Seeking support after hospitalisation for injury: a nested qualitative study of the role of primary care

Background: In the UK, studies suggest that the transition from hospital to home after an injury can be a difficult time and many patients report feeling inadequately prepared. Patients often use primary care services after hospital discharge. These consultations provide opportunities to consider problems that patients experience and to facilitate recovery. Little is known, however, about how patients and service providers view care after hospital discharge and the role played by primary care services, specifically GPs. Aim: To identify good practice and unmet needs in respect of post-discharge support for injured patients. Design and setting: Qualitative study using semi-structured interviews at four sites (Bristol, Leicester/ Loughborough, Nottingham, and Surrey). Method: Qualitative interviews with 40 service providers and 45 hospitalised injured patients. Results: Although there were examples of well-managed hospital discharges, many patients felt they were not provided with the information they needed about their injury, what to expect in terms of recovery, pain control, return to work, psychological problems, and services to help meet their needs. They also described difficulty accessing services such as physiotherapy or counselling. Service providers identified problems with communication between secondary and primary care, lack of access to physiotherapy, poor communication about other services that may help patients, GP service and resource constraints, and difficulties in providing information to patients concerning likely prognosis. Conclusion: Discharge from hospital after an injury can be problematic for patients. Changes in both secondary and primary care are required to resolve this problem