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Falling Through the Cracks: Patients’ Experiences of Care after Injury

Earthy, SM, Kendrick, D, Kellezi, B, Sleney, J, Barnes, J, Beckett, K and Jones, T (2014) Falling Through the Cracks: Patients’ Experiences of Care after Injury In: 43rd Annual Conference of the Society for Academic Primary Care, 2014-07-09 - 2014-07-11, Edinburgh.

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A growing body of literature acknowledges the wide ranging impact of serious injury (Lyons et al 2011, Wiseman et al 2012, Polinder and Haagsma 2010). Early psychological intervention following injury is considered beneficial (O’Donnell 2010). Patients and carers interviewed as part of the Impact of Injuries Study described a physical, emotional and psychological aftermath that included continuing pain, anxiety about symptoms, frustration at physical limitations and enforced dependence, flashbacks, depression and loss of confidence. The period between discharge from hospital and the first out-patient appointment was particularly stressful. This paper compares patient and carer accounts of the support received from primary care with views from GPs and hospital-based professionals on the division of responsibility between primary and secondary care. We undertook a qualitative study, nested within a multicentre longitudinal quantitative study assessing the longer term impact of injuries on physical, psychological, occupational and social functioning in working age adults. A total of 668 adults admitted to acute NHS Trusts following an unintentional injury in four study centres (Nottingham, Bristol, Leicester/Loughborough and Surrey) took part in the quantitative part of the study. The qualitative study involved interviews with 45 patients from the main study, 18 carers and 40 service providers. 25.3% of patients in the main study visited their GP during the first month post injury and this rose to 38.9% at T3 (4 months). Most of the patients interviewed believed that although they could contact their GP with a specific issue, primary care was not generally responsible for their injury care. Many patients interviewed would have welcomed more support during the initial period at home and those who had been contacted by their GP following discharge were very appreciative. A few reported their GP dismissing psychological issues connected to their injury. GPs interviewed were aware of insufficiency of information given to patients on discharge and that patients found the early weeks particularly difficult. There was a perception that primary care had neither the capacity nor specialist orthopaedic knowledge to answer patient concerns regarding speed of recovery or likely prognosis. Hospital doctors and other hospital-based staff were aware of patients’ psychological and emotional needs post-injury but felt ill-equipped to respond. GPs considered themselves well positioned to deal with anxiety, depression and other psychological consequences of injury in a similar way to those resulting from other life events.

Item Type: Conference or Workshop Item (Other)
Divisions : Faculty of Arts and Social Sciences > Department of Sociology
Authors :
Earthy, SM
Kendrick, D
Kellezi, B
Sleney, J
Barnes, J
Beckett, K
Jones, T
Date : 2014
Contributors :
ContributionNameEmailORCID for Academic Primary Care,
Additional Information : Posted here with the publisher's permission.
Depositing User : Symplectic Elements
Date Deposited : 12 Sep 2014 14:55
Last Modified : 31 Oct 2017 16:52

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