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. 2024 May 31;25(1):193.
doi: 10.1186/s12875-024-02443-z.

Telephone consulting for 'Personalised Care and Support Planning' with people with long-term conditions: a qualitative study of healthcare professionals' experiences during COVID-19 restrictions and beyond

Sharon McCann  1 , Vikki A Entwistle  2   3 , Lindsay Oliver  4 , Nick Lewis-Barned  4 , Rebecca Haines  5 , Alan Cribb  6
Affiliations

Telephone consulting for 'Personalised Care and Support Planning' with people with long-term conditions: a qualitative study of healthcare professionals' experiences during COVID-19 restrictions and beyond

Sharon McCann et al. BMC Prim Care. .

Abstract

Background: Personalised Care and Support Planning (PCSP) replaces conventional annual reviews for people with long-term conditions. It is designed to help healthcare professionals (HCPs) and patients engage in conversations as equals and collaboratively plan actions oriented to each patient's priorities, alongside biomedical concerns. Little is known about how the shift to remote consulting initiated with COVID-19 restrictions has impacted PCSP.

Aim: To investigate HCPs' experiences of conducting PCSP conversations remotely and consider implications for the fulfilment of PCSP ambitions as remote consulting continues beyond COVID-19 restrictions.

Methods: 19 semi-structured interviews with HCPs in England and Scotland; interpretive analysis.

Results: HCPs' accounts made clear that COVID-19 restrictions impacted multiple aspects of PCSP delivery, not just the mode of conversation. Broader disruption to general practice systems for gathering and sharing information ahead of PCSP conversations, and moves to 'wide window' appointment times, made it harder for patients to be prepared for PCSP conversations. This constrained scope to achieve PCSP ambitions even with the best professional communication skills. Most remote PCSP conversations were conducted by telephone. In the absence of visual communication with patients, it was sometimes harder to achieve the ambitions of PCSP conversations, including to balance patient and professional agendas, fulfil key planning activities, and foster a relational ethos of equal, collaborative partnership. The challenges were particularly severe when working with new patients and people with complex clinical and social problems. Although options for telephone appointments now offer valued flexibility, sustained experience of struggling to achieve PCSP ambitions via remote consulting led some HCPs to lower their standards for judging a "good" PCSP conversation, and to diminished professional satisfaction.

Conclusions: There are significant challenges to fulfilling the ambitions of PCSP via telephone, especially when preparatory support is limited. This study provides grounds for scepticism about how compatible telephone appointments can be with this person-centred model of working, especially for people who are socially disadvantaged and live with complex health conditions. These threats to the provision of person-centred support for people with long-term conditions warrant careful attention going forward if the PCSP model and its benefits are to be sustained.

Keywords: Healthcare professionals’ experiences; Long-term conditions; Person-centred care; Personalised care and support planning; Primary care; Qualitative interviews; Self-management support; Telephone consulting..

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Conflict of interest statement

LO and NLB contributed to the development of the PCSP approach and work with the Year of Care Partnership®, an NHS organisation that supports the implementation of personalised care and support planning for people with long term conditions. LO (co-author and YOCP National Director) and RH (co-author and GP) were both included as interviewees for this study. All other authors declared no competing interests.

Figures

Fig. 1
Fig. 1
Structure of the PCSP approach
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