Mode of consultation in general practice
- Principal Investigator: Sara Shaw
- 1 October 2022 to 31 March 2024
- Project No: 594
- Funding round: FR4
Background to the research: The shift to remote consulting in UK general practice, using phone and video to help with infection control during the COVID-19 pandemic will have lasting impact on how primary care services are provided to patients and the public. Remote consulting has been the default throughout the pandemic, but there have been wide variations between practices in terms of how care is provided and how patients can access care. Some patients have continued to consult in person. This mix of in-person and remote consulting is likely to continue long term. At the moment we don’t know how decisions are made about which sort of consulting to use, and how to best organise and deliver these different types of appointment in general practice. Aim of the research We want to understand how, when, by whom and why decisions are made to offer different types of appointment, and to consider the implications for the future organisation and delivery of general practice and primary care.
To do that, we plan to work with three general practices that are already participating in research funded by the National Institute of Health Research and have agreed to participate in this new study. Design and methods We will work with these three practices to collect detailed data about consulting: (i) shadowing one GP and one receptionist/care navigator (one week) and then other members of the primary care team (second week) in each practice to gain first hand insights into the work they do and the decisions they make about consulting; (ii) talking with practice staff (e.g. receptionists, GPs, practice nurses) to understand their experience of remote consulting and their role in shaping decisions about the type of appointment offered; (iii) homing in on ten patients with ‘complex needs’ in each practice (30 in total) and tracking their consulting activity over the previous 24 months to understand their use of different types of consultation and how and why this might change over time; and (iv) collecting and analysing routine practice data to understand the levels of use of the different modes of consulting across each practice. We will use the Planning and Evaluation for Remote Consulting Services (PERCS) framework to guide analysis.
Patient and public involvement: We will involve patients and the public in the design and conduct of the research via the study advisory group (already in place), regularly engage with PPI representatives to inform the research, discuss emerging findings and produce a patient-led paper about their experiences of different consultation modalities. Dissemination We plan a range of outputs (webinars, briefing papers, patient animation and academic papers) tailored to four audiences: patients and the public, policymakers, primary care professionals and researchers. Our focus is on informing debate about modes of consulting and the future organisation and delivery of primary care.
Amount Awarded: £398,566