Implementation of remote consulting in UK primary care following the COVID-19 pandemic: a mixed-methods longitudinal study

Mairead Murphy; Lauren J Scott; Chris Salisbury; Andrew Turner; Anne Scott; Rachel Denholm; Rhys Lewis; Geeta Iyer; John Macleod; Jeremy Horwood

doi:10.3399/BJGP.2020.0948

Published eLetters

eLetter submission guidelines

Submit a Response to This Article

Compose eLetter

Title *

Author Information

Contributors

First Name and Middle Initial *

First or given name, e.g. 'Peter'.

Last Name *

Your last, or family, name, e.g. 'MacMoody'.

Email Address *

Your email address, e.g. higgs-boson{at}gmail.com. PLEASE NOTE: your email address will be published.

Occupation *

Your role and/or occupation, e.g. 'Orthopedic Surgeon'.

Affiliation *

Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.

Statement of Competing Interests

Competing interests? *

Yes

Please describe the competing interests

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

Jump to comment:

Patient opinions of telephone consultations in primary care
Romy S. Garbutt and Mili Gupta

Published on: 18 March 2021

Published on: (18 March 2021)
Page navigation anchor for Patient opinions of telephone consultations in primary care
Patient opinions of telephone consultations in primary care
Romy S. Garbutt, Foundation Doctor, East Lancashire Hospital Trust
Other Contributors:
Mili Gupta, GP, Springfenisco Healthlink and Pringle Street Surgery
Thank you for this contribution, Murphy M et al. We have examined remote consultations in primary care, focusing on patient opinions at two Lancashire GP practices.

At both practices, patients reported generally positive experiences, though, similar to GPs¹, some retained preference for face-to-face consultation. Concerns included lack of examination, potential missed diagnoses and communication difficulties. Telephone consultations were described as efficient but less reliable.

Similar to clinicians’ opinions in our practices, GPs report that video consultations did not enhance telephone calls in the absence of examination¹. In contrast, our patients appeared to value video consultations.

Communication difficulties appear common¹. Consistent with GPs reporting that patient descriptions do not always match their clinical picture¹, patients struggled to articulate their problems successfully.

We noticed a striking difference between the practices. One is located in a deprived area, a factor associated with poorer health outcomes². More patients here were deterred from seeking care, which may reflect their apprehension towards virtual appointments. GPs noted that non-verbal cues can be more important in these areas¹. In contrast, those surveyed at the second practice, located in an affluent area with increased employment rates, described a better...
Show More

Thank you for this contribution, Murphy M et al. We have examined remote consultations in primary care, focusing on patient opinions at two Lancashire GP practices.

At both practices, patients reported generally positive experiences, though, similar to GPs¹, some retained preference for face-to-face consultation. Concerns included lack of examination, potential missed diagnoses and communication difficulties. Telephone consultations were described as efficient but less reliable.

Similar to clinicians’ opinions in our practices, GPs report that video consultations did not enhance telephone calls in the absence of examination¹. In contrast, our patients appeared to value video consultations.

Communication difficulties appear common¹. Consistent with GPs reporting that patient descriptions do not always match their clinical picture¹, patients struggled to articulate their problems successfully.

We noticed a striking difference between the practices. One is located in a deprived area, a factor associated with poorer health outcomes². More patients here were deterred from seeking care, which may reflect their apprehension towards virtual appointments. GPs noted that non-verbal cues can be more important in these areas¹. In contrast, those surveyed at the second practice, located in an affluent area with increased employment rates, described a better experience despite care from the same GPs. One explanation is that virtual consultations reduce time out of work. Therefore, we believe that is it important to consider socio-economic statuses when triaging patients, as some may require a lower threshold for face-to-face consultation.

Finally, a concern of patients and GPs is the lack of examination¹. It highlights the importance of safety netting and understanding the limitations of remote consultations. Contrary to guidance in early stages of the pandemic³, a low threshold to see patients of concern is important.

Additionally, a number of patients raised concerns that their needs might burden the NHS, possibly reflecting media emphasis on NHS pressure, alongside fears surrounding COVID-19. Clear communication is required to emphasise that remote consultations remain available and improve workload and safety.

Together, these studies¹ highlight how considering both patient and clinician opinions of virtual consultations could lead to a safe and efficient balance of remote and face-to-face clinics even after the pandemic subsides.

References

1. Murphy M, Scott LJ, Salisbury C, et al. Implementation of remote consulting in UK primary care following the COVID-19 pandemic: a mixed-methods longitudinal study. Br J Gen Pract 2021, doi: 10.3399/BJGP.2020.0948.

2. Arpey, N. C., Gaglioti, A. H. and Rosenbaum, M. E. How socioeconomic status affects patient perceptions of health care: A qualitative study. J Prim Care Community Health 2017; 8(3):169-175. doi: 10.1177/2150131917697439.

3. Andrea D (Mar 10, 2020) GPs urged to go digital to prevent spread of coronavirus. Digital health, www.digitalhealth.net/2020/03/gps-urged-to-go-digital-to-prevent-spread-of-coronavirus (accessed 12 Feb 2021).

Show Less

Competing Interests: None declared.

Main menu

User menu

Search

Implementation of remote consulting in UK primary care following the COVID-19 pandemic: a mixed-methods longitudinal study

Published eLetters

Plain text

Vertical Tabs

Jump to comment:

In this issue

Citation Manager Formats

Keywords

More in this TOC Section

Related Articles

Cited By...

NAVIGATE

RCGP

MY ACCOUNT

NEWS AND UPDATES

AUTHORS & REVIEWERS

CUSTOMER SERVICES

CONTRIBUTE

CONTACT US

Main menu

User menu

Search

Implementation of remote consulting in UK primary care following the COVID-19 pandemic: a mixed-methods longitudinal study

Published eLetters

Plain text

Vertical Tabs

Jump to comment:

In this issue

Citation Manager Formats

Jump to section

Keywords

More in this TOC Section

Related Articles

Cited By...

NAVIGATE

RCGP

MY ACCOUNT

NEWS AND UPDATES

AUTHORS & REVIEWERS

CUSTOMER SERVICES

CONTRIBUTE

CONTACT US