Macdonald Clare, Cross-Sudworth Fiona, Quinn Laura, MacArthur Christine, Bick Debra, Jones Ellie, Taylor Beck
Department of Applied Health Sciences, University of Birmingham, Birmingham, UK
Warwick Medical School, University of Warwick, Coventry, UK.
BJGP Open. 2025 Jul 23;9(2). doi: 10.3399/BJGPO.2024.0229. Print 2025.
Since 2020, the General Medical Services contract requires GP practices in England to offer women a GP appointment 6-8 weeks after birth: the '6-8 week postnatal check' or 'consultation'. Historically, provision of checks was variable, and women still frequently report poor experiences.
To explore GPs' and women's perspectives of the 6-8 week postnatal check, including key components and timing.
DESIGN & SETTING: A mixed-methods study was undertaken with focus groups of GPs and women, and an online survey of GPs in England.
Focus groups explored GPs' and women's experiences of postnatal consultations. An online survey explored GPs' clinical approach, organisation, and improvement potential. Quantitative analysis examined associations between demographics and clinical approach. Thematic framework analysis was used for qualitative data.
In total, 18 women and 14 GPs participated in focus groups; 671 GPs completed the survey. Mental wellbeing and contraception were reported as important topics, although some women were not asked about mental health. GP survey responses indicated most recommendations from national guidance were 'always' or 'very often' covered by most, but not all GPs. Clinical coverage was higher for GPs who used clinical templates, had awareness of guidance, were female, or were a parent. Many GPs ( = 326/670, 49%) needed more time than they were allocated for the consultation ( = 524/670 [78%] allocated ≤15 minutes; = 351/670 [52%] completed in ≤15 minutes).
This study suggests GPs are allocated insufficient time for postnatal consultations, with substantial variation in practice. Specifying consultation duration and consideration of template usage in policy may improve care and outcomes for women.
自2020年以来，英国的全科医疗服务合同要求英格兰的全科医生诊所为产后6至8周的女性提供全科医生预约服务，即“产后6至8周检查”或“会诊”。从历史上看，检查的提供情况参差不齐，女性仍然经常报告体验不佳。
探讨全科医生和女性对产后6至8周检查的看法，包括关键组成部分和时间安排。
采用混合方法进行研究，对全科医生和女性进行焦点小组访谈，并对英格兰的全科医生进行在线调查。
焦点小组探讨了全科医生和女性的产后会诊经历。在线调查探讨了全科医生的临床方法、组织安排和改进潜力。定量分析研究了人口统计学特征与临床方法之间的关联。定性数据采用主题框架分析法。
共有18名女性和14名全科医生参加了焦点小组访谈；671名全科医生完成了调查。心理健康和避孕被报告为重要话题，尽管一些女性未被问及心理健康问题。全科医生的调查回复表明，国家指南中的大多数建议大多数（但不是所有）全科医生“总是”或“非常经常”涵盖。使用临床模板、了解指南、女性或为人父母的全科医生临床覆盖范围更高。许多全科医生（326/670，49%）所需的会诊时间比分配给他们的时间更多（670名中有524名[78%]分配的时间≤15分钟；351/670名[52%]在≤15分钟内完成）。
本研究表明，分配给全科医生进行产后会诊的时间不足，实践中存在很大差异。在政策中明确会诊时长并考虑模板使用情况可能会改善对女性的护理和结果。
