TOGETHER 2 study: Evaluating video and hybrid group consultations in general practice: mixed-methods, participatory study
This study aims to generate a strong evidence base for successful co-design and implementation of video and hybrid group consultations (VHGCs) for chronic conditions in general practice.
WHY IS THIS IMPORTANT
There has been growing interest in group consultations – a relatively new way of delivering clinical care, where patients come together for their consultation, rather than (or in addition to) having one-to-one appointments. Combining clinical care with elements of group education and peer support, group consultations have been primarily used in the context of chronic conditions (e.g. bringing together people living with diabetes for their annual reviews).
During the pandemic, GP practices in the UK started using video platforms to deliver group-based care remotely, supported by a training programme commissioned by NHS England. Following easing of restrictions, some GP practices evolved their group-based care models to include hybrid sessions where some patients attend online and others in-person.
Yet, implementation remains ad hoc, without independent evaluation data or capacity to develop transferable learning. Research on this topic must also address digital inclusion and equity, if these new models of care are to spread and scale up in a sustainable way.
Mixed-methods, multi-site research study using co-design and participatory methods, to generate actionable learning on VHGC implementation, from qualitative, quantitative and cost-related perspectives.
The study consists of 3 interlinked work-packages (WP). WP1 includes a national, cross-sectional survey on VHGC provision in general practice across the UK. In WP2 we will engage patients and general practice staff in co-design workshops to develop VHGC models with emphasis on digital inclusion and equity. In WP3 we will carry out a mixed-methods process evaluation in 10 GP practices across England (5 sites already running VHGCs and 5 comparator sites). Qualitative methods will include interviews, focus groups and ethnographic observation to examine the experiences of patients, carers, clinical and non-clinical NHS staff, commissioners and policy-makers. Drawing on participatory principles, we will also work with up to 4 patients as co-researchers. Quantitative methods will examine the impact of VHGCs on healthcare utilisation in primary and secondary care, patient satisfaction, engagement and activation. We will also assess value for money of group and individual care models from a health economics perspective. There will be ongoing dialogue and synthesis between the different work streams, and patients and public contributors will be involved throughout.
National Institute for Health Research (NIHR) Health Services and Delivery Research (HS&DR) programme (NIHR133895).
March 2022 – February 2024
University of Oxford: Dr Chrysanthi Papoutsi (PI), Dr Sara Shaw (co-PI), Prof Trish Greenhalgh
University of Exeter: Dr Gary Abel, Prof John Campbell
University of York: Prof Cynthia Iglesias
Policy, patient and clinical collaborators: Dr Minal Bakhai, Helene Raynsford, Dr Ellen Fallows, Dr Yasmin Razak, Maggi Bradley, Dipti Gandhi, Jennifer Aston, Dr Jon Dolman.