Physician Perspectives on Factors That Influence Patients' Choice Between the NHS and Private Healthcare: A Qualitative Study.

Introduction The National Health Service (NHS) is the primary provider of healthcare in the UK. Due to several reasons, further exacerbated by the COVID-19 pandemic, the NHS has struggled to meet the healthcare needs of the public. In this healthcare climate, the private sector holds unique opportunities and hurdles. While the relationship between the NHS and the private healthcare sector has been studied, there is a dearth of literature on how patients perceive this relationship and what factors influence them to choose between the two. The aim of this study was to qualitatively identify factors that influence a patient's choice between the NHS and private healthcare. Methodology Ten physicians (six general practitioners (GPs) and four secondary care consultants) were virtually interviewed. Interviews were semi-structured with a question stem, but the interview was open to interviewee-led digression. An iterative approach was taken, and Braun and Clarke's six steps of thematic analysis were undertaken by researchers to analyse the data. Results Three global themes were identified: patient factors, physician factors, and service factors. Factors that influence patients' choice between private healthcare or the NHS were largely the waiting time in the NHS and the control patients had in private healthcare. Other factors include the greater comfort, time and attention provided in private healthcare. Conclusion This study identified three global themes (patient, physician and service factors) from a physician's perspective. However, these themes had significant overlap and their nuanced interactions warrant more in-depth study. While the study had several limitations, it provides a foundation for more studies that can examine the relationship between the NHS and the private sector from a patient's perspective.