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A new University of Oxford-led study in UK general practice shows that staff need more and different training to equip them for delivering remote healthcare.

An older woman using a laptop for a remote consultation with a younger female doctor wearing a face covering.

Training for GP practice staff has not kept pace with changes in the way care is provided since the pandemic, the findings of a new study in UK general practice reveals.

The study, published in the British Journal for General Practice, carried out by Professor Trisha Greenhalgh and her team from the Nuffield Department of Primary Care Health Sciences University of Oxford, along with researchers from University of Plymouth and Nuffield Trust, concludes that a new approach is needed to train all the clinical and non-clinical members of practice teams to better provide care for patients through a mix of telephone, face to face and online consultations.

The researchers found that from senior GPs through to receptionists, all primary care staff groups interviewed felt undertrained for digital and remote models of care delivery with too much focus on how to use new technologies rather than how to work together to provide good care for patients across different consultation types. All staff groups felt that they would benefit from additional training. 

A particular area where people identified training needs was passing requests between different staff members, or making judgements about which patients contact remotely and which to put on another staff member’s urgent call-back list.

The start of the pandemic triggered a shift in how patients receive care from their GP surgeries and many patients are still offered telephone or video consultations with their GP three years later. The research study sought to establish whether GP practice staff felt they had been adequately trained to meet this new model of care. The researchers followed 12 general practices in England, Scotland and Wales for two years as they addressed the challenges of new ways of delivering healthcare, interviewing staff and patients and holding online workshops.

The researchers propose a different approach to providing staff training, less focused on technology, and drawing on established educational principles. They highlight that some aspects of training should occur 'on the job' and involve the whole team.

The research team have developed a set of competencies for all staff groups in general practice. These competencies are reproduced on this webpage. Practices and education providers can use these to help ensure that all staff are adequately trained in providing care by phone and other remote technologies.

Professor Greenhalgh, Chief Investigator for the study from Nuffield Department of Primary Care Health Sciences, within the University of Oxford, said:

'New remote and digital ways of working are often introduced with the hope of increasing efficiency in the health service. But this will only happen if staff are adequately trained, particularly since these new modalities often come with complex workflows and require coordination across staff groups. Our research shows that few general practice staff currently feel capable and confident to use all the modalities (telephone, video and electronic consultations) to their full potential. We hope that the competencies we have produced will help educational providers address these deficiencies.'

Dr Rebecca Rosen, a senior research fellow at the Nuffield Trust, said:
'Remote consultations by phone or online have a huge part to play in improving access to general practice. But we must be sure that the consultations are safe, and acceptable to both patients and staff. With multi-professional teamworking now the norm in general practice, this study shows that we must improve training in remote consulting skills for the whole practice team as a matter of urgency.'

The full article is available in the British Journal of General Practice:

The full set of competencies for all staff groups in general practice can be downloaded on this webpage.


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