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What methods will be used?

The goal is to build up and follow a case study of each practice, showing how the remote-by-default model is playing out locally – including both ‘successes’ and ‘failures’ (and how the practice adapts and responds to the latter). To that end, we’d like to do the following:

 

  • Qualitative interviews with staff (mostly by video)
  • Qualitative interviews with patients (as they prefer: video, phone or in-person)
  • Collection of public-domain data to describe the practice (e.g. size, staffing, demographics, referrals, process / outcome data on long-term conditions, website information, patient information leaflets)
  • Periodic video group meetings with all 11 participating practices (about 6 during the course of the study) to share experiences and brainstorm ideas.
  • Digital inclusion workshops led by our partner mHabitat. We hope these will be fun and creative, helping practices develop ways to meet the needs of potentially excluded groups.

 

What theoretical approach are we using?

Remote consultations are not just a technical innovation; they are also an organisational, social and (in some senses) political one. They influence our identities and our relationships. They change the costs of providing care (and how those costs are distributed).  They have ethical, legal and regulatory implications. They take place in a particular cultural context and that context changes over time. They have potential implications for a ‘greener’ health service if they can reduce the carbon footprint of traveling to appointments. In other words, the study of remote consultations must be done from an interdisciplinary perspective.

 

In Remote by Default 1, we developed a framework, Planning and Evaluating Remote Consultation Services (PERCS), which we will use and refine in the ongoing RBD2 study. PERCS is shown below and a detailed paper describing it is here.

 

 Overview of the PERCS (Planning and Evaluating Remote Consultation Services) framework

PERCS (Planning and Evaluating Remote Consultation Services) framework

 

 

Who are the participating general practices?

The 11 practices are listed below the cover England, Wales and Scotland. They have been selected to represent a wide range of digital maturity (from low to high) and patient demographics (from ‘deep end’ deprived areas to more affluent), and geographies (from urban to suburban, with a particular focus on rural and remote). The practices include some where a high proportion of patients speak limited English and some where many consultations are conducted in Welsh. Some are large and some are small; around half are training practices and only two are regularly involved in other research (such as clinical trials).

 

Peat Rd Medical Practice, Glasgow

Possilpark Health and Care Centre, Glasgow

Swiss Cottage Surgery, London

Manor Surgery, Oxford

Long Hanborough Surgery, Oxfordshire

Ferryview Practice, London

North Road West Medical Centre, Plymouth

Ty Doctor Practice, Nefyn, Wales

Pencoed Medical Centre, Pencoed, Wales

Bron Meirion Surgery, Wales

Bridgewater Surgeries, Watford