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General practitioners’ experiences of emergency care and treatment planning in England : a focus group study
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Huxley, Caroline J., Eli, Karin, Hawkes, Claire, Perkins, Gavin D., George, Rob, Griffiths, Frances and Slowther, Anne-Marie (2021) General practitioners’ experiences of emergency care and treatment planning in England : a focus group study. BMC Family Practice, 22 (1). 128. doi:10.1186/s12875-021-01486-w ISSN 1471-2296.
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Official URL: https://doi.org/10.1186/s12875-021-01486-w
Abstract
Background: Emergency Care and Treatment Plans are recommended for all primary care patients in the United Kingdom who are expected to experience deterioration of their health. The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) was developed to integrate resuscitation decisions with discussions about wider goals of care. It summarises treatment recommendations discussed and agreed between patients and their clinicians for a future emergency situation and was designed to meet the needs of different care settings. Our aim is to explore GPs’ experiences of using ReSPECT and how it transfers across the primary care and secondary care interface. Methods: We conducted five focus groups with GPs in areas being served by hospitals in England that have implemented ReSPECT. Participants were asked about their experience of ReSPECT, how they initiate ReSPECT-type conversations, and their experiences of ReSPECT-type recommendations being communicated across primary and secondary care. Focus groups were transcribed and analysed using Thematic Analysis. Results: GPs conceptualise ReSPECT as an end of life planning document, which is best completed in primary care. As an end of life care document, completing ReSPECT is an emotional process and conversations are shaped by what a ‘good death’ is thought to be. ReSPECT recommendations are not always communicated or transferable across care settings. A focus on the patient’s preferences around death, and GPs’ lack of specialist knowledge, could be a barrier to completion of ReSPECT that is transferable to acute settings. Conclusion: Conceptualising ReSPECT as an end of life care document suggests a difference in how general practitioners understand ReSPECT from its designers. This impacts on the transferability of ReSPECT recommendations to the hospital setting.
Item Type: | Journal Article | ||||||
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Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine R Medicine > RT Nursing |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||
SWORD Depositor: | Library Publications Router | ||||||
Library of Congress Subject Headings (LCSH): | Primary health care -- England, Medical emergencies -- England, Terminal care -- England, Critical care medicine -- England, Primary care (Medicine) -- England | ||||||
Journal or Publication Title: | BMC Family Practice | ||||||
Publisher: | BioMed Central | ||||||
ISSN: | 1471-2296 | ||||||
Official Date: | 24 June 2021 | ||||||
Dates: |
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Volume: | 22 | ||||||
Number: | 1 | ||||||
Article Number: | 128 | ||||||
DOI: | 10.1186/s12875-021-01486-w | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 30 June 2021 | ||||||
Date of first compliant Open Access: | 2 July 2021 | ||||||
RIOXX Funder/Project Grant: |
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