Time, talk, and teamwork: Perceptions of personalised dementia care planning conversations in primary care
- 1Research Department of Primary Care and Population Health, University College London, London, United Kingdom
- 2Centre for Psychiatry and Mental health, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- 3Care Policy & Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
Abstract
Background: Dementia affects over 57 million people worldwide. UK and international policy position personalised, conversation-based care planning as central to post-diagnostic support. However, delivery in primary care is inconsistent, and many practitioners lack dementia-specific communication training. Existing evidence focuses on single roles or settings, leaving a gap in understanding how communication operates across the primary care workforce. Aims: To identify what helps and hinders effective communication for integrated dementia care planning and determine the support and training needs of the wider primary care workforce. Methods: Semi-structured interviews – 11 people with dementia, 13 family carers, and 19 primary care practitioners from diverse roles, exploring experiences of care planning conversations. Reflexive thematic analysis Results: Three themes were developed, progressing from micro-level communication practices (Theme 1: Beyond the tick-box), through triadic dynamics (Theme 2: Balancing voices in the conversation), to organisational influences (Theme 3: From silos to meaningful shared care planning). Time and Conversation as intervention cut across all themes, shaping trust and disclosure. Participants reported reliance on tick box approaches, inconsistent preparation, and uncertainty about care plan purpose and ownership. Non-clinical roles were commonly viewed as well placed to support meaningful conversations, but were often described as constrained by unclear remit and weak integration. Conclusions: A persistent gap remains between policy ambitions and everyday practice. Time-pressured, checklist-driven encounters and fragmented systems undermine shared decision-making. The expanded primary care workforce offers untapped potential to address these gaps, but this requires clearer roles, formal integration, and targeted investment in communicative skills.
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BibTeX
@article{griffiths2026time,
title = {{Time, talk, and teamwork: Perceptions of personalised dementia care planning conversations in primary care}},
author = {Sarah Griffiths and Danielle Wyman and Mike Clark and Greta Rait and Nathan Davies},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0343482},
url = {https://doi.org/10.1371/journal.pone.0343482},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Time, talk, and teamwork: Perceptions of personalised dementia care planning conversations in primary care
AU - Sarah Griffiths
AU - Danielle Wyman
AU - Mike Clark
AU - Greta Rait
AU - Nathan Davies
PY - 2026
DA - 2026/09/15
JO - PLOS One
DO - 10.1371/journal.pone.0343482
UR - https://doi.org/10.1371/journal.pone.0343482
AB - Background: Dementia affects over 57 million people worldwide. UK and international policy position personalised, conversation-based care planning as central to post-diagnostic support. However, delivery in primary care is inconsistent, and many practitioners lack dementia-specific communication training. Existing evidence focuses on single roles or settings, leaving a gap in understanding how communication operates across the primary care workforce. Aims: To identify what helps and hinders effective communication for integrated dementia care planning and determine the support and training needs of the wider primary care workforce. Methods: Semi-structured interviews – 11 people with dementia, 13 family carers, and 19 primary care practitioners from diverse roles, exploring experiences of care planning conversations. Reflexive thematic analysis Results: Three themes were developed, progressing from micro-level communication practices (Theme 1: Beyond the tick-box), through triadic dynamics (Theme 2: Balancing voices in the conversation), to organisational influences (Theme 3: From silos to meaningful shared care planning). Time and Conversation as intervention cut across all themes, shaping trust and disclosure. Participants reported reliance on tick box approaches, inconsistent preparation, and uncertainty about care plan purpose and ownership. Non-clinical roles were commonly viewed as well placed to support meaningful conversations, but were often described as constrained by unclear remit and weak integration. Conclusions: A persistent gap remains between policy ambitions and everyday practice. Time-pressured, checklist-driven encounters and fragmented systems undermine shared decision-making. The expanded primary care workforce offers untapped potential to address these gaps, but this requires clearer roles, formal integration, and targeted investment in communicative skills.
SN - 1932-6203
ER -