Fighting to be heard: a thematic analysis of parent perspectives on safety in UK general practice.

Abstract (English)

BACKGROUND: Children are particularly vulnerable to healthcare-associated harm. Parents play a vital but under-recognised protective role in paediatric patient safety. Parent perceptions of and contributions to safety improvement efforts within hospital settings are well documented, but little is known about parent experiences and perspectives in primary care. AIM: To explore diverse parental perspectives on paediatric safety in primary care and identify target areas for improvement. DESIGN AND SETTING: This qualitative study in UK primary care was conducted through online (<i>n</i> = 2) and in-person (<i>n</i> = 2) workshops with parents, taking place between 24 June and 8 July 2024. METHOD: Workshops were structured around a descriptive analysis of paediatric patient safety incident reports in general practice. Parents discussed and reflected on their own experiences in relation to the findings. Transcripts and field notes were analysed thematically to identify key themes. RESULTS: Parents (<i>n</i> = 33) from varied backgrounds, including under-served communities, participated. Three major themes were identified: <i>responsibility of care</i>, highlighting perceived unclear roles between parents and healthcare teams; <i>navigating the system</i>, where parents described the need to 'fight' for care and the challenges of understanding healthcare processes; and <i>communication and language</i>, emphasising the difficulties of being heard, especially among ethnic minority parents and those lacking the confidence to speak up. CONCLUSION: Parent perspectives on paediatric safety in primary care have highlighted key areas for practices, researchers, and safety improvement teams to target system change and intervention development. Engaging parents as co-designers in these efforts could enhance trust, reduce risk, and improve safety outcomes for paediatric patients.