Southampton communication study (SoCS): managing multiple health concerns

Patients often attend GP appointments with more than one health concern. Evidence suggests patients can find it difficult to voice all of their problems. GPs can struggle to ask about patients additional concerns, especially in the time limited 10 minute consultation.  Little is known about how and when patients raise additional concerns in UK GP consultations and how GPs respond to multiple health concerns. The consequences of different approaches in terms of the full voicing and discussion of concerns and for the smooth progression of the consultation are poorly understood in UK General Practice. The proposed project team will analyse 320 video recordings of GP-patient consultations with 21 GPs, gathered from 11 practices across the South of England (recorded in the Eliciting Patient Concerns Study funded by the SPCR (EPaC)). In this study, whilst patient satisfaction was high amongst the 320 participants after their consultations (as measured by MISS-21 questionnaire), early analysis of some of the recorded consultations suggests that there were some difficulties (such as GPs struggling with patients who arrive with lists of health concerns, and patients finding it difficult to raise or voice their concerns) and difficulties such as these warrant attention. Our proposed further analysis will count the concerns discussed (including how and when in the consultation). This will be followed by a detailed analysis of a smaller number of consultations to look at how patient concerns are raised and then managed, which will entail looking at not only what is said but also how it is said (e.g. volume, laughter, intonation, gaps in talk, overlap), which can be consequential for the discussion of concerns. Our analysis will highlight common moments of miscommunication and identify recommendations for avoiding such moments, with a view to improving the management of patients’ multiple health concerns, using real examples of GP-patient interactions.