title: Seeking support after hospitalisation for injury: a nested qualitative study of the role of primary care.
abstract: 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.
  
  
  OBJECTIVE
  To identify good practice and unmet needs in respect of post-discharge support for injured patients.
  
  
  METHODS
  Qualitative study using semi-structured interviews at four sites (Bristol, Leicester/Loughborough, Nottingham, and Surrey).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Discharge from hospital after an injury can be problematic for patients. Changes in both secondary and primary care are required to resolve this problem.
authors.affiliation: Centre for Transport Studies, Department of Civil, Environmental and Geomatic Engineering, Faculty of Engineering Science, University College London, London.
authors.forename: Nicola
authors.initials: N
authors.lastname: Christie
authors.affiliation: University of the West of England, Research and Innovation, University Hospitals Bristol NHS Foundation Trust, Education Centre, Bristol.
authors.forename: Kate
authors.initials: K
authors.lastname: Beckett
authors.affiliation: Department of Sociology, University of Surrey, Guildford, Surrey.
authors.forename: Sarah
authors.initials: S
authors.lastname: Earthy
authors.affiliation: Nottingham Trent University, Nottingham.
authors.forename: Blerina
authors.initials: B
authors.lastname: Kellezi
authors.affiliation: Department of Sociology, University of Surrey, Guildford, Surrey.
authors.forename: Jude
authors.initials: J
authors.lastname: Sleney
authors.affiliation: Loughborough Design School, Loughborough.
authors.forename: Jo
authors.initials: J
authors.lastname: Barnes
authors.affiliation: Collaboration for Leadership in Applied Health Research and Care (CLAHRC) East Midlands, Nottingham.
authors.forename: Trevor
authors.initials: T
authors.lastname: Jones
authors.affiliation: Division of Primary Care, School of Medicine, Nottingham University, University Park, Nottingham.
authors.forename: Denise
authors.initials: D
authors.lastname: Kendrick
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006301:Health Services Needs and Demand / Q000458:organization & administration*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000458:organization & administration*; D036301:Qualitative Research; D012017:Referral and Consultation; D012189:Retrospective Studies; D006113:United Kingdom; D014947:Wounds and Injuries / Q000628:therapy*; D055815:Young Adult
keywords: general practitioners; injury; patient discharge; primary health care