{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:11:26Z","timestamp":1789495886932,"version":"build-2803163510"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Alzheimer Society UK","award":["597"],"award-info":[{"award-number":["597"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Semi-structured interviews \u2013 11 people with dementia, 13 family carers, and 19 primary care practitioners from diverse roles, exploring experiences of care planning conversations. Reflexive thematic analysis<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0343482","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T17:49:44Z","timestamp":1789494584000},"page":"e0343482","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Time, talk, and teamwork: Perceptions of personalised dementia care planning conversations in primary care"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2652-3163","authenticated-orcid":true,"given":"Sarah","family":"Griffiths","sequence":"first","affiliation":[{"name":"University College London","place":["London, United Kingdom"],"department":["Research Department of Primary Care and Population Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Wyman","sequence":"additional","affiliation":[{"name":"Centre for Psychiatry and Mental health, Wolfson Institute of Population Health","place":["London, United Kingdom"],"department":["Faculty of Medicine and Dentistry"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Clark","sequence":"additional","affiliation":[{"name":"Care Policy & Evaluation Centre, London School of Economics and Political Science","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7216-7294","authenticated-orcid":true,"given":"Greta","family":"Rait","sequence":"additional","affiliation":[{"name":"University College London","place":["London, United Kingdom"],"department":["Research Department of Primary Care and Population Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7757-5353","authenticated-orcid":true,"given":"Nathan","family":"Davies","sequence":"additional","affiliation":[{"name":"Centre for Psychiatry and Mental health, Wolfson Institute of Population Health","place":["London, United Kingdom"],"department":["Faculty of Medicine and Dentistry"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"pone.0343482.ref001","volume-title":"Dementia","author":"World Health Organization","year":"2023"},{"key":"pone.0343482.ref002","volume-title":"World Alzheimer Report 2022: Life after diagnosis: Navigating treatment, care and support","author":"S Gauthier","year":"2022"},{"key":"pone.0343482.ref003","unstructured":"NHS England. Dementia: good care planning \u2013 information for primary care and commissioners. 2017. https:\/\/www.england.nhs.uk\/publication\/dementia-good-care-planninginformation-for-primary-care-and-commissioners"},{"issue":"1","key":"pone.0343482.ref004","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1186\/s12875-019-1042-4","article-title":"The Year of Care approach: developing a model and delivery programme for care and support planning in long term conditions within general practice","volume":"20","author":"S Roberts","year":"2019","journal-title":"BMC Fam Pract"},{"key":"pone.0343482.ref005","volume-title":"Fit for the future: 10 year health plan for England","author":"DHSC","year":"2005"},{"key":"pone.0343482.ref006","unstructured":"NHS England. Quality and Outcomes Framework guidance for 2025\/26. 2025."},{"key":"pone.0343482.ref007","article-title":"The primary care annual dementia review: a qualitative study of the views and experiences of service users and providers","author":"A Wheatley","year":"2022","journal-title":"medRxiv"},{"issue":"7","key":"pone.0343482.ref008","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2023-082083","article-title":"Access to personalised dementia care planning in primary care: a mixed methods evaluation of the PriDem intervention","volume":"14","author":"E Spencer","year":"2024","journal-title":"BMJ Open"},{"issue":"742","key":"pone.0343482.ref009","doi-asserted-by":"crossref","DOI":"10.3399\/BJGP.2023.0216","article-title":"Implementing the Additional Roles Reimbursement Scheme in seven English Primary Care Networks: a qualitative study","volume":"74","author":"D Bramwell","year":"2024","journal-title":"Br J Gen Pract"},{"key":"pone.0343482.ref010","unstructured":"Volkmer A. Assessment and therapy for language and cognitive communication difficulties in dementia and other progressive diseases. In: Pres JR, editor. 2013."},{"issue":"1","key":"pone.0343482.ref011","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0317749","article-title":"What are the challenges that social prescribers face when supporting people within dementia and how can these be addressed? A qualitative study","volume":"20","author":"C Di Lorito","year":"2025","journal-title":"PLoS One"},{"key":"pone.0343482.ref012","unstructured":"Personalised Care Institute. https:\/\/www.personalisedcareinstitute.org.uk\/ Accessed 2023 October 1."},{"key":"pone.0343482.ref013","unstructured":"Social Prescribing: Learning for Link Workers. https:\/\/www.e-lfh.org.uk\/programmes\/social-prescribing\/"},{"issue":"5","key":"pone.0343482.ref014","doi-asserted-by":"crossref","DOI":"10.1093\/ageing\/afaf120","article-title":"Communication strategies for delivering personalised dementia care and support: a mixed-methods systematic review and narrative synthesis","volume":"54","author":"AM Sunjaya","year":"2025","journal-title":"Age Ageing"},{"issue":"1","key":"pone.0343482.ref015","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1186\/s12875-025-03011-9","article-title":"Social prescribing in primary care for people living with dementia: a qualitative exploration of different roles and services in England","volume":"26","author":"A Pick","year":"2025","journal-title":"BMC Prim Care"},{"issue":"7","key":"pone.0343482.ref016","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1177\/14713012231185281","article-title":"Practitioners\u2019 ability to remotely develop understanding for personalised care and support planning: a thematic analysis of multiple data sources from the feasibility phase of the Dementia Personalised Care Team (D-PACT) intervention","volume":"22","author":"H Wheat","year":"2023","journal-title":"Dementia (London)"},{"issue":"4","key":"pone.0343482.ref017","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1080\/2159676X.2019.1628806","article-title":"Reflecting on reflexive thematic analysis","volume":"11","author":"V Braun","year":"2019","journal-title":"Qualitative Research in Sport, Exercise and Health"},{"issue":"6","key":"pone.0343482.ref018","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"A Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"key":"pone.0343482.ref019","unstructured":"Mental Capacity Act. 2005."},{"issue":"5","key":"pone.0343482.ref020","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1177\/14713012241231916","article-title":"Reflections on co-production: Developing a dementia research funding application with a diverse lived experience group","volume":"23","author":"S Griffiths","year":"2024","journal-title":"Dementia (London)"},{"issue":"2","key":"pone.0343482.ref021","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1177\/1471301217690904","article-title":"Involving individuals with dementia as co-researchers in analysis of findings from a qualitative study","volume":"18","author":"M Stevenson","year":"2019","journal-title":"Dementia (London)"},{"issue":"13","key":"pone.0343482.ref022","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1177\/1049732315617444","article-title":"Sample Size in Qualitative Interview Studies: Guided by Information Power","volume":"26","author":"K Malterud","year":"2016","journal-title":"Qual Health Res"},{"issue":"1","key":"pone.0343482.ref023","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1186\/s12913-023-09869-8","article-title":"Quality communication can improve patient-centred health outcomes among older patients: a rapid review","volume":"23","author":"SH Sharkiya","year":"2023","journal-title":"BMC Health Serv Res"},{"key":"pone.0343482.ref024","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1037\/amp0000151","article-title":"Journal article reporting standards for qualitative primary, qualitative meta-analytic, and mixed methods research in psychology: The APA publications and communications board task force report","author":"HM Levitt","year":"2018","journal-title":"American Psychological Association"},{"issue":"3","key":"pone.0343482.ref025","doi-asserted-by":"crossref","DOI":"10.1093\/geront\/gnae186","article-title":"People With Dementia Disclosing Their Diagnosis to Social Networks: A Systematic Review and Meta-Synthesis","volume":"65","author":"G Kohl","year":"2025","journal-title":"Gerontologist"},{"issue":"742","key":"pone.0343482.ref026","doi-asserted-by":"crossref","DOI":"10.3399\/BJGP.2023.0433","article-title":"Challenges and enablers to implementation of the Additional Roles Reimbursement Scheme in primary care: a qualitative study","volume":"74","author":"B Jones","year":"2024","journal-title":"Br J Gen Pract"},{"issue":"1","key":"pone.0343482.ref027","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s12913-018-2893-4","article-title":"Facilitators and barriers of implementing and delivering social prescribing services: a systematic review","volume":"18","author":"JV Pescheny","year":"2018","journal-title":"BMC Health Serv Res"},{"issue":"8","key":"pone.0343482.ref028","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1080\/13607863.2025.2481970","article-title":"Providing inclusive care and empowering people with dementia as a clinical pharmacist: a qualitative study of clinical pharmacist\u2019s experiences","volume":"29","author":"A Burnand","year":"2025","journal-title":"Aging Ment Health"},{"key":"pone.0343482.ref029","unstructured":"NHS England. Comprehensive model of personalised care. Available from: https:\/\/www.england.nhs.uk\/personalisedcare\/comprehensive-model-of-personalised-care\/"},{"key":"pone.0343482.ref030","unstructured":"NHS England. Neighbourhood Health Guidelines. https:\/\/www.england.nhs.uk\/long-read\/neighbourhood-health-guidelines-2025-26\/ Accessed 2023 October 1."},{"key":"pone.0343482.ref031","unstructured":"NHS England. Dementia training standards framework. https:\/\/www.hee.nhs.uk\/our-work\/dementia-awareness\/core-skills Accessed 2023 October 1."}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0343482","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T17:49:51Z","timestamp":1789494591000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0343482"}},"subtitle":[],"editor":[{"given":"Gursharan K","family":"Singh","sequence":"first","affiliation":[{"name":"Queensland University of Technology - QUT: Queensland University of Technology","place":["AUSTRALIA"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,15]]},"references-count":31,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,15]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0343482","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,15]]}}}