Remote consultations in primary care during covid-19: Views and experiences of healthcare professionals and patients

Problem

Covid-19 has created healthcare delivery challenges previously unseen. In the initial stages of the pandemic the rapid switch to remote consultations first was necessary to limit Covid-19 transmission and increase safety. Despite the limited understanding of its acceptability, effectiveness, and long-term impact on health inequalities. Remote consultations have continued due to covid-19 measures. However, almost two years into the pandemic, it is important to assess the impact of this natural experiment on the views of patients, particularly considering the consequences of a digital first approach to primary care access to populations with greater need, such as those with multimorbidity, disability or learning difficulties.

Approach

Approximately 10 patient and 10 professional participants will be invited to take part in a telephone interview, using a flexible topic guide to explore their views and experiences of remote consultations. The semi-structured interviews will be audio-recorded, transcribed verbatim and thematically analysed using Nvivo software. The approach will highlight particular patient cases of interest to explore equity of access and quality of care, which will describe different pathways through the system and will provide narrative examples to showcase benefits, disadvantages, barriers and facilitators related to the different consultation types. Healthcare professional interviews will also highlight experiences of new methods of triage and consultation and their views on the impact of these on patient access and quality of care.

Findings

Although the findings are to be determined, we expect that they will provide insight into some of the populations that are not as well represented in the survey, for example those unemployed, those who have struggled with technology, multiple long-term conditions, ethnic minority populations, disabled, learning difficulties etc. Implications of the findings will help to inform the development of future research targeted at marginalised populations where the impact of recent service changes are less well understood.

Consequences

The findings of our work will be shared with primary care practices to inform plans to implement e- and video-consulting in purposive quality improvement programmes post COVID-19, with particular reference to equity in access to healthcare. It will also enable learnings from service delivery during the pandemic to be shared, ensuring that positive changes are not lost.