A joint project between the Universities of Oxford and Plymouth and supported by us and our colleagues at ARC Oxford and Thames Valley has received £750,000 of funding from the Economic and Social Research Council to support the delivery of effective remote care to patients by GPs. The research team, which includes our Deputy Director and Professor in Primary Care Research Richard Byng and researchers from the Nuffield Trust, is led by Professor Trisha Greenhalgh from the University of Oxford.
The way that patients access GP services has changed dramatically during the COVID-19 pandemic because of the contagious nature of the disease, with many services moving online and patients more likely to arrange and attend appointments remotely. The study, ‘Remote-by-Default Care in the COVID-19 Pandemic', aims to support the development of tools to help clinicians assess people effectively by phone or video as well as to support the changes to services through research and strengthen supporting infrastructure for digital innovation in the NHS.
The Health Secretary’s recent announcement, that in-person GP appointments will only be available for compelling clinical reasons, means that the study and its outcomes are increasingly significant for the delivery of effective care to patients. The Plymouth arm of the study will focus on the impact of these changes on those living in poverty and from marginalised groups. Researchers will work closely with the Deep End group of practices, a network of GP practices that cover the most deprived patient areas in the city, as well as the Devon Clinical Commissioning Group.
Professor Byng, who is also a practising GP in Plymouth, said: “While we have seen some advantages to the increased use of telephone, video and email based consultation, there are significant challenges, especially for those without the best phones, without credit and without homes, as well as for those living with frailty, mental health problems or learning difficulties. We will investigate these challenges and help support the best mix of face-to-face and remote working for these groups.”
Professor Greenhalgh said: “Because COVID-19 is so contagious, the way the NHS works has changed dramatically. For the first time since 1948, you can’t walk into a GP surgery and ask to be seen. You must apply online, phone the surgery or contact NHS111. You may then get a call-back (phone or video) from a clinician, or a face-to-face appointment, possibly in a ‘hot hub’ – one of the new, GP-led centres for COVID-19 patients.
These changes to what used to be the family doctor service are radical, frightening and difficult. They cut to the core of what it is to care and be cared for, and what ‘good’ and ‘excellent’ health services look and feel like, and patients may wonder whether the doctor will be able to assess them properly by video or phone.”
Keep up to date with the outcomes of the study on the University of Plymouth Project Page Remote-by-Default Care in the COVID-19 Pandemic: addressing the micro, meso-and macro-level challenges of a radical new service model