Table 2 Illustrative quotes from discrete choice experiment cognitive interviews and stakeholder consultation focus groups

 Comprehensive assessment

DCE.01

‘… .although I mean it should be carried on throughout I think, whatever, I don’t think that should be an option, it should be discussed because there have been times that I’ve come in here and on my assessment day I’ve been too out of it to talk about anything’ B02022

 Continuous communication

DCE.02

‘Yeah and, you know, the family think, I wouldn’t want them out of it completely, if they wanted to come in and discuss things I’d like it to be an option yeah but not feel that they were pressurised into it …’ B02022

DCE.03

‘yes, the distance was a big influence on me, erm, and also the communication with the family, I didn’t like it when there was no communication’ B03021

 Continuity of care

DCE.04

‘There’s this problem here again with GPs, erm, I had to fill in a form today to say whom my GP was, well I’ve got a named GP which everybody has but I very rarely see her because she only works one day a week now’ B02022

 Acceptability of the DCE

DCE.05

‘Well you see, I’m not ill am I? I’m only just injured’ B03023

‘Yes, yeah’ Interviewer

‘So then I don’t really feel that level of care’ B03023

DCE.06

‘Straight away I will not go for one because it’s only 5 miles and there isn’t a community one within 5 miles as far as I can see’ B02023

DCE.07

‘So once again I’m drawn to service B but there’s no phoning when admitted, I don’t know, it’s interesting that I find that so important isn’t it?’ B02021

DCE.08

‘It’s a brilliant idea, it’s wonderful [indecipherable at 12:50] staff to do it, it’s nothing to do with me but it’s wonderful’ B02023

  Change in patient care needs and practice with an increasingly older population

SC.01

‘I think patients that previously would have come here are being discharged directly home from the acute hospitals and being supported at home because of the services that are now in place in the community and whether we’re getting patients that would have typically remained in the acute hospitals but actually because they’re not needing any acute interventions, we’re having to manage them here and they are, …., medically complex and often quite on a knife edge where it doesn’t take very much at all to tip them over where you’ll have to put a lot of medical interventions to keep them here and not transfer them back into the acute’ A02003 Advanced Nurse Practitioner

  Person-centred focus on gathering key information

SC.02

‘It’s about how you come to a decision about when it’s time to move that person on whether it’s that they, if they progress better by going home sooner and having support in the community for that individual or whether they need to stay here and have another 6 weeks of walking practice, you know, it’s what is going to help that person get to their optimum and I don’t know if it’s a tool thing, I don’t think it’s a simple tool, I think it’s a combination of effectively working and yeah, agreeing a plan and working out something together it’s not one person doing their tick box kind of thing’ Participant in group 03

SC.03

‘It’s very frequently, patients referred for rehabilitation and it’s very, very clear when they arrive that they’re not for rehabilitation and actually there hasn’t been those conversations so they come here for rehabilitation [and end-of-life care] because no one’s had time to have those conversations previously and it happens an awful lot doesn’t it?’ Participant in group 02

  Continuous communication with the family to support and inform care planning

SC.04

‘a lot of the conversations that we have to have, probably for every day, we’re pretty much having a meeting with a family to say, this is where they’re at, they’re not as good as they were previously, so, you know, we’re recommending A, B and C to, you know, you know, they may not be appropriate to return home or, they’re going to need this and this to manage at home, and they can be really challenging conversations to have’ A04001 Physiotherapist

  Supporting patient’s psychological adaption to change in ‘what I can do’

SC.05

‘that would be the time to be honest because people are quite often coming over here for intensive rehab … when actually the poor patient you see sitting in front of you, it’s quite obvious that that’s not going to happen so erm, and spending the time at that initial assessment you find what direction you’re actually going in then, it’s the time to be honest and to gather a lot of information’ A02016 Ward sister

SC.06

‘Yeah there’s [not] a magic front door at home that cures all ills when they get there’ Participant in Group 01

  Managing care at points of transition in care settings

SC.07

‘one of my ideas was very similar to the therapy point of view where they have a sort of health passport document where it could be with the patient or it could be as a part of their notes but where is vital information that we struggle to find’ A01015 Staff nurse

  Tension between nationally standardised tools and flexibility in use

SC.08

‘making the information movable between care settings so the information is fluent and the same’ A01008 Older people mental health liaison

SC.09

‘it has to be fit for purpose and the staff need to want to fill it in and it needs to be accurate’ A02016 Ward sister

SC.10

‘how do you make sure that there’s that kind of local ownership and things grow locally, erm, but it doesn’t become so there’s a post code lottery’ A02019 Commissioner