Urgent care out of hours: a comparison of the experiences of older people and parents of young children in a semi-rural area

Aim: Older people and parents of young children are the most frequent users of out of hours care. However, their needs and expectations of care may be different. The aim of this study was to explore and compare the experiences and views of these two groups following the transfer of responsibility for out of hours services from General Practitioners (GPs) to a Primary Care Trust (PCT). Methods: Qualitative research using semi-structured interviews with 19 informants living in a geographically large, semirural PCT area in England served by 15 GP practices. Interviews were taped, transcribed and analysed using a thematic framework. Findings: Older people presented with more complex health problems than young children, and expressed more reluctance at calling the service. Both groups experienced similar access problems for using the primary care centre (PCC). Older people reported fewer difficulties obtaining a home visit, though experienced continuity problems when illness episodes lasted longer than one shift. Both groups questioned the ability of a doctor to diagnose accurately using only telephone assessment. Conclusion: Despite differences in presenting symptoms and attitudes to service use, older people and parents with young children experienced similar problems in accessing care at the PCC. Older people more frequently received home visits than parents with young children, and it may be that social context is not sufficiently taken into account when assessing need for a home visit. Practitioners should be aware that older people tend to minimise symptoms and should be cautious of relying on lay interpretations of illness when carrying out telephone assessments with this group.