Overview Summary of Project
This study addresses the overuse of healthcare interventions in UK primary care, which can harm patients and strain healthcare systems. Overuse includes unnecessary tests, treatments, referrals, or diagnoses that are unlikely to benefit patients but could cause harm, such as side effects, psychological distress, or financial burdens. Healthcare professionals (HCPs) face challenges balancing necessary care with avoiding overuse, often due to factors like diagnostic uncertainty, fear of complaints, time pressures, patient expectations, and rigid clinical guidelines.
This research explores HCPs’ experiences and perceptions of ‘not doing’, the intentional decision to avoid unnecessary interventions based on patients’ medical needs, values, and preferences. It also examines the under-researched area of documenting such decisions. Current professional guidelines offer limited direction in the documentation of ‘not doing’, and HCPs are often apprehensive about potential repercussions.
This study, grounded in social constructivism, uses 40 semi-structured interviews with HCPs, including GPs, Paramedics and Nurses. Participants are recruited through purposive sampling. An interview guide, co-designed with PPI representatives and GP advisors, uses text-based vignettes to prompt discussion.
Interviews conducted via video call are audio recorded, transcribed, and analysed using Reflexive Thematic Analysis (RTA) with NVivo software. This method highlights patterns and variations while ensuring reflexivity and rigour.
Questions
In Primary Care within the UK NHS, how can the decision-making processes concerning the choice not to undertake specific actions ('not do') be effectively recorded to instill confidence and reassurance in the HCPs making the decisions? Sub-questions. 1. What are HCPs' perceptions and experiences of decision-making in the context of ‘not doing’ in primary care? 2. What are the views of HCPs in primary care on recording and accounting for ‘not doing’? 3. What are the views of HCPs regarding what more could be done to encourage the adoption of a ‘not doing’ approach in primary care?
