Fighting to be heard: Thematic analysis of parent perspectives of safety in general practice

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/Setting A qualitative study was conducted through online (n=2) and in-person (n=2) workshops with parents, taking place between June and 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. Thematic analysis of transcripts and field notes was conducted via NVIVO to identify key themes. Results Thirty-three parents from varied backgrounds, including under-served communities, participated. Three major themes are described: (1) Responsibility of care, highlighting perceived unclear roles between parents and healthcare teams; (2) Navigating the system, where parents described the need to 'fight' for care and the challenges of understanding healthcare processes; and (3) Communication and language, 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-partners in these efforts could enhance trust, reduce risk, and improve safety outcomes for paediatric patients.