Table 7 Interview excerpts reflective of the theme ‘Communication pathways and interaction’

“…..you’ve got to be able to understand it well enough yourself to explain it to the patient in terms of they understand that they can engage with and then they’re likely to understand why they should comply with something that then is quite a nuisance, potentially”

GP, Anticoagulation in atrial fibrillation (P66)

“….yeah, communication skills is a big one, because if you can’t communicate as to why these are important you’re not going to get them to anywhere near, and obviously be aware of your actual knowledge of them…”

Practice Nurse, Treatment targets in type 2 diabetes (P51)

“…. I had to write to cardiology who hadn’t, who had patients on aspirin or hadn’t recommended warfarin yet they had a CHADs score of two, and so it, I felt it was confusing for the patient if they’d been told at clinic that they didn’t need it, then they turned up to see a GP who said that they did, so I felt I needed clarity from secondary care, so I had to write to a relatively large proportion of patients who’d been seen by secondary care to ask and clarify the situation…”

GP, Anticoagulation in atrial fibrillation (P52)

“….I think things are communicated much better now…….. I think we know about them sooner most practices, our practice does have a prescribing lead…….so it’s sent to one person and it’s that persons responsibility to then erm give the information to the other members of the, of the team. The use of a good clinical computer system always make it easy if you have the information there …….if you have a formulary then obviously things are added that are recommended, that again makes it easier…… because clinicians do have an awful lot to think about in a ten minute consultation ……. so yeah.”

Practice Manager, Risky prescribing (P23)