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Identifying patient-centred recommendations for improving patient safety in General Practices in England: A qualitative content analysis of free-text responses using the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire

Lookup NU author(s): Professor Sarah SlightORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2017 John Wiley & Sons Ltd. Background: There is a growing interest in identifying strategies to achieve safer primary health-care provision. However, most of the research conducted so far in this area relies on information supplied by health-care providers, and limited attention has been paid to patients' perspectives. Objective: To explore patients' experiences and perceptions of patient safety in English general practices with the aim of eliciting patient-centred recommendations for improving patient safety. Methods: The Patient Reported Experiences and Outcomes of Safety in Primary Care questionnaire was sent to a random sample of 6736 primary care users registered in 45 English practices. We conducted a qualitative content analysis of responses to seven open-ended items addressing patients' experiences of safety problems, lessons learnt as a result of such experiences and recommendations for safer health care. Results: A total of 1244 (18.4%) participants returned completed questionnaires. Of those, 678 (54.5%) responded to at least one open-ended question. Two main themes emerged as follows: (i) experiences of safety problems and (ii) good practices and recommendations to improve patient safety in primary care. Most frequent experiences of safety problems were related to appointments, coordination between providers, tests, medication and diagnosis. Patients' responses to these problems included increased patient activation (eg speaking up about concerns with their health care) and avoidance of unnecessary health care. Recommendations for safer health care included improvements in patient-centred communication, continuity of care, timely appointments, technical quality of care, active monitoring, teamwork, health records and practice environment. Conclusion: This study identified a number of patient-centred recommendations for improving patient safety in English general practices.

Publication metadata

Author(s): Ricci-Cabello I, Saletti-Cuesta L, Slight SP, Valderas JM

Publication type: Article

Publication status: Published

Journal: Health Expectations

Year: 2017

Volume: 20

Issue: 5

Pages: 961-972

Print publication date: 01/10/2017

Online publication date: 28/02/2017

Acceptance date: 15/12/2016

Date deposited: 09/08/2017

ISSN (print): 1369-6513

ISSN (electronic): 1369-7625

Publisher: John Wiley & Sons Ltd


DOI: 10.1111/hex.12537


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Funder referenceFunder name
part-funded by the National Institute for Health Research School for Primary Care Research (NIHR SPCR).