title: Staff perceptions on patient motives for attending GP-led urgent care centres in London: a qualitative study.
abstract: OBJECTIVE
  General practitioner (GP)-led urgent care centres were established to meet the growing demand for urgent care. Staff members working in such centres are central in influencing patients' choices about which services they use, but little is known about staff perceptions of patients' motives for attending urgent care. We hence aimed to explore their perceptions of patients' motives for attending such centres.
  
  
  METHODS
  A phenomenological, qualitative study, including semistructured interviews. The interviews were analysed using thematic content analysis.
  
  
  METHODS
  2 GP-led urgent care centres in 2 academic hospitals in London.
  
  
  METHODS
  15 staff members working at the centres including 8 GPs, 5 emergency nurse practitioners and 2 receptionists.
  
  
  RESULTS
  We identified 4 main themes: 'Confusion about choices', 'As if increase of appetite had grown; By what it fed on', 'Overt reasons, covert motives' and 'A question of legitimacy'. The participants thought that the centres introduce convenient and fast access for patients. So convenient, that an increasing number of patients use them as a regular alternative to their community GP. The participants perceived that patients attend the centres because they are anxious about their symptoms and view them as serious, cannot get an appointment with their GP quickly and conveniently, are dissatisfied with the GP, or lack self-care skills. Staff members perceived some motives as legitimate (an acute health need and difficulties in getting an appointment), and others as less legitimate (convenience, minor illness, and seeking quicker access to hospital facilities).
  
  
  CONCLUSIONS
  The participants perceived that patients attend urgent care centres because of the convenience of access relative to primary care, as well as sense of acuity and anxiety, lack self-care skills and other reasons. They perceived some motives as more legitimate than others. Attention to unmet needs in primary care can help in promoting balanced access to urgent care.
authors.affiliation: Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK.
authors.forename: Geva
authors.initials: G
authors.lastname: Greenfield
authors.affiliation: Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Ignatowicz
authors.affiliation: Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK.
authors.forename: Shamini
authors.initials: S
authors.lastname: Gnani
authors.affiliation: London Central and West Unscheduled Care Collaborative, London, UK.
authors.forename: Medhavi
authors.initials: M
authors.lastname: Bucktowonsing
authors.affiliation: London Central and West Unscheduled Care Collaborative, London, UK.
authors.forename: Tim
authors.initials: T
authors.lastname: Ladbrooke
authors.affiliation: Charing Cross Hospital Emergency Department, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Hugh
authors.initials: H
authors.lastname: Millington
authors.affiliation: Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK.
authors.forename: Josip
authors.initials: J
authors.lastname: Car
authors.affiliation: Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK.
authors.forename: Azeem
authors.identifier: http://orcid.org/0000-0002-2357-9858
authors.initials: A
authors.lastname: Majeed
mesh_terms: D000046:Academic Medical Centers; D000553:Ambulatory Care / Q000706:statistics & numerical data; D000554:Ambulatory Care Facilities; D001291:Attitude of Health Personnel; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D058005:General Practitioners; D006801:Humans; D008131:London; D009042:Motivation; D009722:Nurse Practitioners; D036301:Qualitative Research
keywords: ACCIDENT & EMERGENCY MEDICINE; PRIMARY CARE; QUALITATIVE RESEARCH