Patients' perceptions and experiences of patient safety in primary care in England.
One of the most remarkable features of patient safety research in primary care is the sparse attention paid to patients' own experiences.



To explore patient's perceptions and experiences of patient safety in primary care in England.



We conducted a qualitative study in the South of England with an opportunistic sample of 27 primary care users. Information was obtained from four patient focus groups. A thematic content analysis was conducted by three analysts and consensus reached within the research team on the key themes that emerged.



Participants' conceptualizations of patient safety referred to high standards of health care delivery within a relationship of trust. Participants identified four main factors that they believed could potentially affect patient safety. These included factors related to (i) the patient (attitudes, behaviours and health literacy); (ii) the health professional (attitudes, behaviours and accuracy of diagnoses); (iii) the relationship between patients and health professionals (communication and trust); and (iv) the health care system (workload, resources, care coordination, accessibility, interdisciplinary teamwork and accuracy of health care records). Confidentiality, continuity of care and treatment-related safety emerged as cross-cutting major threats to patient safety.



The exploration of participants' perceptions and experiences allowed the identification of a wide variety of themes that were perceived to impact on patient safety in primary care. The findings of this study could be used to enrich current frameworks that are exclusively based on professional or health care system perspectives.
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK, ignacio.riccicabello@phc.ox.ac.uk.
Ignacio
I
Ricci-Cabello
Àrea de recerca. Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain, Centre de recerca adscrit. Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain.
Mariona
M
Pons-Vigués
Àrea de recerca. Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain, Centre de recerca adscrit. Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain.
Anna
A
Berenguera
Àrea de recerca. Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain, Centre de recerca adscrit. Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain.
Enriqueta
E
Pujol-Ribera
Department of Pharmacy, School of Medicine Pharmacy and Health, Durham University, Durham, UK, Department of Pharmacy, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, The Center for Patient Safety Research and Practice, Division of General Internal Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA and.
Sarah Patricia
SP
Slight
Institute for Health Research, University of Exeter Collaboration for Academic Primary Care (APEx), University of Exeter Medical School, Exeter, UK.
Jose Maria
JM
Valderas
D000328:Adult; D000368:Aged; D003142:Communication; D003266:Continuity of Patient Care / Q000592:standards*; D004739:England; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000592:standards*; D036301:Qualitative Research
Focus groups; health services research; patient safety; primary health care; qualitative research.