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Argues that reflective professional supervision, a forum where the complexities of the interpersonal interactions that underpin the provision of healthcare can be explored in a supportive and confidential setting, should continue for the duration of a doctor's career, with potential benefits including enhanced job satisfaction and resilience, better workplace communication and improved interpersonal skills. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.

After the war, Neville became a consultant haematologist in the blood transfusion service in Bristol. In recent years, her health failed, her vision deteriorated with the onset of macular degeneration, and she was registered blind.

Objective This study aimed to understand the experiences of palliative care patients when accessing or making decisions about out of hours (OOH) services. It also aimed to illuminate barriers and enablers to accessing appropriate and timely care following the introduction of the 2004 New General Medical Services Contract. Method Longitudinal prospective qualitative study using semi-structured interviews and telephone interviews over 6 months and analysed for thematic content. 32 patients defined as receiving palliative care in six General Practices and three hospices selected on the basis of size and rural/urban location in Southern England were recruited. Results Continuity of care was highly valued. Participants described the importance of being known by the healthcare team, and the perceived positive implications continuity could have for the quality of care they received and the trust they had in their care. Various factors prevented participants from seeking help or advice from OOH services, despite having health concerns that may have benefitted from medical assistance. Prior poor experience, limited knowledge of services and knowing who to call and, indeed, when to call were all factors that reportedly shaped participants’ use of OOH services. Conclusions Interpersonal or relationship continuity and management continuity are vital to the process of optimising the patient experience of OOH palliative care. While recent service innovations are tackling some of the issues highlighted, this research reinforces the value patients with palliative care needs places on continuity and the need to improve this aspect of care management.

Uptake of childhood immunisation fluctuates in the UK. Convenience, access and parents' relationships with professionals influence uptake. This study explores the decision-making by parents about their children's immunisation through focus groups with analysis to identify categories of concern. Issues raised in focus groups included fear, risk, anger, worry and guilt, confusion, difficulty of decision-making and trust of professionals. The parents of completely and incompletely immunised children shared areas of concern, but there were also significant differences. There was a subset of parents of incompletely immunised children who had decided that their children would not have full immunisation, and this group had little trust in information provided by healthcare professionals. Simply providing more information is unlikely to change their decision.