The value of choice: a qualitative study.

BACKGROUND Providing choice in health care is part of an ongoing policy initiative. AIM To explore how people understand choice in healthcare provision. DESIGN OF STUDY A qualitative study using semi-structured interviews. SETTING South East England. METHOD Twenty-two people were interviewed about the issue of choice in general, and choice in healthcare in particular. Data were analysed using template analysis. RESULTS Participants discussed choice in the NHS within the context of the GP consultation. Four main themes about choice were identified: positive aspects of choice; the appearance of choice; unwanted choice; and the role of information in choice. Participants valued choice in principle, and having choice was seen as positive. However, the provision of choice options was not always associated with the possibility of meaningful choice. Participants expressed that in some instances they were given the appearance rather than the substance of choice. Making - as opposed to having - choice was often unwanted and considered as indicative of erosion in trust in the GP. Information was seen as a necessary, but not sufficient, prerequisite of informed choice. CONCLUSION People value having choices rather than making choices but are concerned about choice provision for its own sake rather than choice that is available in a meaningful way. Health care policy that recommends an increase in choice per se may be met with scepticism which could ultimately undermine, rather than promote, the doctor-patient relationship.