Abstract
BackgroundTheoretical models have sought to comprehend and conceptualise how people seek help from health professionals but it is unclear if such models apply to urgent care. Much previous research does not explain the complex interactions that influence how people make sense of urgent care and how this shapes service use. This paper aims to conceptualise the complexity of sense-making and help-seeking behaviour in peoples’ everyday evaluations of when and how to access modern urgent care provision.MethodsThis study comprised longitudinal semi-structured interviews undertaken in the South of England. We purposively sampled participants 75+, 18–26 years, and from East/Central Europe (sub-sample of 41 received a second interview at + 6–12 months). Framework analysis was thematic and comparative.ResultsThe amount and nature of the effort (work) undertaken to make sense of urgent care was an overarching theme of the analysis. We distinguished three distinct types of work: illness work, moral work and navigation work. These take place at an individual level but are also shared or delegated across social networks and shaped by social context and time. We have developed a conceptual model that shows how people make sense of urgent care through work which then influences help-seeking decisions and action.ConclusionsThere are important intersections between individual work and their social networks, further shaped by social context and time, to influence help-seeking. Recognising different, hidden or additional work for some groups may help design and configure services to support patient work in understanding and navigating urgent care.
Highlights
Theoretical models have sought to comprehend and conceptualise how people seek help from health professionals but it is unclear if such models apply to urgent care
A typology of urgent care work and a conceptual model of urgent care sense-making and help-seeking was developed from analysis of serial semi-structured interviews that explored perspectives, experiences and decision making around urgent care
We show how work takes place at an individual level but may be shared or delegated across social networks and shaped by social context and time
Summary
Theoretical models have sought to comprehend and conceptualise how people seek help from health professionals but it is unclear if such models apply to urgent care. A range of urgent care services is available in England alongside emergency departments and the 999 emergency ambulance service These include general practice out-of-hours services, a telephone-based triage non-emergency service that can assess and refer patients to different services (‘NHS 111’), walk-in centres, and minor injuries units. A further policy imperative has been an aspiration to use urgent care to divert people away from overcrowded emergency services and to encourage greater use of self-care [8]. The impact of these structural changes has created an increasingly complex care landscape characterised by fragmentation and blurred boundaries between services [14]. In the face of this complexity, there is a need to understand peoples’ help-seeking behaviours and the work that they do to make sense of urgent care
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