH palliative care. While recent service innovations are tackling some of the issues highlighted, this research reinforces the value patients with palliative care needs places on continuity and the need to improve this aspect of care management.
2045-435X
1-10
Leydon, Geraldine M.
c5cdaff5-0fa1-4d38-b575-b97c2892ec40
Shergill, Narinder K.
c959cba1-75ba-48bb-904b-1a67ad440d02
Campion-Smith, Charles
d3fb5065-31de-417c-bdc7-9a5486505c55
Austin, Helen
54cb7149-ef80-4576-aaee-f76a36b60c31
Eyles, Caroline
f8518cbb-669f-4cf6-bacb-4a174e385483
Baverstock, Jenny
82f3fd4c-2b09-4c0d-8485-15afbc53be59
Addington-Hall, Julia
87560cc4-7562-4f9b-b908-81f3b603fdd8
Sloan, Richard
93815737-4099-4212-8178-b5d1f6798d33
Moore, Michael V.
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Leydon, Geraldine M.
c5cdaff5-0fa1-4d38-b575-b97c2892ec40
Shergill, Narinder K.
c959cba1-75ba-48bb-904b-1a67ad440d02
Campion-Smith, Charles
d3fb5065-31de-417c-bdc7-9a5486505c55
Austin, Helen
54cb7149-ef80-4576-aaee-f76a36b60c31
Eyles, Caroline
f8518cbb-669f-4cf6-bacb-4a174e385483
Baverstock, Jenny
82f3fd4c-2b09-4c0d-8485-15afbc53be59
Addington-Hall, Julia
87560cc4-7562-4f9b-b908-81f3b603fdd8
Sloan, Richard
93815737-4099-4212-8178-b5d1f6798d33
Moore, Michael V.
1be81dad-7120-45f0-bbed-f3b0cc0cfe99

Leydon, Geraldine M., Shergill, Narinder K., Campion-Smith, Charles, Austin, Helen, Eyles, Caroline, Baverstock, Jenny, Addington-Hall, Julia, Sloan, Richard and Moore, Michael V. (2013) Discontinuity of care at end of life: a qualitative exploration of OOH end of life care. BMJ Supportive & Palliative Care, 3 (4), 1-10. (doi:10.1136/bmjspcare-2012-000266).

Record type: Article

Abstract

Objective This study aimed to understand the experiences of palliative care patients when accessing or making decisions about out of hours (OOH) services. It also aimed to illuminate barriers and enablers to accessing appropriate and timely care following the introduction of the 2004 New General Medical Services Contract.

Method Longitudinal prospective qualitative study using semi-structured interviews and telephone interviews over 6 months and analysed for thematic content. 32 patients defined as receiving palliative care in six General Practices and three hospices selected on the basis of size and rural/urban location in Southern England were recruited.

Results Continuity of care was highly valued. Participants described the importance of being known by the healthcare team, and the perceived positive implications continuity could have for the quality of care they received and the trust they had in their care. Various factors prevented participants from seeking help or advice from OOH services, despite having health concerns that may have benefitted from medical assistance. Prior poor experience, limited knowledge of services and knowing who to call and, indeed, when to call were all factors that reportedly shaped participants’ use of OOH services.

Conclusions Interpersonal or relationship continuity and management continuity are vital to the process of optimising the patient experience of OOH palliative care. While recent service innovations are tackling some of the issues highlighted, this research reinforces the value patients with palliative care needs places on continuity and the need to improve this aspect of care management.

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More information

Published date: 7 June 2013
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 352676
URI: https://eprints.soton.ac.uk/id/eprint/352676
ISSN: 2045-435X
PURE UUID: 3536a0f7-0ffb-426b-90c1-cc6a8c71bba5
ORCID for Geraldine M. Leydon: ORCID iD orcid.org/0000-0001-5986-3300
ORCID for Jenny Baverstock: ORCID iD orcid.org/0000-0003-1777-2894
ORCID for Michael V. Moore: ORCID iD orcid.org/0000-0002-5127-4509

Catalogue record

Date deposited: 20 May 2013 10:52
Last modified: 20 Jul 2019 00:59

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Contributors

Author: Narinder K. Shergill
Author: Charles Campion-Smith
Author: Helen Austin
Author: Caroline Eyles
Author: Richard Sloan

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