Perceptions of communication between people with communication disability and general practice staff

To explore consultation between people with communication disability and General Practice (GP) staff from the perspectives of both patients and staff.

Communication disability causes a particular problem in primary care. This issue has not yet been investigated from the perspective of both patients and GP staff.

Eight focus groups were held - four with GP practices, two with people with intellectual disability and two with people who had had a stroke. Picture symbols and Talking Mats, a visual communication framework, were used to assist the participants with communication disability. Discussions were audio recorded and analysed thematically.

Twenty GP staff, 12 people with aphasia and six people with learning disability were interviewed.

GP staff expressed frustration with not being understood and not understanding but there was a lack of awareness of the reasons behind these difficulties. They all said they mainly relied on carers. They recognized the significance of poor communication in terms of access to health services and agreed that the extent of the problem was greater than they had previously believed. People with communication disability described significant problems before, during and after the consultation. Although some acknowledged that they needed help from their carer, most objected to staff speaking to the carer and not to them.

The main priorities for GP staff were the need for relevant training and simple resources. The main priorities for people with communication difficulty were continuity of staff, trust, better GP staff communication skills, and less reliance on carers.