A qualitative study exploring critical care survivors’ and their clinicians’ shared experiences of navigating a fragmented care system

Recovery following a critical illness is challenging. Follow-up clinic provision is standard of care, but the effectiveness of services remain unclear, with some data demonstrating limited or potential detrimental effects. While the patients’ perspective has been described previously, no studies combine with clinician experience. We explored this combined experience to understand modifiable factors in effective delivery of critical care follow-up services. We conducted a single-centre qualitative interview study in a large UK adult critical care service as part of an evaluation of a pilot follow-up service. Semi-structured interviews with sixteen patients and seven clinicians were analysed using reflexive thematic analysis. Patients experienced uncertainty, fragmented care, and psychological distress as immediate, ongoing challenges marked by a lack of guidance and support. Clinicians described the same broad issues but perceived them somewhat differently, as reflecting the inherent unpredictability of recovery, and caused by delayed presentation of needs, and the constraints imposed by complex care systems. By combining patient and clinician perspectives, our study identifies mismatches in expectations, timing of support, and perceived responsibility. Our data highlight the need for systemic improvements in follow-up care and the importance of integrated social and healthcare services to ensure that patients receive timely and comprehensive support.