Remote By Default 2: Optimising the Remote-by-default Model in the United Kingdom (UK) General Practice

NCT05244941 | Unknown

• 1 other identifier: 300719
• Study Type: observational
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Aim; To inform high-quality, safe and equitable care in the United Kingdom (UK) general practice (GP) in the context of policies which require phone, video or e-consultation by default. BACKGROUND When COVID struck, general practice shifted to predominantly phone, video or e-consultations instead of face-to-face. Remote had benefits (e.g. reducing spread of COVID), but also downsides (technical glitches; inequalities of access; missed diagnoses; reduced continuity of care; and patients simply not seeking care at all). Despite this, the Secretary of State for Health of the UK, Matt Hancock declared on 30th July 2020 that remote-by-default is here to stay. RESEARCH QUESTION To what extent is remote-by-default, introduced for infection control during the pandemic, fit for purpose for the long term - and how can we make remote care better and safer? DESIGN AND METHODS Mixed-method case study with co-design workshops and cross-sector stakeholder events. OBJECTIVES AND METHODS

1. 1.GP PRACTICES The investigators will support 10 GP practices to develop effective remote services and alternatives where needed. The investigators will help them collect data and use their findings to inform improvement efforts.
2. 2.PATIENTS The investigators will interview 40 patients selected for diversity (age, ethnicity, locality, socio-economic status, condition\[s\], digital literacy), and hold two workshops (one remotely and one in person, Covid allowing) where patients help co-design ways to combine remote and face-to-face models.
3. 3.WIDER SYSTEM The investigators will engage stakeholders - including policymakers, professional bodies, industry, civil society and patient groups - in ongoing dialogue about how to deliver and support a more equitable, less risky remote-by-default service. The investigators will interview patients and hold cross-sector stakeholder events (big Zoom meetings), working both before and after the events to build relationships and action ideas.

Conditions

COVID-19

Outcome Measures

Primary Outcomes (2)

• Qualitative experience of remote by default care access in the primary care setting in the UK

  Iteratively develop support for change in 10 GP practices to inform a more fit for purpose model of remote by default care access in the primary care setting in the UK

  through study completion, an average of 2 years

• Support for cross stakeholder policy action on informing a fit for purpose remote by default care access in the primary care setting in the UK

  Support for cross stakeholder policy action, through creation of policy briefs, academic papers and resources

  through study completion, an average of 2 years

Study Arms (1)

Cross site-case study

Qualitative methods: semi-structured interviews for patients, front line clinical practitioners, and health system stakeholders, case study building across sites

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

General population

You may qualify if:

• over 18
• willing and able to provide informed consent
• diagnosed with any relevant condition, receiving care from participating services

You may not qualify if:

• inability to read or speak English unless a relevant translator is available
• co-morbidity preventing participation

Sponsors & Collaborators

• University of Oxford: lead
• University of Plymouth: collaborator
• Nuffield Trust: collaborator

Study Sites (1)

University of Oxford

Oxford, United Kingdom

Location

MeSH Terms

Conditions

COVID-19

Condition Hierarchy (Ancestors)

Pneumonia, Viral; Pneumonia; Respiratory Tract Infections; Infections; Virus Diseases; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Lung Diseases; Respiratory Tract Diseases

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 27, 2021
• First Posted: February 17, 2022
• Study Start: September 1, 2021
• Primary Completion: September 30, 2022
• Study Completion: August 31, 2023
• Last Updated: April 6, 2022

Record last verified: 2022-03

Locations

GB (1)