Alternatives to the face-to-face consultation in general practice: focused ethnographic case study
Alternatives to the face-to-face consultation in general practice: focused ethnographic case study
Background: NHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives.
Aim: to understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice.
Design and setting: focused ethnographic case studies took place in eight UK general practices between June 2015 and March 2016.
Method: non-participant observation, informal conversations with staff, and semi-structured interviews with staff and patients were conducted. Practice documents and protocols were reviewed. Data were analysed through charting and the ‘one sheet of paper’ mind-map method to identify the line of argument in each thematic report.
Results: case study practices had different rationales for offering alternatives to the face-to-face consultation. Beliefs varied about which patients and health issues were suitable. Co-workers were often unaware of each other’s practice; for example, practice policies for use of e-consultations systems with patients were not known about or followed. Patients reported benefits including convenience and access. Staff and some patients regarded the face-to-face consultation as the ideal.
Conclusion: experience of implementing alternatives to the face-to-face consultation suggests that changes in patient access and staff workload may be both modest and gradual. Practices planning to implement them should consider carefully their reasons for doing so and involve the whole practice team.
e293-e300
Atherton, Helen
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Brant, Heather
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Ziebland, Sue
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Bikker, Annemieke
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Campbell, John
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Gibson, Andy
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McKinstry, Brian
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Porqueddu, Tania
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Salisbury, Chris
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April 2018
Atherton, Helen
9bb8932e-7bb7-4781-ab97-114613de99b1
Brant, Heather
e3112697-fc0a-466c-bb40-5f6f89a214d1
Ziebland, Sue
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Bikker, Annemieke
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Campbell, John
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Gibson, Andy
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McKinstry, Brian
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Porqueddu, Tania
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Salisbury, Chris
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Atherton, Helen, Brant, Heather, Ziebland, Sue, Bikker, Annemieke, Campbell, John, Gibson, Andy, McKinstry, Brian, Porqueddu, Tania and Salisbury, Chris
(2018)
Alternatives to the face-to-face consultation in general practice: focused ethnographic case study.
British Journal of General Practice, 68 (669), .
(doi:10.3399/bjgp18X694853).
Abstract
Background: NHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives.
Aim: to understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice.
Design and setting: focused ethnographic case studies took place in eight UK general practices between June 2015 and March 2016.
Method: non-participant observation, informal conversations with staff, and semi-structured interviews with staff and patients were conducted. Practice documents and protocols were reviewed. Data were analysed through charting and the ‘one sheet of paper’ mind-map method to identify the line of argument in each thematic report.
Results: case study practices had different rationales for offering alternatives to the face-to-face consultation. Beliefs varied about which patients and health issues were suitable. Co-workers were often unaware of each other’s practice; for example, practice policies for use of e-consultations systems with patients were not known about or followed. Patients reported benefits including convenience and access. Staff and some patients regarded the face-to-face consultation as the ideal.
Conclusion: experience of implementing alternatives to the face-to-face consultation suggests that changes in patient access and staff workload may be both modest and gradual. Practices planning to implement them should consider carefully their reasons for doing so and involve the whole practice team.
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Accepted/In Press date: 20 November 2017
e-pub ahead of print date: 28 March 2018
Published date: April 2018
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Local EPrints ID: 486560
URI: http://eprints.soton.ac.uk/id/eprint/486560
ISSN: 0960-1643
PURE UUID: bbf82e27-7a0d-4f03-b84e-6ea45e173a80
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Date deposited: 26 Jan 2024 17:34
Last modified: 18 Mar 2024 04:18
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Author:
Helen Atherton
Author:
Heather Brant
Author:
Sue Ziebland
Author:
Annemieke Bikker
Author:
John Campbell
Author:
Andy Gibson
Author:
Brian McKinstry
Author:
Tania Porqueddu
Author:
Chris Salisbury
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