dc.contributor.author | Quinn, C | |
dc.contributor.author | Denman, K | |
dc.contributor.author | Smithson, P | |
dc.contributor.author | Owens, C | |
dc.contributor.author | Sheaff, R | |
dc.contributor.author | Campbell, J | |
dc.contributor.author | Porter, I | |
dc.contributor.author | Annison, J | |
dc.contributor.author | Byng, R | |
dc.date.accessioned | 2018-02-13T15:41:56Z | |
dc.date.issued | 2018-02-02 | |
dc.description.abstract | BACKGROUND: Offenders frequently have substantial healthcare needs and, like many other socially marginalised groups, often receive healthcare in inverse proportion to their needs. Improved continuity of healthcare over time could contribute to addressing these needs. General Practitioners need to be able to support people with complex social and medical problems, even in systems that are not specifically designed to manage individuals with such degrees of complexity. We aimed to examine offenders' perspectives on factors that contributed to, or worked against, creating and sustaining their access to healthcare. METHODS: From a sample of 200 participants serving community or prison sentences in South West (SW) and South East (SE) England, who were interviewed about their health care experiences as part of the Care for Offenders: Continuity of Access (COCOA) study, we purposively sampled 22 participants for this sub-study, based on service use. These interviews were transcribed verbatim. A thematic analytic approach initially applied 5 a priori codes based on access and different components of continuity. Data were then examined for factors that contributed to achieving and disrupting access and continuity. RESULTS: Participants described how their own life situations and behaviours contributed to their problems in accessing healthcare and also identified barriers created by existing access arrangements. They also highlighted how some General Practitioners used their initiative and skills to 'workaround' the system, and build positive relationships with them; feeling listened to and building trust were particularly valued, as was clear communication. Limitations faced by General Practitioners included a lack of appropriate services to refer people to, where the offender patients would meet the access criteria, and disagreements regarding medication prescriptions. CONCLUSIONS: General Practitioners can make a positive contribution to supporting access to healthcare for an under-served population by facilitating more flexible and less formal access arrangements, by using their relationship skills, and by problem-solving. General Practitioners should recognise their potential to transform people's experience of healthcare whilst working in imperfect systems, particularly with vulnerable and marginalised groups who have complex medical and social needs. | en_GB |
dc.description.sponsorship | The study was funded by the National Institute for Health Research Service
Delivery and Organisation Programme (NIHR SDO) Project reference 08/
1713/210. Professor Richard Byng’s time was also supported by the National
Institute for Health Research (NIHR) Collaboration for Leadership in Applied
Health Research and Care South West Peninsula. | en_GB |
dc.identifier.citation | Vol. 19: 22 | en_GB |
dc.identifier.doi | 10.1186/s12875-018-0708-7 | |
dc.identifier.uri | http://hdl.handle.net/10871/31456 | |
dc.language.iso | en | en_GB |
dc.publisher | BioMed Central | en_GB |
dc.relation.source | All audio recordings and transcripts are stored in secure, password protected
storage at the University of Plymouth. The data that support the findings of
this study are available from Professor Richard Byng but restrictions apply to
the availability of these data, which were used under license for the current
study, and so are not publicly available. Data are however available from the
authors upon reasonable request and with permission of Cardiff Multi-Centre
Research Ethics Committee. | en_GB |
dc.relation.url | https://www.ncbi.nlm.nih.gov/pubmed/29390968 | en_GB |
dc.rights | © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. | en_GB |
dc.subject | Access | en_GB |
dc.subject | Continuity | en_GB |
dc.subject | General practitioner | en_GB |
dc.subject | Offenders | en_GB |
dc.subject | Primary care | en_GB |
dc.subject | Qualitative | en_GB |
dc.title | General practitioner contributions to achieving sustained healthcare for offenders: a qualitative study. | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2018-02-13T15:41:56Z | |
exeter.place-of-publication | England | en_GB |
dc.description | This is the final version of the article. Available from BioMed Central via the DOI in this record. | en_GB |
dc.identifier.eissn | 1471-2296 | |
dc.identifier.journal | BMC Family Practice | en_GB |