Falling Through the Cracks: Patients’ Experiences of Care after Injury

Sarah Earthy, Denise Kendrick, Blerina Kellezi, Judith Sleney, Jo Barnes, Kate Beckett and Trevor Jones on Behalf

of the Impact of Injury Group

Elevator Pitch presentation at the 43rd Annual

Conference of the Society for Academic Primary Care, Edinburgh, 11th July 2014

Professor Denise Kendrick Dr Blerina Kellezi Trevor Jones

Kate BeckettProfessor Elizabeth Towner Dr Sarah Earthy

Judith Sleney

Dr Jo BarnesProf. Andrew Morris

Collaboration for Leadership inApplied Health Research and Care

Nottingham, Derbyshire & Lincolnshire

SAPC 2014: Falling Through the Cracks: Patients’ Experiences of Care after an Injury

• Multicentre longitudinal (12 months) quantitative study • 668 working age adults admitted to acute NHS Trusts in 4 study centres

(Protocol in Kendrick, D., et al., BMC Public Health, 2011.)

Nested qualitative interview study 45 patients 18 carers 40 service providers

(including 3 GPs)

…the impact is also psychological, emotional, financial and social

Injury is physical but…

SAPC 2014: Falling Through the Cracks: Patients’ Experiences of Care after an Injury

“it impacts on every aspect of your life; your work, your

social life, your family, everything” (59 year old man)

“and I couldn’t sort of cope with things, which

is not me at all” (69 year old woman)

“Their anxiety and depression in a way is not different from somebody who maybe

lost their job or had several bereavements in the family and how the therapist would work to help them will be similar. [..] But you’re talking about quite a few months down the line because we expect most

people just to cope with it and get over it.” (GP)

“My GP… is absolutely brilliant and she phoned me up when I came out

of hospital to find out how I was and if there was anything she could do.” (54 year old woman)

“I’ve got to stop being so afraid of doing things. […] Some days were like swimming through mud, I didn’t feel I was getting

anywhere.” (68 year old woman, lower limb injury)

“You just wish there was something for them because I don’t have time or the capacity to deal with it. I don’t even have the skill set to sit there

and listen and talk somebody through that.” (Orthopaedic Surgeon)

SAPC 2014: Falling Through the Cracks: Patients’ Experiences of Care after an Injury

Secondary Care – clinical management of the physical injury

Primary Care – relatively uninvolved post-injury; potential

for improving psychological support to injured patients?

Patients - isolated, anxious,

distressed