Across a range of long-term conditions, patients' experiences of health care can be understood in terms of nuanced understandings of relational and management continuity. Continuity experiences, meanings and expectations, as well as barriers and facilitators, are influenced by the model of care rather than type of condition.

Patient preference studies could provide valuable insights to a National Institute for Health and Care Excellence committee into the preferences patients have for different treatment options, especially if the study sample is representative of the broader patient population. We identify three main uses of patient preference studies along a technology's pathway from drug development to clinical use: in early clinical development to guide the selection of appropriate endpoints, to inform benefitrisk assessments carried out by regulators and to inform reimbursement decisions made by health technology assessment bodies. In the context of the National Institute for Health and Care Excellence's methods and processes, we do not see a role for quantitative patient preference data to be directly incorporated into health economic modelling. Rather, we see a role for patient preference studies to be submitted alongside other types of evidence. Examples where patient preference studies might have added value in health technology assessments include cases where two distinctly different treatment options are being compared, when patients have to decide between multiple treatment options, when technologies have important nonhealth benefits or when a treatment is indicated for a heterogenous population.

People with many long-term conditions are at increased risk of inadequate management continuity with potential negative impacts on their care. Experiences of relational continuity, with potential buffering effects, are not associated with the number of long-term conditions.

Objectives: To explore patients' perceptions of events that may represent errors in long-term illness care and evaluate potential associations with dimensions of quality in health care. Methods: Qualitative study based on semi-structured interviews with 33 patients with long-term conditions. Results: Patients' accounts revealed experiences of errors arising from health care. Errors of access included difficulties of gate-keeping leading to problems in gaining access to primary care consultations, diagnostic tests and specialist care. Potential harms included delayed diagnosis or delayed delivery of specialist care. Errors of interpersonal care included patients' perceptions of not being taken seriously, including perceived failure by professionals to respond adequately to reports of adverse drug reactions or accounts of painful symptoms. Potential harms included continuing medication-related symptoms, negative emotional reactions and breakdown in communication between patients and professionals. Errors were noted at transitions between primary and secondary care including failures of information transfer and communication. Conclusions: Problems of gaining access to care and problems at transitions between levels of care may sometimes constitute errors, but they may also give rise to circumstances in which errors occur. Interpersonal and communication problems may also be associated with errors. There appears to be a close relationship between broader concepts of quality of care and the concept of patient safety.

Graduated compression stockings are used prophylactically on a variety of patients within acute hospitals. Anecdotal evidence suggests patients have a limited understanding of this treatment. The aim of this qualitative study was to explore patients' experiences of compression stockings and to ascertain perceptions of their use. Information was gathered using telephone interviews from a sample of 12 adults who had been patients within the past 2 months, and who had worn compression stockings for more than 48 hours. The results showed that patients received little or no information from healthcare staff regarding compression stockings, but that they did have knowledge from other sources, such as long-haul flight advice. This raises issues of informed consent and patient empowerment and highlights the need for both verbal and written information. The information gained informed a patient information leaflet, which was developed in partnership with a patient focus group.