In the United Kingdom (UK) and internationally, general practitioners (GPs) arrange large numbers of laboratory tests, radiological and other investigations for patients in their care. The UK Quality and Outcomes Framework of the GP Contract expanded primary healthcare’s involvement in the management of many long-term conditions increasing the number of investigations performed by general practices . This is likely to continue given the Scottish Government’s vision that primary healthcare teams will undertake more complex work in partnership with other community agencies [2, 3].
In order to cope with the increasing complexity and volume of primary healthcare work, administrators have developed additional skills and responsibilities such as co-ordination of repeat prescribing systems, undertaking phlebotomy and healthcare assistant duties [4–6]. In addition, they are often involved in the handling and communication of test results to patients which carries a significant, often safety-critical risk.
Primary healthcare based research and improvement studies concerned with the management of laboratory tests results have demonstrated the potential for patients to be avoidably harmed as a consequence of inadequate systems, including the communication processes for informing patients of test result outcomes and necessary follow-up actions [7, 8]. A significant proportion of all medico-legal claims in primary healthcare are related to delayed, missed or inaccurate diagnoses with unsafe and ineffective laboratory test ordering and results management systems frequently cited as contributory factors in these failures .
However, much of the patient safety work is limited to the study of USA and European secondary healthcare systems [7, 8, 10–14]. Overall, there is a paucity of related research in the United Kingdom (UK) and wider Europe despite the widespread recognition of the safety-critical nature of this issue in the evidence base and by medical indemnity organisations. Much of the aforementioned research has focused on the critical review of organisational systems, and of the perceptions and experiences of clinicians and healthcare managers on what can go wrong [8, 15–18]. The views and experiences of patients who routinely interact with frontline primary healthcare staff when attending for investigations and re-attending for results are limited to a small number of studies, but none has been undertaken in the European context. The critical importance of the voice of patients in contributing to patient safety research and improvement is lacking, particularly on this issue where they are able to directly observe and experience potential and actual human-system errors and their consequences on a daily basis .
There is a lack of evidence on how patients’ experiences of interacting with the practices’ results handling systems impacts upon safety. Patients’ understanding of the responsibilities of healthcare professionals and staff and their experience as partners in the communication of results is required to help inform safe and effective systems . The aim of this study was to identify the perceptions and experiences of patients with respect to the handling and communication of test results in primary healthcare.