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Background: The National Health Service (NHS) and general practice are increasingly adopting digital services. These services can impact both positively and negatively upon patient experiences, and access to digital services is not equal amongst all groups. Within a wider project examining digital facilitation (the Di-Facto study) our team conducted a patient survey amongst English primary care practices aiming to investigate patient views of what supports uptake and use of web-based services. This paper reports on the analysis of the free-text responses from the patient survey. Methods: The Di-Facto patient survey was distributed to practices in eight clinical commissioning groups (CCGs) in England between 2021–2022. We examined free-text responses to two questions relating to access to primary care web-based and support for web-based services. We used qualitative reflexive thematic analysis based on a six-stage process to analyse responses. Results: Of the 3051 patients who responded to the Di-Facto survey, 2246 provided a free-text response. We present our findings in two major themes: systems and structures and their impact on use of web-based services, and 'what works for me', a description of how respondents described what worked, or did not work in terms of their interactions with web-based services. Respondents described how the technology, such as poor practice website design, confusion over multiple digital apps, data security and concerns about eConsultation offerings impacted on use of web-based services. Respondents described practice level barriers, such as a lack of or inconsistent provision, which prevented optimal use of web-based services. Respondents described personal and technical barriers that impacted on their use of digital services, and described which web-based services worked well for them. Respondents felt that web-based services were not a replacement for face-to-face interactions with a doctor. Conclusions: This analysis of free-text responses from a large patient survey highlights the system, practice, and person level barriers and facilitators to use of digital services in primary care. With an increasing push towards digital solutions in NHS primary care, practices should consider the design, rollout and communication of their web-based services to support patient access. [ABSTRACT FROM AUTHOR]

Background Health literacy is important because of the high proportion of the population with skills below those needed to become and stay healthy, and the resultant negative impact on people's lives. A recent study in England has shown that, as is true in other industrialized nations, a significant proportion of people (43–61%) have literacy and numeracy skills below those needed to fully understand and use health materials. This paper describes a project designed to build on these findings with key stakeholders to develop an action plan to address a mismatch between population skills and the health system complexity. Method The multi-stage project involved an initial meeting of stakeholders that allowed participants to share knowledge and experience, and make suggestions for change. Subsequent web-based surveys enabled widening of the stakeholder group, identification of further potential actions, and participant rating of the impact of the suggested actions on this mismatch. Next, a meeting enabled the group to identify priorities for change that would be feasible and cost-effective. Results Forty-one participants were recruited from a range of patient, health, lifelong learning, civil service, and industry perspectives. Suggested topics for action fell into four areas; improving health services, building health literacy skills in the population and workforce, recognizing the importance of public information developed outside the health arena, and funding for health literacy research and development. Following consideration of likely cost, impact, and feasibility, five suggested areas were prioritized for action, three involving improvements in the health service, and two involving the development of public health literacy skills. The importance of inter-sectoral approaches to this complex issue was identified. Discussion This project recruited key stakeholders with a wide range of relevant expertise and perspectives. It resulted in a clear, coherent action plan to address the population skills: health system complexity mismatch. Next steps include implementation, evaluation, and widening to other areas of life important to public health and well-being such as public safety messages and social care. [ABSTRACT FROM AUTHOR]

This paper outlines a service improvement project undertaken in one acute cardiac ward within a regional NHS trust in the east of England that explored the impact of advancing patient- and family-centred care within an acute adult setting. The project was implemented and evaluated over a 9-month period between March and December 2012 and data collected via a pre and post-intervention survey. The results demonstrated that the majority of family carers wanted to be involved in patient care. The provision of flexible family visiting, facilitated and supported family carer involvement in care provision and improved partnership working between family carers and the multidisciplinary team, had a positive impact on the patient and family carer experience. This project has demonstrated the value of involving family carers in acute adult inpatient care provision and the importance of flexible family visiting to enable this to be successful. [ABSTRACT FROM AUTHOR]

Accessible summary We gave a questionnaire to self-advocates who were attending a conference. The questionnaire asked them how they felt about the information they get with their medicine., Fifty-eight people completed the questionnaire. Many of them said they did not get enough information about their medicine. Most people wanted easy-read leaflets and pictures., There are many different places to find easy-read information on the internet. We think they should be collected and checked. We also think that doctors and chemists need to spend more time with people to explain about medicines., Abstract Background Previous research has found that people with learning disabilities are not given prescription information that is tailored to their needs. We wanted to find out people's information requirements. Materials and Methods A questionnaire was co-produced by the authors and consultants with learning disabilities. It asked what information people received from their GP and pharmacist about medications. The questionnaire was circulated at a self-advocacy conference in the North of England. Fifty-eight self-advocates completed the questionnaire. Results Information from GPs and pharmacists was mainly instructional, referring to when and how to take the medicine and dosage. Most respondents struggled to read the leaflets and remember verbal information. Many wanted the information in easy-read format, and some wanted pictures or diagrams as well. A key theme was that health professionals often talked only to carers or support workers rather than involving the patient directly, and some respondents disclosed that they were not informed about side effects or alternative medications. Conclusions Health professionals should take time to discuss health issues and medication with the individual rather than only with carers. This could be facilitated by providing information in an accessible format. [ABSTRACT FROM AUTHOR]

The article discusses a British study that investigated the association between the type of organization providing out of hours general practitioner and services users' experience of such care and sociodemographic characteristics of service and their experiences of such care. Topics include the possibility of recall bias regarding the timing and experience of the contact, and poorer overall experience of care in Asian service users than white service users.