General practitioners’ experiences of emergency care and treatment planning in England: a focus group study
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 de...
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| Format: | Article |
| Language: | English |
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BMC
2021-06-01
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| Series: | BMC Family Practice |
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| Online Access: | https://doi.org/10.1186/s12875-021-01486-w |
| _version_ | 1818114261953544192 |
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| author | Caroline J. Huxley Karin Eli Claire A. Hawkes Gavin D. Perkins Rob George Frances Griffiths Anne-Marie Slowther |
| author_facet | Caroline J. Huxley Karin Eli Claire A. Hawkes Gavin D. Perkins Rob George Frances Griffiths Anne-Marie Slowther |
| author_sort | Caroline J. Huxley |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-11T03:47:55Z |
| format | Article |
| id | doaj.art-dd282f32e315438e9cc083725a8a6ffd |
| institution | Directory Open Access Journal |
| issn | 1471-2296 |
| language | English |
| last_indexed | 2024-12-11T03:47:55Z |
| publishDate | 2021-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Family Practice |
| spelling | doaj.art-dd282f32e315438e9cc083725a8a6ffd2022-12-22T01:21:58ZengBMCBMC Family Practice1471-22962021-06-012211810.1186/s12875-021-01486-wGeneral practitioners’ experiences of emergency care and treatment planning in England: a focus group studyCaroline J. Huxley0Karin Eli1Claire A. Hawkes2Gavin D. Perkins3Rob George4Frances Griffiths5Anne-Marie Slowther6Warwick Medical School, University of WarwickWarwick Medical School, University of WarwickWarwick Medical School, University of WarwickWarwick Medical School, University of WarwickSt Christopher’s HospiceWarwick Medical School, University of WarwickWarwick Medical School, University of WarwickAbstract 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.https://doi.org/10.1186/s12875-021-01486-wPrimary health careEmergency care and treatment plansDNACPREnd of life careRecommended Summary Plan for Emergency Care and TreatmentReSPECT |
| spellingShingle | Caroline J. Huxley Karin Eli Claire A. Hawkes Gavin D. Perkins Rob George Frances Griffiths Anne-Marie Slowther General practitioners’ experiences of emergency care and treatment planning in England: a focus group study BMC Family Practice Primary health care Emergency care and treatment plans DNACPR End of life care Recommended Summary Plan for Emergency Care and Treatment ReSPECT |
| title | General practitioners’ experiences of emergency care and treatment planning in England: a focus group study |
| title_full | General practitioners’ experiences of emergency care and treatment planning in England: a focus group study |
| title_fullStr | General practitioners’ experiences of emergency care and treatment planning in England: a focus group study |
| title_full_unstemmed | General practitioners’ experiences of emergency care and treatment planning in England: a focus group study |
| title_short | General practitioners’ experiences of emergency care and treatment planning in England: a focus group study |
| title_sort | general practitioners experiences of emergency care and treatment planning in england a focus group study |
| topic | Primary health care Emergency care and treatment plans DNACPR End of life care Recommended Summary Plan for Emergency Care and Treatment ReSPECT |
| url | https://doi.org/10.1186/s12875-021-01486-w |
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