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Why Primary Care Clinicians use Advice and Guidance: A qualitative study
Alice Faux-Nightingale1, Rosie Harrison2, Claire Burton3
1Keele University, Keele, United Kingdom of Great Britain and Northern Ireland a.faux-nightingale@keele.ac.uk.
Summary
Primary care clinicians use Advice and Guidance (A&G) to support patient care and decision-making. Effectiveness hinges on timely, helpful specialist responses within primary care capacity.
Area of Science:
- Qualitative research
- Healthcare policy
- Primary care medicine
Background:
- Advice and Guidance (A&G) facilitates specialist input for primary care clinicians, aiding decision-making and reducing referrals.
- A&G use has expanded significantly, particularly post-COVID-19 and due to contractual shifts.
- Concerns exist regarding A&G's impact on workload, response times, and usability, despite policy focus.
Purpose of the Study:
- To explore the utilization of Advice and Guidance (A&G) in English primary care.
- To understand the decision-making processes influencing primary care clinicians' (PCCs) use of A&G.
Main Methods:
- Qualitative study employing 20 semi-structured video interviews with purposively sampled primary care clinicians.
- Data analysis through reflexive thematic analysis within an interpretive description framework.
- Collaborative theme development with researchers and patient and public involvement and engagement (PPIE) contributors.
Main Results:
- Clinicians' decisions to use A&G are shaped by clinical presentation (acuity, complexity), navigating healthcare pathways, prior A&G experiences, and decision validation.
- Key barriers include delayed responses and concerns about inequitable workload distribution.
- These factors influence the effective integration of A&G into routine practice.
Conclusions:
- Primary care clinicians utilize A&G for patient care support and decision-making enhancement.
- The effectiveness of A&G is contingent upon receiving timely and clinically relevant responses.
- Integrating A&G as a primary route to elective care requires ensuring responses align with primary care remit and capacity.
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