PP32 Be Sure: a qualitative exploration of healthcare experience by ethnicity and perspectives of healthcare providers following injury presentation to emergency services in England

<h3>Background</h3> Although access to free healthcare is universal in the United Kingdom, evidence suggests variations by ethnicity in terms of outcomes following injury. The BE SURE study offers insights into use and outcomes of emergency healthcare for injury by minority ethnic groups to inform theories on mechanisms of access to help reduce disparities between minority ethnic and White British groups in the UK. This paper asks what emergency care processes contribute to differences in health outcomes between these groups. <h3>Methods</h3> We conducted semi-structured phone interviews (n=18) with minority ethnic patients, identified from 597 survey respondents who recently used ambulance and ED services for injury. We also conducted online focus groups and interviews with staff (n=21) from ambulance services and emergency departments, GP, allied services, and third sector organisations in three study sites in England. The sessions were recorded, transcribed, and thematically coded using framework analysis. <h3>Results</h3> Patient participants of predominantly Indian and Pakistani, Black African, and other ethnic minority backgrounds largely reported having had good experiences with receiving healthcare following injury, with many praising staff. Staff participants, consisting of ED consultants, call handlers, paramedics, GPs, clinical managers, and refugee programme managers, emphasised that healthcare organisations employ multiple processes to provide care in an equal manner to all. However, both groups’ reported experiences suggested how inequalities in mechanisms of access might arise with three emerging themes: Communication, Attitudes, assumptions, and preconceptions during the patient journey through emergency care, Institutions’ operationalisation of equal access processes concerning resource scarcity <h3>Conclusion</h3> Experiences and views from patients and staff included in this study suggest how inequalities in access may be embedded in processes within NHS emergency care systems. The findings will inform our development of theory related to this important topic.