The relationship between GPs and hospital consultants and the implications for patient care

a qualitative study

Rod Sampson, Rosaline Barbour, Philip Wilson

Research output: Contribution to journalArticle

18 Citations (Scopus)
5 Downloads (Pure)

Abstract

BACKGROUND: Improving the quality of care of at the medical primary-secondary care interface is both a national and a wider concern. In a qualitative exploration of clinicians' relationship at the interface, we want to study how both GPs and hospital specialists regard and behave towards each other and how this may influence patient care.

METHOD: A qualitative interview study was carried out in primary and secondary care centres in NHS Highland health board area, Scotland. Eligible clinicians (general practitioners and hospital specialists) were invited to take part in a semi-structured interview to explore the implications of interface relationships upon patient care. A standard thematic analysis was used, involving an iterative process based on grounded theory.

RESULTS: Key themes that emerged for clinicians included communication (the importance of accessing and listening to one another, and the transfer of soft intelligence), conduct (referring to perceived inappropriate transfer of workload at the interface, and resistance to this transfer), relationships (between interface clinicians and between clinicians and their patients), and unrealistic expectations (clinicians expressing idealistic hopes of what their colleagues at the other interface could achieve).

CONCLUSION: The relationship between primary and secondary care clinicians, and, in particular, difficulties and misunderstandings can have an influence upon patient care. Addressing key areas identified in the study may help to improve interface relationships and benefit patient care.

Original languageEnglish
Article number45
JournalBMC Family Practice
Volume17
DOIs
Publication statusPublished - 14 Apr 2016

Fingerprint

Consultants
Patient Care
Secondary Care
Primary Health Care
Hope
Secondary Care Centers
Interviews
Quality of Health Care
Scotland
Workload
Intelligence
General Hospitals
General Practitioners
Communication
Health

Keywords

  • Attitude of Health Personnel
  • Consultants
  • Female
  • General Practitioners
  • Humans
  • Interprofessional Relations
  • Interviews as Topic
  • Male
  • Patient Care
  • Primary Health Care
  • Qualitative Research
  • Referral and Consultation
  • Scotland
  • Secondary Care
  • Specialization
  • State Medicine
  • Journal Article
  • Research Support, Non-U.S. Gov't

Cite this

The relationship between GPs and hospital consultants and the implications for patient care : a qualitative study. / Sampson, Rod; Barbour, Rosaline; Wilson, Philip.

In: BMC Family Practice, Vol. 17, 45, 14.04.2016.

Research output: Contribution to journalArticle

@article{a9c1fa5be7864e929ac0716126e37f60,
title = "The relationship between GPs and hospital consultants and the implications for patient care: a qualitative study",
abstract = "BACKGROUND: Improving the quality of care of at the medical primary-secondary care interface is both a national and a wider concern. In a qualitative exploration of clinicians' relationship at the interface, we want to study how both GPs and hospital specialists regard and behave towards each other and how this may influence patient care.METHOD: A qualitative interview study was carried out in primary and secondary care centres in NHS Highland health board area, Scotland. Eligible clinicians (general practitioners and hospital specialists) were invited to take part in a semi-structured interview to explore the implications of interface relationships upon patient care. A standard thematic analysis was used, involving an iterative process based on grounded theory.RESULTS: Key themes that emerged for clinicians included communication (the importance of accessing and listening to one another, and the transfer of soft intelligence), conduct (referring to perceived inappropriate transfer of workload at the interface, and resistance to this transfer), relationships (between interface clinicians and between clinicians and their patients), and unrealistic expectations (clinicians expressing idealistic hopes of what their colleagues at the other interface could achieve).CONCLUSION: The relationship between primary and secondary care clinicians, and, in particular, difficulties and misunderstandings can have an influence upon patient care. Addressing key areas identified in the study may help to improve interface relationships and benefit patient care.",
keywords = "Attitude of Health Personnel, Consultants, Female, General Practitioners, Humans, Interprofessional Relations, Interviews as Topic, Male, Patient Care, Primary Health Care, Qualitative Research, Referral and Consultation, Scotland, Secondary Care, Specialization, State Medicine, Journal Article, Research Support, Non-U.S. Gov't",
author = "Rod Sampson and Rosaline Barbour and Philip Wilson",
note = "Acknowledgements Clinicians assisting development of topic guide, all based in NHS Highland; Mr Angus Cain (Consultant Ear, Nose & Throat), Professor Steve Leslie (Consultant Cardiologist), Professor Ronald Macvicar (Postgraduate Dean, North of Scotland Region of NHS Education for Scotland (NES)), Dr Jerry O’Rourke (General Practice Principal), Professor Ken Walker (Consultant Colorectal surgeon). Clinicians involved in pilot of the semi-structured questionnaire; Dr Beth Macfarlane (General Practice Principal), and Dr Russell Drummond (Consultant Endocrinologist). Gillian Heron, Cairn Medical Practice who transcribed interview recordings. Funding The research was funded by both the local NHS Highland Research & Development Committee, and the “RCGP Allen & Margaret Wilson Memorial Fund.” The Chief Investigator (Dr Rod Sampson) received no personal payment for the study. No drug company is involved in this research.",
year = "2016",
month = "4",
day = "14",
doi = "10.1186/s12875-016-0442-y",
language = "English",
volume = "17",
journal = "BMC Family Practice",
issn = "1471-2296",
publisher = "BioMed Central",

}

TY - JOUR

T1 - The relationship between GPs and hospital consultants and the implications for patient care

T2 - a qualitative study

AU - Sampson, Rod

AU - Barbour, Rosaline

AU - Wilson, Philip

N1 - Acknowledgements Clinicians assisting development of topic guide, all based in NHS Highland; Mr Angus Cain (Consultant Ear, Nose & Throat), Professor Steve Leslie (Consultant Cardiologist), Professor Ronald Macvicar (Postgraduate Dean, North of Scotland Region of NHS Education for Scotland (NES)), Dr Jerry O’Rourke (General Practice Principal), Professor Ken Walker (Consultant Colorectal surgeon). Clinicians involved in pilot of the semi-structured questionnaire; Dr Beth Macfarlane (General Practice Principal), and Dr Russell Drummond (Consultant Endocrinologist). Gillian Heron, Cairn Medical Practice who transcribed interview recordings. Funding The research was funded by both the local NHS Highland Research & Development Committee, and the “RCGP Allen & Margaret Wilson Memorial Fund.” The Chief Investigator (Dr Rod Sampson) received no personal payment for the study. No drug company is involved in this research.

PY - 2016/4/14

Y1 - 2016/4/14

N2 - BACKGROUND: Improving the quality of care of at the medical primary-secondary care interface is both a national and a wider concern. In a qualitative exploration of clinicians' relationship at the interface, we want to study how both GPs and hospital specialists regard and behave towards each other and how this may influence patient care.METHOD: A qualitative interview study was carried out in primary and secondary care centres in NHS Highland health board area, Scotland. Eligible clinicians (general practitioners and hospital specialists) were invited to take part in a semi-structured interview to explore the implications of interface relationships upon patient care. A standard thematic analysis was used, involving an iterative process based on grounded theory.RESULTS: Key themes that emerged for clinicians included communication (the importance of accessing and listening to one another, and the transfer of soft intelligence), conduct (referring to perceived inappropriate transfer of workload at the interface, and resistance to this transfer), relationships (between interface clinicians and between clinicians and their patients), and unrealistic expectations (clinicians expressing idealistic hopes of what their colleagues at the other interface could achieve).CONCLUSION: The relationship between primary and secondary care clinicians, and, in particular, difficulties and misunderstandings can have an influence upon patient care. Addressing key areas identified in the study may help to improve interface relationships and benefit patient care.

AB - BACKGROUND: Improving the quality of care of at the medical primary-secondary care interface is both a national and a wider concern. In a qualitative exploration of clinicians' relationship at the interface, we want to study how both GPs and hospital specialists regard and behave towards each other and how this may influence patient care.METHOD: A qualitative interview study was carried out in primary and secondary care centres in NHS Highland health board area, Scotland. Eligible clinicians (general practitioners and hospital specialists) were invited to take part in a semi-structured interview to explore the implications of interface relationships upon patient care. A standard thematic analysis was used, involving an iterative process based on grounded theory.RESULTS: Key themes that emerged for clinicians included communication (the importance of accessing and listening to one another, and the transfer of soft intelligence), conduct (referring to perceived inappropriate transfer of workload at the interface, and resistance to this transfer), relationships (between interface clinicians and between clinicians and their patients), and unrealistic expectations (clinicians expressing idealistic hopes of what their colleagues at the other interface could achieve).CONCLUSION: The relationship between primary and secondary care clinicians, and, in particular, difficulties and misunderstandings can have an influence upon patient care. Addressing key areas identified in the study may help to improve interface relationships and benefit patient care.

KW - Attitude of Health Personnel

KW - Consultants

KW - Female

KW - General Practitioners

KW - Humans

KW - Interprofessional Relations

KW - Interviews as Topic

KW - Male

KW - Patient Care

KW - Primary Health Care

KW - Qualitative Research

KW - Referral and Consultation

KW - Scotland

KW - Secondary Care

KW - Specialization

KW - State Medicine

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1186/s12875-016-0442-y

DO - 10.1186/s12875-016-0442-y

M3 - Article

VL - 17

JO - BMC Family Practice

JF - BMC Family Practice

SN - 1471-2296

M1 - 45

ER -