No abstract

This is the unspecified version of the paper.This version of the publication may differ from the final published version. The health user survey identified younger rather than older users (mean age of 35.6 years -SD 15.5), where 50% had not seen a health professional about their concern, with over 40% unable to obtain a convenient or emergency appointment with their GP. Over a third of the attendees were already receiving treatment and over 40% of these saw their complaint as an emergency. Over half of respondents expected to see a doctor, one-quarter expected to see a nurse and only 1% expected to see a pharmacist across both services, although WiCs are nurse-led services. More respondents expected a prescription from a visit to a WiC, whereas in the ED a third of respondents sought health advice or reassurance. Conclusion: A number of unscheduled care strategies are, or have just been, developed with the emphasis on moving demand into community-based services. Plurality of services provides service users with a range of alternative access points but can cause duplication of services and repeat attendance. Managing continued increase in emergency and unscheduled care is a challenge. The uncertainties in prospective decision making could be used to inform service development and delivery. Permanent repository link

One aspect of the implementation of patient-centred care is the improvement of consultations between service users and practitioners, and this can be done through 'communicative action'. This article explains how observing video recordings of consultations in a walk-in centre can help service users and practitioners better understand each other's conversations and interactions.

A video lifeworld or a conversation analysis approach for analysing health care consultations 21.03.2011 1 Socio phenomenology and conversation analysis: interpreting video lifeworld health care interactions.

This is the unspecified version of the paper.This version of the publication may differ from the final published version. alike to understand the dynamics of videoed health consultations, the role of the participants within it and the potential to consciously alter the outcome by altering behaviour during the process of interaction. The empirical study examines health consultation participation and develops an interpretative method of analysis that includes image elicitation (via videos), phenomenology (to identify the components of the analytic framework), text and narrative (to depict the stories of interactions) and a reflexive mode (to develop the conceptual framework for analysis).. The analytic framework is derived from a lifeworld conception of human mutual shared interaction which is presented here as a novel approach to understanding patient-centred care. The video materials used in this study were derived from consultations in a Walk-in Centre (WiC) in East London. The conceptual framework produced through the process of video analysis is comprised of different combinations of movement, knowledge and emotional conversations that are used to classify objective or engaged WiC health care Permanent repository linkinteractions. The videod interactions organise along an active or passive, facilitative or directive typical situation continuum illustrating different kinds of textual approaches to practice that are in tension or harmony.The schema demonstrates how practitioners and consumers interact to produce these outcomes and indicates the potential for both consumers and practitioners to be educated to develop practice dynamics that support patientcentred care and impact on health outcomes.