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dc.contributor.authorQuinn, Cen
dc.contributor.authorDenman, Ken
dc.contributor.authorSmithson, Pen
dc.contributor.authorOwens, Cen
dc.contributor.authorSheaff, WRen
dc.contributor.authorCampbell, Jen
dc.contributor.authorPorter, Ien
dc.contributor.authorAnnison, Jen
dc.contributor.authorByng, Ren
dc.date.accessioned2018-02-02T14:38:24Z
dc.date.available2018-02-02T14:38:24Z
dc.date.issued2018-02-02en
dc.identifier.issn1471-2296en
dc.identifier.urihttp://hdl.handle.net/10026.1/10723
dc.description.abstract

Abstract Background: Offenders frequently have substantial healthcare needs and, like many other socially marginalised groups, often receive healthcare in inverse proportion to their needs. Improved continuity of healthcare over time could contribute to addressing these needs. General Practitioners need to be able to support people with complex social and medical problems, even in systems that are not specifically designed to manage individuals with such degrees of complexity. We aimed to examine offenders’ perspectives on factors that contributed to, or worked against, creating and sustaining their access to healthcare. Methods: From a sample of 200 participants serving community or prison sentences in South West (SW) and South East (SE) England, who were interviewed about their health care experiences as part of the Care for Offenders: Continuity of Access (COCOA) study, we purposively sampled 22 participants for this sub-study, based on service use. These interviews were transcribed verbatim. A thematic analytic approach initially applied 5 a priori codes based on access and different components of continuity. Data were then examined for factors that contributed to achieving and disrupting access and continuity. Results: Participants described how their own life situations and behaviours contributed to their problems in accessing healthcare and also identified barriers created by existing access arrangements. They also highlighted how some General Practitioners used their initiative and skills to ‘workaround’ the system, and build positive relationships with them; feeling listened to and building trust were particularly valued, as was clear communication. Limitations faced by General Practitioners included a lack of appropriate services to refer people to, where the offender patients would meet the access criteria, and disagreements regarding medication prescriptions. Conclusions: General Practitioners can make a positive contribution to supporting access to healthcare for an under-served population by facilitating more flexible and less formal access arrangements, by using their relationship skills, and by problem-solving. General Practitioners should recognise their potential to transform people’s experience of healthcare whilst working in imperfect systems, particularly with vulnerable and marginalised groups who have complex medical and social needs.

en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.subjectgeneral practitioneren
dc.subjectprinary careen
dc.subjectaccessen
dc.subjectcontinuityen
dc.subjectoffendersen
dc.subjectqualitativeen
dc.titleGeneral practitioner contributions to achieving sustained healthcare for offenders: a qualitative studyen
dc.typeJournal Article
plymouth.volume19en
plymouth.publisher-urlhttps://link.springer.com/epdf/10.1186/s12875-018-0708-7?author_access_token=MLiMx9ovtbeerLKuFcvp62_BpE1tBhCbnbw3BuzI2RNRmo4FQv850D8oiXPmVs9a93TqyOUUwCfOMFB2XsE5Xl9G62mm1dEPiLVIVDhfKfBv8Mh73SGXXZ5BZ86WjDSh3txPkPf6uQEC1Mm-keR0QQ==en
plymouth.publication-statusPublisheden
plymouth.journalBMC Family Practiceen
dc.identifier.doi10.1186/s12875-018-0708-7en
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/00 Groups by role
plymouth.organisational-group/Plymouth/00 Groups by role/Academics
plymouth.organisational-group/Plymouth/00 Groups by role/Professional Services staff
plymouth.organisational-group/Plymouth/Faculty of Business
plymouth.organisational-group/Plymouth/Faculty of Business/Plymouth Business School
plymouth.organisational-group/Plymouth/Faculty of Medicine and Dentistry
plymouth.organisational-group/Plymouth/Faculty of Medicine and Dentistry/Centre for Clinical Trials & Health Research
plymouth.organisational-group/Plymouth/Faculty of Medicine and Dentistry/Centre for Clinical Trials & Health Research/RC reporting group CTPS
plymouth.organisational-group/Plymouth/Faculty of Medicine and Dentistry/Collaboration for the Advancement of Medical Education Research Assessment
plymouth.organisational-group/Plymouth/Faculty of Medicine and Dentistry/PenCLAHRC
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA18 Law
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA20 Social Work and Social Policy
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/Institute of Health and Community
plymouth.organisational-group/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)
plymouth.organisational-group/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)/CCT&PS
dcterms.dateAccepted2018-01-24en
dc.rights.embargoperiodNot knownen
rioxxterms.versionofrecord10.1186/s12875-018-0708-7en
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2018-02-02en
rioxxterms.typeJournal Article/Reviewen


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