Inclusion Health Action in General Practice (IHAGP): evaluation

Appendix D: Patient Interview Discussion Guide

Inclusion Health Action in General Practice Evaluation

Discussion Guide: Patient Interviews

Perceptions of GP (10 mins)

We’ll begin by discussing your experiences with your local GP service.

To start, in one word, how would you describe your experience at your GP?

Probe: what makes you say that?

Would you say it’s generally a positive or negative experience?

Probe: and why is that?

Do you trust that you can get an appointment at your GP when you need to?

Probe: why/why not?

Do you trust your general practice to provide good quality care?

Probe: why/why not?

Do you feel listened to by staff at your general practice when you go to them with an issue?

Probe: why/why not?

Probe for examples.

Participant Check-In #1

Thank you for being so open about your experiences with your general practice.

I’m now going to ask a series of questions about how you access your general practice.

Are you happy to keep going?

Personal experiences with GP (15 minutes)

How do you currently interact with your general practice?

PROBE:

• When was your last appointment at your GP practice?
• How often do you contact your GP practice?
• How do you make appointments? (Phone the practice? Use an app? Another way?)
• How long do you wait to ‘be seen’ after contacting the practice?
• What type of appointments are you normally given? (e.g. are they in person, over the phone, mix of both?)
  • Probe: which of these do you prefer? Why is this?
  • Probe: do you have any home visits?
    • What are these like? What type/s of practice staff come to your home? (e.g. GP, nurse)
    • How often do you have home visits?
• Do you feel you were seen by the right type of practice staff for your needs? (e.g. doctor, practice nurse, advanced nurse practitioner, mental health nurse, community link worker, allied health professional e.g. physiotherapist, pharmacist)
• How long are your appointments normally? (e.g. standard vs extended appointments)

And how long have you been a patient at your GP?

Has your experience at your GP changed since you first started going there?

Probe: in what ways?

Probe: has this change been generally for the better or the worse?

Has your general practice contacted you to check in, help you book an appointment or offer support?

If yes

How did they contact you?

Probe: by phone, letter, other?

Did you find this [outreach] helpful?

Probe: why/why not?

Probe: did it help you manage your health/condition? Feel confident doing so?

Probe: did it make you feel more supported by your general practice?

And how would you say this outreach has impacted your relationship with the practice?

Probe: made more trusting of the practice?

Probe: changed how you view the practice?

Probe: made more willing or confident to interact with the practice in future?

Is there anything that would have made this outreach more helpful to you?

Specific examples of how longer consultations or additional support benefited them (10 minutes)

We mentioned the length of appointments earlier.

Have you been given an appointment of longer than 10 minutes (extended appointment) at your General Practice in the past year?

If yes:

• How many of these have you had in the past year? Who are they with? (e.g. GP, advanced nurse practitioner)
• Do you find these useful?
  • If yes, why?
  • If no, why not?
• What do you think is particularly good about these?

Probe for examples

Probe: did it help you manage your condition? Feel confident doing so?

Probe: did it make you feel more supported by your general practice?

Have you attended any of the following through your GP practice?

• Group to provide feedback on your experience
• Health or wellbeing group/session
  • Probe: based in the community or with member of gp team?

Participant Check-In #2

Thank you for telling us a bit more about your experience at your GP.

I’m next going to ask about any barriers you experience to accessing your GP and what you think could be done to improve this.

Are you happy to keep going?

Any remaining barriers to accessing care and suggestions for improvement (10 minutes)

Is there anything that makes it hard for you to get care or support from your General Practice?

[E.g. registration, booking process, GP preference, getting to/attending appointments, interpreters]

Prompt: is there anything that makes it particularly difficult?

Do you feel like you know enough about the services that your General Practice offers?

Probe: is there clear information on this? How do you find this information?

How would you prefer for your general practice to get in touch with you?

What do you think could improve your experience at your General Practice?

Probe for suggestions

What do you think could improve your relationship with your General Practice staff?

Probe for suggestions

Conclusions and wrap-up (2 mins)

Thank you very much for taking the time to share your views with me today – is there anything that we didn’t cover that you would like to mention?

Reaffirm confidentiality

Mention £35 incentive payment (for patients)

Thank and close